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How to Fall Asleep With Anxiety

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Nicholas Gibson

Published 10/11/2021

Updated 10/31/2022

It’s a situation we’ve all experienced: It’s 2 a.m., and instead of dreaming deeply your mind is racing from one worry to another, making it impossible for you to relax and drift off. 

Anxiety can take a serious toll on your ability to fall and stay asleep. Because poor-quality sleep zaps you of energy, the effects of nighttime anxiety can extend to every aspect of your life, from your physical health to your ability to concentrate, think and retain information. 

It’s a frustrating phenomenon that can create an endless feedback loop, with bad sleep leading to worse anxiety, and worse anxiety leading to even more difficulties falling asleep.

The good news is that it’s completely possible to gain control of your anxiety and fall asleep with the right combination of positive habits, lifestyle changes and, in some cases, professional help.

Below, we’ve explained how and why anxiety can develop, as well as the effects it can have on your sleep.

We’ve also shared 15 actionable tips you can use to control your nighttime anxiety and enjoy better, deeper and more refreshing sleep.

If you struggle to fall asleep due to anxiety, you’re certainly not alone. An estimated 19.1 percent of American adults dealt with anxiety disorders in the past year, and more than 35 percent of all adults have been affected by short sleep duration (less than seven hours of sleep per 24-hour period).

Anxiety can vary in severity. Types of anxiety and anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder and specific phobias, such as intense fears that are linked to specific objects or situations. 

While it’s normal to feel anxious from time to time, chronic, severe anxiety that occurs during the night can take a major toll on your ability to relax and sleep properly. 

The exact symptoms of anxiety can vary from person to person. You might feel overly worried about the future, for example, which prevents you from relaxing. 

Some people may experience physical anxiety symptoms such as an elevated heart rate and a spike in blood pressure.

When nighttime

anxiety causes you to experience insomnia, you may experience the following symptoms:

  • Spending much of the night awake

  • Lying in bed for a long time before you’re able to fall asleep

  • Sleep disturbances that cause you to wake up at night or early in the morning

  • Feeling tired and as if you haven’t slept right after you wake up

Anxiety likely isn’t your favorite bedmate. Dealing with anxiety that prevents you from sleeping can be frustrating, especially when it’s a persistent, ongoing issue that occurs night after night.

Luckily, anxiety is treatable. 

If your anxiety is preventing you from sleeping, try the following techniques to ease your worries, promote relaxation and get a more refreshing night’s sleep.

Stick to a Consistent Sleep Routine

When it comes to falling and staying asleep, consistency is key. If you don’t have a set bedtime, try to establish one. 

Force yourself to stick to a routine and be in bed, with the lights out ready to sleep by a certain time every night.

In addition to sleeping on a specific schedule, it may help to establish some basic sleep hygiene rules about the way you sleep, wake and use your bed. For example:

  • Limit your use of your bed to sleeping and sex. Avoid using your bed to read, work on your computer or watch television.

  • Only go to bed when you feel tired. Don’t use your bed as a sofa, or as a place to relax during the daytime.

  • Get out of bed at the same time every morning. This helps to establish your day and means you’ll always go to bed after roughly the same amount of alert-type time on a daily basis.

While these habits might seem simple, they can have a big impact on your ability to relax in bed and fall asleep within a reasonable amount of time. 

Don’t Obsess Over Time Spent Asleep

When you get into bed after your normal bedtime, it’s easy to obsess over the fact that you may not get as much sleep as you need.

This often creates a self-fulfilling prophecy in which your anxiety about not getting enough sleep causes you to struggle to fall asleep — reducing the amount of time available for sleeping during the night, and worsening your anxiety about how you’ll feel the next day. 

When this happens, it can lead to hours spent tossing and turning as your worries about lack of sleep stick in your head. 

Instead of worrying about the total amount of time you’ll spend sleeping, it’s better to accept that not every night of sleep will be perfect. 

By accepting this, you’ll be more able to focus on the five or six hours of deep sleep you can get, rather than worrying about the one or two hours you’ll miss.

If You Can’t Sleep, Do Something Relaxing

It’s normal to sometimes find it difficult to fall asleep. If you get into bed at your normal bedtime but can’t doze off within 20 minutes, it’s okay to get out of bed for a little while.

