Anxiety and Sleep: Nighttime Loops That Keep You Awake

It’s a familiar scenario for many; you crawl into bed exhausted, but your mind won’t stop racing with worries. Anxiety often strikes hardest at night, sabotaging your ability to sleep. Unfortunately, the relationship is a two-way street: lack of sleep can also amplify anxiety, creating a vicious cycle that feels impossible to escape. Research confirms this loop is real. In fact, scientists have found that insomnia and anxiety feed into each other, each making the other worse¹. Understanding how this nighttime loop works is the first step towards breaking it.

How Anxiety Disrupts Your Sleep

Anxiety is notorious for keeping people awake. When you are anxious, your body’s “fight-or-flight” stress response stays activated long past bedtime. Stress hormones like cortisol remain high, your heart rate stays up, and your thoughts race. This state of hyperarousal makes it extremely difficult to fall asleep or stay asleep. It’s no surprise that sleep disruption is a hallmark symptom across anxiety disorders. People with chronic anxiety often report lying awake with tension, unable to “turn off” their worries.

Over time, anxiety can condition you to dread bedtime itself. You might start worrying in advance about not being able to sleep, a form of anticipatory anxiety that only fuels more insomnia. Ironically, the more you need sleep to face the next day, the harder it becomes to get it. Night after night of tossing and turning can lead to full-blown insomnia. In fact, research shows that individuals suffering from persistent insomnia are far more likely to have an anxiety disorder, where one study found they were 17 times more likely to experience clinically significant anxiety compared to people without insomnia. In short, an anxious mind at night keeps you awake, and ongoing sleep loss then feeds the anxiety.

How Sleep Loss Fuels Anxiety

Missing out on sleep doesn’t just make you tired; it ramps up your brain’s anxiety levels. A landmark experiment at the University of California, Berkeley, demonstrated this clearly. Participants who were kept awake all night showed anxiety levels spiked by up to 30% higher the next day. Brain scans revealed why: the sleepless night effectively shut down the prefrontal cortex, the region that controls rational thought and keeps emotions in check, while the brain’s deeper emotional centres became overactive. As senior researcher Matthew Walker explained, it was like the brain’s “emotional accelerator” was floored with no brake. In this overtired state, people feel far more anxious, edgy, and unable to cope with stress.

Crucially, getting quality sleep helped calm the brain. In the same study, after a full night of recovery sleep (especially deep non-REM sleep), participants’ anxiety levels plummeted back down as their prefrontal brain activity was restored. This finding supports what many of us intuitively know, everything feels more manageable after a good night’s sleep.

Chronic sleep deprivation can, therefore set the stage for chronic anxiety. Insomnia doesn’t just come from anxiety; it can also cause anxiety disorders. Long-term studies indicate that people with persistent sleep problems have a much higher risk of developing an anxiety disorder down the line. The nighttime loop of anxiety and sleeplessness can become a self-perpetuating cycle: worry leads to poor sleep, and poor sleep leaves you even more anxious.

Breaking the Anxiety–Insomnia Cycle

The good news is that there are effective strategies to break out of this loop. Both scientific research and practical clinical experience show that addressing sleep and anxiety together can lead to improvement in both. In one major study, treating people’s insomnia with cognitive-behavioural therapy not only improved their sleep, it also significantly reduced their anxiety and depression symptoms. In fact, some researchers found that when patients with both insomnia and anxiety were treated for insomnia first, their anxiety levels fell as much as if they’d been treated for anxiety directly. Better sleep, it turns out, can be a powerful natural anxiolytic (anxiety reducer).

You can take steps on your own to calm nighttime anxiety and set yourself up for better sleep. Here are some evidence-based tactics:

• Keep a consistent sleep schedule: Go to bed and wake up at the same time every day, even on weekends. A regular rhythm trains your body’s internal clock to know when it’s time to sleep. One large study of 75,000 people found that night owls with irregular late bedtimes had higher rates of anxiety and mood disorders, whereas those who shifted to earlier, consistent bedtimes saw their mental health improve. Consistency is key to stabilising your sleep–mood cycle.
  
  
• Create a calming pre-bed routine: Signal to your brain that it’s time to wind down. For at least 30-60 minutes before bed, dim the lights and do relaxing activities (for example, reading or gentle stretching). Avoid bright screens and stressful tasks at night – scrolling the news or work emails will keep your mind on high alert. A predictable, soothing routine helps transition you from the busy day into sleep.
  
  
• Limit stimulants and depressants: Be mindful of what you consume in the hours before bed. Caffeine can linger in your system for 6+ hours, so cut off coffee in the afternoon to prevent it from sabotaging your sleep. Likewise, while alcohol may make you drowsy, it disrupts your sleep quality and suppresses REM sleep, often leading to fragmented, non-refreshing rest. Stick to herbal tea or warm milk in the evening instead of caffeinated or alcoholic drinks.
• If using Medicinal Cannabis to help sleep, get the dose right for you. Early studies indicated that THC reduces REM sleep. However, recent meta-analysis of studies indicates this may only be applicable for high-dose THC, whereas lower doses do alter this. Getting the dose right is important, and everyone has different needs, so speak to your doctor about this.
  
  
• Practise relaxation techniques: If anxiety is keeping your mind buzzing, deliberate relaxation exercises can help quiet the nervous system. Deep breathing, progressive muscle relaxation, or mindfulness meditation before bed can reduce physical tension and interrupt racing thoughts. Even simple habits like doing a brief journaling session to write out your worries or to-do list a couple of hours before bedtime can get concerns out of your head so they don’t rattle around when you’re trying to sleep.
  
  
• Use the bed only for sleep (or intimacy): Train your brain to associate your bed with relaxation and sleepiness, not with worrying. If you’re unable to fall asleep after about 20 minutes, don’t stay in bed tossing and turning. Get up and do something quiet and calming (like listening to soft music or reading in dim light) until you feel sleepy, then return to bed. This breaks the link between your bed and the frustration of sleepless hours. Over time, this technique retrains your body to expect sleep when you’re in bed.
  
  

Finally, if you’re struggling with severe or persistent anxiety and insomnia, consider reaching out to a healthcare professional. Sometimes breaking the loop might require guided therapy or short-term medication to reset your sleep and ease anxiety. Therapies like CBT for insomnia and anxiety can give you structured tools to manage worry and restore healthy sleep patterns. With the right tactics and support, you can calm your mind at night and reclaim the restful sleep you need, allowing both your days and nights to become calmer and brighter.

References

1. Alvaro, P. K., Roberts, R. M., & Harris, J. K. (2013). A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression. Sleep, 36(7), 1059–1068.
2. Taylor, D. J., Lichstein, K. L., Durrence, H. H., Reidel, B. W., & Bush, A. J. (2005). Epidemiology of insomnia, depression, and anxiety. Sleep, 28(11), 1457–1464..
   
   
3. Ben Simon, E., Rossi, A., Harvey, A. G., & Walker, M. P. (2020). Overanxious and underslept. Nature human behaviour, 4(1), 100–110.
   
   
4. Freeman, D., et al. (2017). The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. The lancet. Psychiatry, 4(10), 749–758.
   
   
5. Lok, R., & Zeitzer, J. M. (2025). Chronotype and Mental Health: Are Late Sleepers More Vulnerable?. Current psychiatry reports, 27(10), 544–552.