What causes nighttime anxiety?
Anxiety at night can be caused by many factors. Some common triggers include:
- Stress or worry about the next day – Going over the to-do list for tomorrow or fretting about an upcoming event can make it hard to relax and sleep.
- Underlying anxiety disorder – Conditions like generalized anxiety disorder (GAD) or panic disorder can cause anxiety that persists into the night.
- Medication side effects – Some medications like asthma inhalers, thyroid hormones, and stimulants can cause jitteriness, rapid heartbeat, and shaking.
- Caffeine late in the day – Consuming caffeine too close to bedtime can disrupt sleep and cause anxiety.
- Alcohol use – While alcohol may help some people feel sleepy initially, as it starts to wear off it can provoke anxiety and interrupt sleep.
- Nicotine – Smoking and vaping nicotine can also lead to nighttime anxiety and sleep problems.
- Sleep deprivation – Not getting enough sleep can make anxiety worse, creating a vicious cycle.
- Physical factors – Conditions like reflux, restless leg syndrome, or frequent urination can wake you up and cause anxiety.
If you frequently experience anxiety at night without an identifiable cause, it’s a good idea to talk to your doctor. They can check for any underlying health issues and help determine if anxiety medication could help.
Lifestyle changes to reduce nighttime anxiety
Making certain lifestyle adjustments can help minimize anxiety during the late evening hours:
Avoid stimulants
Cut back on caffeine, nicotine, and other stimulants at least 4-6 hours before bed. Caffeine’s effects can last up to 12 hours.
Establish a calming bedtime routine
Do relaxing activities like light yoga, reading, or taking a bath 1-2 hours before lying down to sleep. Dim the lights and put away electronic devices.
Exercise during the day
Physical activity reduces overall anxiety levels. However, avoid vigorous exercise within 2 hours of bed, as it can interfere with falling asleep.
Limit daytime napping
Napping for more than 30 minutes can make it tougher to fall asleep at night.
Write down worries and plans
Jot down thoughts, to-dos, and worries earlier in the day so they don’t keep you up at night. Come up with plans to tackle them the next day.
Check bedroom conditions
Factors like noise, light, and temperature can affect sleep quality. Use blackout curtains, a fan or white noise machine, and ensure your bedroom is cool.
When to seek professional treatment
If self-help measures don’t relieve your nighttime anxiety, consult your primary care physician or a mental health professional. They can assess if prescription medication or therapy could help.
Some signs it’s time to seek help include:
- Anxiety or panic interfering with your sleep every night
- Anxiety lasting more than 6 months
- Anxiety causing significant distress or disrupting your daily functioning
- Self-medicating with drugs, alcohol or risky behaviors to cope with anxiety
A combination of therapy and/or medication often produces the best results. Some treatment options include:
Cognitive behavioral therapy (CBT)
CBT helps identify and change thought patterns contributing to anxiety. Strategies like cognitive restructuring and exposure therapy can reduce nighttime worries.
Relaxation techniques
Deep breathing, visualization, progressive muscle relaxation help deactivate the body’s stress response. Mindfulness meditation helps reduce rumination.
Anxiety medications
Medications like SSRIs or benzodiazepines can help relieve anxiety. Benzodiazepines work quickly but risk dependence. SSRIs take 4-6 weeks to work.
Better sleep hygiene
Your provider may recommend sleep restriction, stimulus control therapy and sleep efficiency techniques to improve sleep.
Quick tips to calm anxiety at night
When you feel anxiety building at night, try these fast tips to relax:
Deep breathing
Taking slow, deep breaths triggers your relaxation response. Inhale for a count of 4, hold for 4, exhale for 6. Repeat until calm.
Progressive muscle relaxation
Tense and relax muscle groups one by one. This reduces physical tension that fuels anxiety.
5-4-3-2-1 grounding
Name 5 things you see, 4 things you feel, 3 things you hear, 2 thing you smell, 1 good thing about yourself. This brings mental focus to the present.
Mindful meditation
Focus on your breath, a mantra like “I am calm”, or a relaxing image. This halts escalating worries.
Distract yourself
Read a book, do a puzzle, play relaxing music. This distracts you from anxious thoughts.
Write down thoughts
Jot down the thoughts keeping you up. Put them aside by saying you’ll tackle them tomorrow.
Get out of bed
If you’ve been awake more than 20 minutes, get up and do a calming activity until you feel sleepy.
Preparing for the next day
If anxiety tends to build overnight about the next day, take steps in the evening to feel organized and ready to sleep:
- Make a to-do list for what you need to tackle tomorrow
- Get prepared for the morning by laying out clothes, packing bags, etc.
- Know your schedule and route to take to work or school
- Set an alarm so you don’t wake early and worry
- Calculate how much sleep you’ll get based on your wake-up time
- Remind yourself you can handle challenges with preparation
- Do a quick tidying and straightening up to feel organized
Having a steady wind-down routine, destressing activities, and a regular sleep and wake time also keeps anxiety at bay.
