Why Do I Get Anxiety At Night

To answer the question on why one gets anxiety at night, unfortunately, there isn’t a clear cut answer for the same. It’s almost entire subjective, A.K.A, it depends on the individual experiencing anxiety. 

One answer could be that because your external world goes dark and quiet, you hear your internal world a lot louder - worries about your career, relationships and finances could creep up even if everything is running normally.

However, while that is a generalised answer, there are a number of factors that can contribute to night-time anxiety and panic attacks.

Overview

Anxiety is a crippling feeling and can creep up on anyone without prior warning. This can sometimes even keep you up at night. Anxiety at night can cause insomnia and panic attacks, which can cause a decrease in productivity during the daytime. This sounds like a vicious cycle, but luckily, there are ways to cope and manage nighttime anxiety.

Causes of anxiety at night

The causes of night-time anxiety may include:

  • Consuming too much caffeine close to bedtimecan cause increased jitteriness and scattered thoughts, increasing anxiety
  • Lack of sleep, which can lead to moodiness and anxiety in itself 
  • Worries over work or family issues, or over tasks that need to be completed in the near future
  • Stress over long-term goals or issues 
  • Smoking, which has shown to have a direct correlation with increased anxiety, tension and insomnia
  • Bedtime hunger can also cause anxiety and insomnia 
  • Traumatic life experiences or having post-traumatic stress disorder
  • Certain medications are also known to increase the incidence of night-time anxiety 

Signs and symptoms of anxiety and night

The main message is that although anxiety symptoms can vary widely and are extremely subjective, no one's experience should be minimized simply because they don't exhibit as many symptoms as someone else who is also experiencing anxiety. Everyone's symptoms and feelings matter.

Signs and symptoms of night-time anxiety include: 

  • Palpitations - feeling your heartbeat racing  in your chest
  • Nervousness - feeling jittery or restless 
  • Chest pain - this is especially scary because it can feel like you’re having a heart attack 
  • Feeling overwhelmed by your thoughts and having the sense that they are consuming you
  • Breathlessness - difficulty catching your breath 
  • Difficulty falling asleep or maintaining your sleep
  • Nightmares while asleep
  • Panic attacks 
  • Gastrointestinal issues, i.e issues with your digestive system 
  • Tingling or numbness in your fingers 
  • Feeling overwhelmed or exhausted the next morning

Please consult with your practitioner if these symptoms persist or keep recurring. 

Nighttime anxiety has a significant impact on the quality of life, and can affect productivity levels, mood, and functionality. As mentioned earlier, lack of sleep can lead to nighttime anxiety, which can trigger a vicious cycle. 

Management and treatment for anxiety at night

Night-time anxiety is attributed to poor sleep hygiene, another term used to describe sleep quality. 

Fortunately, there are multiple ways to help reduce the incidence of nighttime anxiety, which can help improve your sleep hygiene and your overall quality of life. 

  • Reduce your screen time before going to bed 

It’s a universal fact that electronics are a necessity in this generation. However, a lot of us do not understand the concept of establishing boundaries with our own electronic devices. 

The light emitted from devices, known as blue light, can affect the way we sleep, and the information we receive from checking our phones prior to going to sleep can trigger night-time anxiety. It definitely is tempting to check on your phone to send that final text or watch that last TikTok before going to sleep, but in order to reduce the incidence of night-time anxiety, keeping devices aside one hour before going to bed is suggested. 

  • Regulate your stress

Stress is one of the most common triggers for Generalized anxiety disorders, and sleep disorders such as insomnia and restlessness. 

Stress triggers the body to enter a fight-or-flight mode, as it thinks you are in danger. This causes the release of hormones such as cortisol and adrenaline, which causes you to constantly feel ‘on edge’ or like you are running away from something. This is also why you might find it difficult to disconnect from your work and struggle falling asleep. 

These issues highlight the importance of establishing boundaries between work and everyday life. Stress causes a host of adverse effects on the body and gives rise to a range of mental health disorders, if not properly regulated. 

It is also important to take short, constructive breaks in the middle of your work to ensure that you do not feel overwhelmed or overstimulated, and to practice mindfulness during your everyday routine. 

  • Avoid caffeine close to bedtime

Studies show that consuming caffeine in the hours preceding bedtime triggers anxiety, restlessness and insomnia. Hence, it is prudent to avoid beverages such as sodas, coffee, energy drinks and even green tea during the evenings, as that increases the incidence of insomnia and anxiety.

During the evenings, it is better to consume soothing beverages such as chamomile and jasmine tea, as those are known to have calming effects. 

  • Create a night-time routine

The body loves routine and consistency. Creating a night-time routine prepares the body to wind down and have a restful night’s sleep. Moving intentionally on a routine sets the tone for a productive morning. 