When you’re out of bed, try to engage in relaxing activities such as reading a book, listening to soothing music or writing down your thoughts from the previous day. 

Doing so can help you unwind until you feel sleepy enough to return to bed. 

While you’re out of bed, make sure not to switch on too many lights or engage in any activities that will increase your alertness. 

Avoid Long Naps

Taking a brief nap during the day may have health benefits, including potentially improving some aspects of your mental function.

However, it’s important to keep your naps short, as taking a long afternoon nap may prevent you from feeling tired at night.

According to the Johns Hopkins Sleep Disorders Center, an ideal daytime nap should last for 20 to 40 minutes and take place before 4 p.m. 

Napping for longer periods of time can not only affect your ability to sleep — it may also cause you to feel groggy and tired after waking.

Limit Caffeine Intake

Caffeine is a powerful stimulant that can be a real help, especially if you’re the type who needs a little extra kick of energy in the morning.

However, the five-hour half-life of caffeine means that even a small cup of coffee enjoyed in the afternoon can cause some caffeine to linger in your body well into the night, potentially keeping you anxious and awake.

If you often find it difficult to fall asleep, avoid caffeine after midday. By restricting your caffeine intake to the morning, you’ll be able to enjoy the early morning energy boost of a cup of coffee without the effects of caffeine keeping you awake at night. 

Try an Over-the-Counter Sleep Aid

If your anxiety is preventing you from feeling tired, you may be able to speed the process of slowing down for the night with an over-the-counter sleep aid.

Some of the best sleep aids include chamomile and melatonin, a hormone released by the pineal gland responsible for regulating your sleep-wake cycle.

Since over-the-counter sleep products are available, well, over the counter, they’re much more accessible than prescription sleeping pills. They’re also less likely to cause serious issues such as dependence. 

Not sure where to begin? These Sleep Gummy Vitamins which contain melatonin, chamomile and L-theanine, can be helpful for promoting sleep on occasional restless nights.   

Use Relaxation Techniques

Simple techniques and exercises can help you calm down and stop worrying for long enough to drift off to sleep. Try the following techniques to relax, control your anxiety and enjoy a better night’s sleep:

  • Deep breathing exercises. Simple techniques such as slow, deep breathing may help to promote relaxation and reduce anxiety, making it easier for you to calm your mind as you get into bed and prepare to fall asleep.

  • Guided imagery. Also referred to as visualization, this technique involves visualizing a peaceful scene that makes you feel relaxed and sleepy. To start, try imagining yourself quietly falling asleep in a soft, comfortable bed.

  • Progressive muscle relaxation. Progressive muscle relaxation technique involves tensing muscles individually while inhaling, then relaxing them as you exhale. It may help you to feel calm and fall asleep more easily.

  • Autogenic training. This technique involves consciously relaxing certain areas of your body. It’s designed to promote relaxation and calmness using your body's own natural relaxation response.

  • Listening to relaxing music. While not a technique per se, listening to relaxing music before bed may help you get into a peaceful, anxiety-free mood that makes it easier for you to fall and stay asleep.

  • Taking a warm bath. Research has shown that taking a warm bath (defined as “water-based passive body heating”) can possibly help improve sleep quality and efficiency.

You may need to experiment with several different relaxation techniques before finding one that helps you to control your anxiety, calm your mind and fall asleep more easily.

If You Smoke, Quit

While just about everyone is familiar with the negative effects smoking can have on your physical health, fewer people are aware that smoking can have a serious effect on your mood and ability to fall asleep. 

In a study published in the Journal of Addiction Medicine, researchers found that smoking could contribute to insomnia in adults who’ve smoked for several decades.

Other research has linked smoking with anxiety. In a 2015 study, researchers found that people who smoke were 50 percent more likely to develop anxiety than lifetime non-smokers.

While quitting smoking isn’t a quick solution like muscle relaxation or deep breathing, it may be a good way to reduce your anxiety and improve your sleep habits over the long term.

Avoid Large Meals Before Bed

While eating before bed doesn’t appear to directly cause anxiety, it may cause you to feel less comfortable in bed.

Limit your consumption of food right before you go to sleep. 

Make sure to especially avoid heavy or spicy meals late at night, as these may cause indigestion and make it more challenging for you to feel comfortable and fall asleep.