When to seek emergency treatment
Occasionally, anxiety can spiral out of control and require emergency care. Seek immediate medical help if you experience:
- Rapid, pounding heart rate or chest pain
- Feeling like you’re choking or can’t breathe
- Tingling or numbness in your hands, feet or face
- Feeling like you’re losing control or going crazy
- Thoughts of harming yourself
Call 911 or go to the nearest ER. Tell the triage nurse you’re having an anxiety attack and feel unsafe.
Though anxiety feels awful, it isn’t dangerous or life threatening. Staying calm, using coping strategies, and realizing that the episode will pass can help until you receive medical care.
When anxiety becomes a sleep disorder
If anxiety routinely disrupts your sleep quality or makes it hard to fall asleep, you may have a sleep disorder. Two types closely tied to anxiety are:
Insomnia
Insomnia is defined as persistent struggles with sleep at least 3 nights per week for 3 months. Anxiety and worrying often play a role in chronic insomnia.
Sleep anxiety
Also called psychophysiological insomnia, sleep anxiety is a conditioned anxiety response at bedtime. You may associate the bed with frustration over inability to sleep.
Speak with your doctor if you consistently experience:
- Difficulty falling asleep or staying asleep
- Not feeling rested after sleeping
- Fatigue/sleepiness disrupting daily life
- Increased errors or accidents
- Problems with focus, memory, or mood
Your provider can recommend cognitive behavioral therapy for insomnia (CBTI) or medications to reestablish healthy sleep habits.
When to seek mental health treatment
If self-help measures and lifestyle changes don’t reduce debilitating anxiety, consult a psychologist, psychiatrist or counselor. They can provide therapy and teach coping techniques tailored to your needs.
Signs it may be time to seek mental health treatment include:
- Experiencing panic attacks multiple times per week
- Severe anxiety disrupting work performance, schoolwork or relationships
- Inability to leave home or socialize due to anxiety
- Increasing depression along with anxiety
- Ongoing anxiety not explained by an underlying health condition
- Abusing drugs, alcohol or risky behaviors to cope with anxiety
Working with a therapist can help uncover the roots of your anxiety and change unhelpful thought patterns that fuel it. Therapy combined with anti-anxiety medication often produces optimal results.
When to see your primary care doctor
Your family physician can provide an initial assessment of anxiety symptoms and check for underlying health triggers like:
- Hormonal imbalances – Such as thyroid, estrogen or testosterone deficiency
- Respiratory disorders – Like asthma or COPD
- Drug interactions
- Vitamin deficiencies – Such as Vitamin D or B12 deficiency
- Heart disease
- Chronic pain or nerve disorders
- Sleep apnea
- Gastroesophageal reflux disease (GERD)
- Kidney disease
Your doctor can order lab tests to look for potential physical causes and evaluate if anti-anxiety medication may help.
Some signs your anxiety may have a medical basis include:
- Symptoms start later in life with no psychological trigger
- Experiencing unrelated physical symptoms like appetite changes or fatigue
- Anxiety getting worse for no particular reason
- Feeling shaky, sweating or tingling for no reason
- Anxiety not improving with stress reduction
Discuss any new medications, supplements or health changes with your doctor to assess if they could be contributing. Keeping your physician informed provides the best holistic care.
When to try natural remedies
Many people with mild to moderate anxiety find relief through home remedies like:
Chamomile tea
Chamomile has anti-anxiety properties. Sip a cup about an hour before bedtime. Avoid caffeine after 2pm.
Essential oils
Lavender, bergamot, and clary sage oils have calming effects when inhaled or massaged on pulse points. Add a few drops to your bath before bed.
Magnesium supplements
Magnesium deficiency can cause anxiety. Taking 300-500 mg daily helps relax muscles. Opt for chelated versions for best absorption.
Adaptogen herbs
Herbs like ashwagandha, passionflower, and Rhodiola Rosea alleviate anxiety. Follow dosage on packaging.
Meditation
Just 10-15 minutes daily can lower anxiety levels long-term. Try phone apps like Calm, Headspace, or Insight Timer.
Yoga
Gentle evening yoga helps relax the body and calm the mind before bedtime. Avoid stimulating “power” classes at night.
However, check with your doctor before trying new supplements, especially with existing health conditions or medications.
Home remedies are ideal for situational anxiety tied to an identifiable stressor that passes. But persistently high anxiety or panic attacks often needs professional treatment. Don’t hesitate to seek help – chronic anxiety takes a toll on your physical and mental health.
Conclusion
Anxiety and panic at night can be frightening. But various strategies exist to restore peace and relaxation after dark. Lifestyle changes like avoiding stimulants, establishing a nighttime routine, and preparing mentally for the next day can prevent worries from escalating in the late hours. Relaxation practices like deep breathing, mindfulness, and muscle relaxation curb anxiety as soon it strikes at night.
Getting anxiety under control is vital for both physical and mental health. Chronic anxiety often indicates an underlying issue requiring professional care – don’t hesitate to consult a doctor or mental health professional if symptoms are ongoing or severely impacting your life. With the right treatment approach tailored to your needs, you can overcome anxiety and sleep soundly once again.