Establishing a good night-time routine involves shutting off devices and blue light sources one hour before bedtime, setting time aside for a soothing self-care routine, as well as some meditation if time permits. Meditation has been shown to not only calm the mind but also improve focus. Practising gratitude at the end of each day is also a form of self-care. 

  • Regular exercise 

Having a regular exercise routine has been shown to improve sleep cycles in several individuals. A study done in 2016 among young women suffering from anxiety showed that short-term exercise helped improve the quality of sleep. Setting time aside to perform moderate-intensity aerobic exercises.1 3 days a week for 30 minutes per session doesn’t just have benefits related to our appearance and cardiovascular health, but also helps calm ourselves down and provide more perspective on seemingly tough life situations. 

  • Change the way you eat 

Eating foods that your body cannot usually tolerate, especially at night, is a one-way ticket for gastrointestinal chaos. Studies.2 show that consuming oily, spicy or pungent foods close to bedtime triggers digestive issues and a rise in body temperature, disturbing your sleep and affecting its quality. It is also known that gut health has a direct influence on the functionality of the nervous system, therefore it is wise to eat light during the evening time to ensure a restful night’s sleep. 

  • Talk to someone about it 

In this day and age, it is easier to brush our issues under the carpet and minimise them in order to focus on the bigger tasks at hand - however, individually they all hold weight and affect how we function on a day-to-day basis. With how fast-paced the world has become, it is always advisable to consult with a trusted practitioner on how you feel, as your night-time anxiety can be attributed to a larger issue at hand that requires attention, such as generalized anxiety disorder, sleep disorders or other mental health disorders. 

Generalized anxiety disorder can often be mistaken as work stress, or as someone just ‘going through the motions of life’. Individuals affected could resort to sleep medications in order to have a restful night - however, this is a temporary remedy that could potentially have harmful effects later on.3 Talking to a physician or to a therapist is always advisable as they can help you figure out any underlying issues you might be dealing with. 

FAQs

Can I prevent anxiety at night

Yes! Night-time anxiety is preventable with the right actions being taken. Moving intentionally on what needs to be changed in your routine and creating boundaries to ensure a healthy work-life balance, although easier said than done, helps in improving night-time anxiety. 

Having people around you that you can rely on and confide in about what you are going through, also helps.

How common is anxiety at night

According to the Cleveland Clinic, anxiety affects approximately 40 million people in the USA. 

How is night-time anxiety treated? 

Night-time anxiety can be treated using Cognitive Behavioral Therapy (CBT). 

CBT is a form of talking therapy, which teaches you your behavioural patterns and how you can change them to improve your lifestyle using biofeedback.4 In a sense, you are healing yourself without the use of medications. The results are not immediate and can take anywhere between six weeks to a year to see considerable effects. 

CBT is used to treat a host of mental health issues and is widely purported for its benefits.

When to see a doctor

If you have taken the necessary steps to ensure better sleep hygiene, but are still not satisfied with the results, see a physician to think about what the possible next steps can be. 

Your physician can help diagnose any underlying health problems, and prescribe you the necessary lifestyle changes and medications. It is important to ensure transparency with your physician so you can come to the root cause of your night-time anxiety.    

Summary

It is very easy to isolate yourself from everyone else and go through your issues alone - it is important to understand that you are not alone. Night-time anxiety is treatable and preventable, with a dearth of resources available at your fingertips.

References

  1. Akbari Kamrani AA, Shams A, Shamsipour Dehkordi P, Mohajeri R. The effect of low and moderate intensity aerobic exercises on sleep quality in men older adults. Pak J Med Sci. 2014;30(2):417-421. doi:10.12669/pjms.302.4386 
  2. Edwards SJ, Montgomery IM, Colquhoun EQ, Jordan JE, Clark MG. Spicy meal disturbs sleep: an effect of thermoregulation?. Int J Psychophysiol. 1992;13(2):97-100. doi:10.1016/0167-8760(92)90048-g
  3. Kripke DF. Surprising view of insomnia and sleeping pills. Sleep. 2013;36(8):1127-1128. Published 2013 Aug 1. doi:10.5665/sleep.2868
  4. Piaserico S, Marinello E, Dessi A, Linder MD, Coccarielli D, Peserico A. Efficacy of Biofeedback and Cognitive-behavioural Therapy in Psoriatic PatientsA Single-blind, Randomized and Controlled Study with Added Narrow-band Ultraviolet B Therapy. Acta Derm Venereol. 2016;96(217):91-95. doi:10.2340/00015555-2428
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Nandini Menon

MBBS (Bachelor of Medicine, Bachelor of Surgery) - MS Ramaiah Medical College, Bangalore, India

Nandini is a Doctor from India with a passion for artificial intelligence, and has an eye for seeking out what shapes the future of healthcare.
She is currently doing her Masters in Clinical Critical Care at the University of Glasgow, Scotland and is the acting Student Representative for her course. She is actively working towards a future in medical writing to help educate the public on the advancements in the healthcare industry.

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