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Sleep Anxiety: Overcoming the Fear of Sleep

Katelyn Hagerty FNP

Medically reviewed by Vicky Davis, FN

Written by Our Editorial Team

Last updated 9/24/2021

Remember, as a little kid when you’d watch something scary and you’d be afraid to fall asleep? Or how about when you’d be so worried about something the next day you didn’t want to sleep? 

Most of us at some point have experienced some version of this, and for many of us, there is a grown-up version of this, as well — the often-dreaded sleep anxiety. 

Discover what sleep anxiety is, why you might be impacted by sleep anxiety and how you can overcome it.

What Is Sleep Anxiety? 

Sleep anxiety ranges from person to person, but typically shows up as some type of anxiety about sleep. 

This could mean fear of falling asleep, difficulty staying asleep or worry about the inability to wake up feeling refreshed. 

A closely related term that may be helpful is insomnia, the clinical term for people who have sleep issues, which happens to be a common complaint stated in research for those that have anxiety.  

Anxiety vs. Insomnia

You may be asking yourself at this point…. Do I have anxiety? Or am I experiencing insomnia? Or sleep anxiety? Or both? 

According to one review, the best available evidence is that insomnia and anxiety can go both ways. 

Meaning you may have anxiety contributing to insomnia, or your insomnia may be contributing to anxiety. 

Another relationship you may want to learn about is anxiety and depression

Why Does Anxiety Impact Sleep? 

The same research referenced above outlines the nitty-gritty scientific version of how anxiety impacts sleep. 

But here’s the thing — sleep anxiety isn’t actually what might be happening at work or in your life, for example, but is how your body and mind respond chemically. 

Anxiety sets off a sense of fear or stress (whether real or perceived) in our body that increases our arousal or alertness. 

This, in turn, triggers specific hormones that interact with our nervous system. 

When our nervous system is on alert due to this, it can interrupt your sleep quality.  

Sleep anxiety can contribute to poor sleep and sleep deprivation, which can take a toll on your mental health. 

Anxiety Disorders and Their Interactions with Sleep 

The specific cause of sleep anxiety will vary for everyone. It could be situational or rooted in an anxiety disorder. 

Anxiety disorders are a common occurrence in the general population. In fact, according to the Anxiety and Depression Association of America, 40 million American adults have an anxiety disorder.

Specifically, generalized anxiety, panic disorder, OCD or PTSD may have some impact on your sleep, which could be one reason why you’re anxious about falling sleep. 

Panic Disorder 

A panic disorder is a term for those who experience frequent anxiety attacks (also known as panic attacks) that are unpredictable. 

The most common symptoms are often the physical feeling of a panic attack (shortness of breath, palpitations, sweating, etc.) and are sometimes accompanied by a fear of losing control, death or going mad. 

It’s common for those with panic disorder to experience disturbances in their sleep, with a fear of either falling asleep or staying asleep. 

In addition, in some cases, those with panic disorder may experience nocturnal panic attacks, meaning a panic attack brought on in sleep. 

Generalized Anxiety Disorder 

Generalized anxiety disorder is a persistent state of anxiety. 

The symptoms of GAD consist of anxiety and worry about many events, accompanied by an impact on motor tension, ultimately resulting in restlessness, fatigability, muscle tension or an effect on vigilance resulting in sleep disturbances, restlessness and difficulty concentrating. 

Given the symptoms, one can see how sleep anxiety is quite common for those with GAD. It’s even estimated that about 60 percent to 70 percent of patients with GAD experience sleep issues. 

Obsessive-Compulsive Disorder 

Obsessive-compulsive disorder often referred to as OCD, is rooted in extreme obsessions or compulsions that disrupt everyday life. 

Most commonly, these are anxieties around contamination, aggression, sexual nature or compulsions related to checking, cleaning or counting. 

Those that suffer from OCD have been found to complain of sleep anxiety due to compulsive behavior. 

Post-Traumatic Stress Disorder 

Post-traumatic stress disorder, often referred to as PTSD, is the term for neuropsychological problems following a traumatic event. 

PTSD is commonly grouped into different ways one might experience it, most commonly those that relive the trauma or fear reliving it, those preoccupied trying to avoid memories, and those that are generally hypervigilant. 

A common symptom of PTSD is vivid nightmares of a traumatic event. 