Exercise During the Day

Exercise has numerous benefits, from improving your cardiovascular health to lowering your risk of several forms of chronic disease.

Research suggests that physical activity also has a protective effect against the development of mental health issues, including anxiety.

Other research has found that regular exercise is linked with improvements in sleep quality and duration.

To get the mental and physical benefits of exercise, aim to get 150 minutes of moderate-intensity aerobic activity as well as at least two muscle-building workouts in each week.

This can be as simple as riding your bike around the neighborhood and doing pushups at home, taking part in a group exercise class every other day or working out with weights in your local gym. 

Limit Technology Before Bedtime

Using your computer, tablet or smartphone during the evening is fine, but it’s best to switch it off or put it away at least an hour before you go to bed. 

This is because many electronic devices emit blue light — a form of artificial light that can delay your body’s release of the sleep hormone melatonin, slow your circadian rhythm and stop you from feeling sleepy.

Limiting your technology use late at night not only cuts down on blue light exposure — it also helps reduce anxiety from doomscrolling through negative stories on social media. 

Use Light to Your Advantage

Your ability to fall asleep is greatly affected by your circadian rhythm — a natural, 24-hour cycle that forms part of your body’s internal clock.

A variety of factors can affect your circadian rhythm, including your exposure to bright light at certain times of day.

According to the National Institute for Occupational Safety and Health, exposure to bright light two hours before your typical bedtime can shift the time at which you start to feel tired later into the night, potentially preventing you from falling asleep in a normal way.

In contrast, bright morning light can shift your sleeping time earlier, helping you to relax and fall asleep sooner after you get into bed.

If you find falling asleep difficult, try to limit your exposure to light, whether natural or artificial, for two hours before you go to sleep. 

Keep lighting inside your home dim and limit your use of devices that emit bright light.

And to help yourself wake up in the morning, try to spend time in a brightly lit area of your home as you prepare for the day.

While this may not have a noticeable effect on anxiety, it can help you to feel tired earlier, which may improve your ability to fall asleep. 

Review Your Medications

Some medications can have stimulating or anxiety-promoting effects that may interfere with your ability to fall and stay asleep. 

If you’re prescribed medication, talk to your healthcare provider to see if it could be contributing to your sleep-related anxiety. 

Your healthcare provider may adjust your dosage, switch you to a different medication or suggest using your medication earlier in the day.

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Consider Cognitive Behavioral Therapy (CBT)

One of the most effective ways to treat anxiety is with therapy, particularly cognitive behavioral therapy.

Cognitive behavioral therapy involves identifying the specific thought patterns that cause you to feel anxious, then replacing them with realistic, less harmful thoughts that give you more control over your feelings and behavior.

You may take part in CBT locally at a therapist’s office, or remotely with services such as online counseling. 

In some cases, your healthcare provider may suggest taking part in cognitive behavioral therapy while you use medication or make other changes to your lifestyle. 

Use Medication to Treat Anxiety and Improve Sleep

Good habits, lifestyle changes and relaxation techniques can have a big impact on your ability to control anxiety and fall asleep. 

However, if you have an anxiety disorder, making changes to your habits and lifestyle might not b

e enough to control your symptoms and prevent insomnia.

If you have persistent or severe anxiety that stops you from sleeping properly, your healthcare provider may prescribe medication to control your symptoms and help you fall asleep faster.

Common medications used to manage anxiety include benzodiazepines, antidepressants and buspirone. In some cases, you may be prescribed prescription sleeping medication to make it easier for you to feel drowsy and fall asleep. 

Anxiety and sleep medications are effective, but some can cause side effects and dependence when used inappropriately or for long periods of time. 

If you’re prescribed medication, make sure to follow your healthcare provider’s directions and use your medication exactly as prescribed. 

Poor sleep can take a toll on just about every aspect of your life, from your mental function to your mood, immune system and physical performance. 

And while it’s far from uncommon to have occasional bad nights due to anxiety, when your anxiety starts to cause chronic insomnia, it’s important to take action.

You can do this by using the techniques listed above, talking to your healthcare provider, or by using online mental health services such as online psychiatry and online therapy. 

For more information, check out these free mental health resources to find out more about coping with anxiety, depression and other common mental health issues. Taking care of yourself can help you get some healthful Z’s. 

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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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