How To Stop Anxiety Attacks at Night

Have you ever tried to relax and unwind at the end of a long day, but find you’re even more stressed out? It’s common for daytime stress and worries to spill into the evening hours. And if you have an anxiety disorder, you may feel symptoms, including restlessness, irritability, and muscle tension, are worse at night.

Having anxiety at night can affect your quality of life, especially how well you sleep. Nighttime anxiety can keep you from falling asleep or staying asleep. Not getting enough sleep creates a vicious cycle that makes it harder to cope with stress and anxiety the next day.

Understanding why nighttime anxiety happens can help you break the cycle.

Why Does Anxiety Get Worse at Night?

More than 40 million Americans have anxiety, according to the Anxiety & Depression Association of America (ADAA). It’s the most common mental health problem in the United States. Even if you’ve had a good day, you can start to feel restless and anxious right before bed.

The COVID-19 pandemic has also affected America’s nighttime anxiety. A 2021 survey by the American Academy of Sleep Medicine (AASM) found 56% of adults reported an increase in sleep problems since the pandemic began.

Causes of nighttime anxiety

It’s difficult to know why your anxiety gets worse at night. But many of the things that can contribute to anxiety during the day can also trigger anxiety at night. Some of these include:

  • Having too much caffeine. Too much caffeine restricts blood vessels, which can increase blood pressure and contribute to anxiety.
  • Drinking too much alcohol. Up 50% of people receiving treatment for problematic alcohol use may also have an anxiety disorder. That’s according to the National Institute on Alcohol Abuse and Alcoholism.
  • Medications you take. Several medications can cause anxiety as a side effect. These include stimulants, corticosteroids, allergy medications, and thyroid medications.
  • Media consumption and social media use. The American Psychological Association’s 2019 Stress in America report found a link between news consumption and anxiety. Social media use may also contribute to anxiety and sleep problems.
  • COVID-19. Research has linked pandemic life and concerns to anxiety, depression, stress, sleep problems, and suicidality. That’s according to a 2020 review of studies published in Sleep Medicine.
  • Uncontrolled anxiety disorder. Anxiety is highly treatable. Yet only 36.9% of people with diagnosed anxiety disorders seek treatment, according to the ADAA.

How To Calm Anxiety at Night

Anxiety and sleep often make for a chicken-and-egg scenario. On one hand, sleep problems are a common sign and symptom of an anxiety disorder. On the other hand, sleep problems can increase your risk of anxiety.

Research has also linked not getting adequate sleep to chronic diseases, including heart disease, diabetes, and mental health problems. People who don’t sleep enough are nearly 2.5 times more likely to report frequent mental distress compared to people who do. That’s according to a 2021 population-based study of adults age 18 to 64 in Preventing Chronic Disease.

A sleepless night can increase anxiety the next day by up to 27%, according to a 2019 study by the University of California, Berkeley. The researchers called this sleep-loss-induced anxiety.

Coping with your anxiety during the day can help you reduce your chances of having anxiety at night.

Tips to reduce anxiety before bed

If you start to feel restless or anxious before bed, try these tips:

  • Do diaphragmatic breathing exercises—taking slow, deep breaths. According to a 2019 systematic review in JBI Evidence Synthesis, this technique may help trigger body relaxation responses. These include reducing the stress hormone known as cortisol in your blood and lowering your blood pressure.
  • Write your thoughts and worries in a journal.
  • Listen to some soothing music. Chanting can also help reduce acute stress.
  • Take a warm bath before bed.
  • Turn off news and electronics at least 30 minutes before bed. The blue light from these devices can also interrupt your body’s production of melatonin. It’s a brain chemical that helps you feel drowsy and fall asleep.

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How To Stop Anxiety Attacks at Night

In some cases, anxiety can suddenly wake you up while you’re sleeping. You can have symptoms of a panic attack, including sweating, trembling, chest pain, and feelings of impending doom.

This is known as a nighttime or nocturnal panic attack. It’s common in people with panic disorder. But even those without panic disorder can have panic attacks at night.

Like all panic attacks, nocturnal panic attacks come on suddenly. Oftentimes, there’s not a known trigger.

It can take up to 20 minutes to get through a nighttime panic attack. These tips can help you to calm down during and after a panic attack at night:

  • Choose a category (such as countries or animals) and list as many things in the category as you can.
  • Slowly recite the alphabet or count to 10. This changes your focus.
  • Don’t stay in bed if you can’t sleep. Get up and sit in a quiet room.
  • Try some deep breathing exercises. Wait until after your panic attack has passed. Doing deep breathing exercises during panic attacks may make them worse.

Get a Good Night’s Sleep

To control both anxiety and sleep problems, focus on getting enough quality sleep each night. You may not realize that you’re not getting enough quality sleep each night.

So, what’s a good night’s sleep to reduce your risk of anxiety and other physical and mental health issues? Both the Centers for Disease Control and Prevention and the AASM recommend adults get at least seven hours of solid sleep each night. Children and teens may need eight to 11 hours of sleep each night, depending on your child’s age.

Because sleep deprivation can contribute to anxiety, protecting your sleep is important to reduce nighttime anxiety and anxiety in general. Here’s what you can do to help you fall asleep and stay asleep.

Get Treatment

Anxiety can happen to anyone from time to time, whether it’s daytime or nighttime anxiety. If you have anxiety all the time or it gets in the way of life, you may have an anxiety disorder.

Though reducing stress and making other lifestyle changes are important, they don’t cure anxiety disorders. Your anxiety can even get worse if left untreated.

It’s important to get professional medical help to figure out what’s causing your anxiety and get appropriate care. Treatment for anxiety disorders often combines psychotherapy, including cognitive behavioral therapy, and medications.

Sources

The Effect of Diaphragmatic Breathing on Attention, Negative Affect, and Stress in Healthy Adults. Frontiers in Psychology. 2017. Link.

Stress in America 2019. American Psychological Association. Link.

Leo Sher. COVID-19, Anxiety, Sleep disturbances and Suicide. Sleep Medicine. June 2020.Link.

Effect of Inadequate Sleep on Frequent Mental Distress. Preventing Chronic Disease. June 17, 2021. Centers for Disease Control and Prevention. Link.

Stressed to the Max? Deep Sleep Can Rewire the Anxious Brain. Science Daily. Nov. 4, 2019. Link.

Susan Hopper, Sherrie Murray, Lucille Ferrara, Joanne Singleton. Effectiveness of Diaphragmatic Breathing for Reducing Physiological and Psychological Stress in Adults: a Quantitative Systematic Review. JBI Evidence Synthesis. Sept. 2019. Link.

Americans Continue Struggling for a Good Night's Sleep During the Pandemic. American Academy of Sleep Medicine. April 2021. Link.

Coping with Panic Attacks. Anxiety & Depression Association of America. Webinar. Link.

Tips to Manage Anxiety and Stress. ADAA. Link.

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.