Unlike other anxieties, where sleep anxiety is a shared experience, PTSD can even be discovered and diagnosed based on sleep anxieties like nightmares. 

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If You Can’t Sleep Right Now

For those of you who may be lying in bed right now experiencing some type of sleep anxiety, the information above may help you understand what you're experiencing, but it doesn’t help you fall back asleep at this moment.  

Here are a couple of tips for falling asleep if you're lying awake…

  • If you can’t sleep, it may seem counterintuitive, but try getting up. Do something relaxing until you feel tired enough to fall asleep.  

  • Make your room quiet and cozy. Try to keep it dark with minimal distractions. 

  • Put away your electronics.  

  • If you’re hungry, eat something light.  

Considering Sleeping Medication? 

Sleeping medication can be helpful to sleep. However, it should be used sparingly and most often if you are experiencing a routine change. 

For example, perhaps you are traveling or shifting your work schedule to nights. 

Side effects of sleeping pills can be severe, and you should consult a healthcare professional before you take anything. 

Reducing Sleep Anxiety with Routine

In medical speak, often referred to as sleep hygiene, is the routine and habits that we can shift  to support healthy sleep. This could mean:

  • Creating a sleep schedule

  • Scheduling a bedtime 

  • Trying to get up at the same time every day

  • Establishing a bedtime routine (without screens!)

  • Trying to eat dinner at least a couple of hours before bed

  • Implementing physical activity and exercise into your day-to-day

  • Avoiding caffeine in the afternoon or evening

  • Avoiding alcohol right before bed 

Treating Anxiety Disorders 

Although good sleep hygiene can be helpful, some more severe sleep anxieties — or anxiety disorders in general — may need anxiety treatment or additional support.   

In the same research that studied the relationship between sleep and anxiety, the sleep laboratory outlined specific treatment options for some anxiety disorders- including psychotherapy and medication. 

Psychotherapy 

Psychotherapy can be beneficial for almost any anxiety disorder. Some may choose to solely do psychotherapy, while some may combine it with the use of medication.

The types of psychotherapy treatment typically vary based on the anxiety disorder or healthcare provider. 

For example, for PTSD, some individuals might benefit from individual or group psychotherapy. 

You can find several types of therapy online through our platform, including online counseling and anonymous support groups

Medication

Medication has also been shown to help with a variety of anxiety disorders.

Specific medication will vary depending on the anxiety you are experiencing. Selective serotonin reuptake inhibitor (known as SSRIs), tricyclic antidepressants (TCAs), benzodiazepines (BZDs)

buspirone and antidepressants are all used in some cases of anxiety. 

Talk with a healthcare provider about what medication would be best for you and your symptoms. 

You can also specifically mention your concern about how anxiety is impacting your sleep. 

The specific treatment option you decide on will depend on what you and your doctor determine is best. Just know there are options out there, including natural remedies as well. 

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The Final Word on Sleep Anxiety

Because feelings of fear and stress are common with sleep anxiety, it may feel daunting to try and make things better. 

But at the same time, the importance of sleep on your mental health and wellbeing can greatly impact your day-to-day. 

Finding out what’s going on and your treatment options (or just lifestyle changes) may help you overcome your fear of sleep. 

7 Sources

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.

  1. Sleep Disorders. Anxiety and Depression Association of America. Retrieved from: https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders
  2. Staner L. (2003). Sleep and anxiety disorders. Dialogues in clinical neuroscience, 5(3), 249–258. Retrieved from:https://doi.org/10.31887/DCNS.2003.5.3/lstaner
  3. 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. Retrieved from: https://academic.oup.com/sleep/article/36/7/1059/2453875?login=true
  4. Suni, E. (2020, Sept. 20). Mental Health and Sleep. Retrieved from: https://www.sleepfoundation.org/mental-health
  5. Facts and Statistics. Anxiety and Depression Association of America. Retrieved from: https://adaa.org/about-adaa/press-room/facts-statistics
  6. Hershner, S.,& Shaikh, I. (2020, August.) Healthy sleep habits. Retrieved from: https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/
  7. Incze, M., Redberg, R. F., & Gupta, A. (2018). I Have Insomnia—What Should I Do?. JAMA internal medicine, 178(11), 1572-1572. Retrieved from: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2701632

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.

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