By Courtney Leiva
Expert review by Ronee Welch, Sleep Coach and Owner of Sleeptastic Solutions

While everyone struggles to fall asleep and tosses and turns in bed now and then, frequent nights without slumber could indicate a more serious issue—a sleep disorder.

About one-third of U.S. adults report that they get less than the recommended amount of sleep. This, in turn, could indicate other medical concerns, including untreated mental health issues. A 2019 article published by the Harvard Medical School suggests that those with mental health conditions—especially anxiety—are more likely to have insomnia or other sleep disorders.

Not everyone who struggles with sleep necessarily has mental health concerns. But if feelings of dread, restlessness, and uneasiness keep you up at night, it’s best to address those issues head-on.

Below, our in-depth guide shows how anxiety goes hand-in-hand with sleep and explains what treatment can help manage the symptoms.

Illustration of man laying awake in bed

Circumstantial Anxiety vs. Anxiety Disorders

Feeling Anxious?

According to clinical hypnotherapist Mahesh Grossman, everyone experiences anxiety at some point—whether it’s triggered by switching jobs, moving into a new place, or other significant life changes.

Those situations fall under the circumstantial anxiety category since they are induced by a stressful situation and usually subside when the event is over, Grossman says.

On the other hand, anxiety disorders are defined by chronic anxiousness that lasts for six months or longer and may require treatment from a physician in some cases, he adds.

“Situational anxiety is the kind of worrying and fear response to something that makes sense,” Grossman tells SleepMoment.

“An anxiety disorder is chronic anxiousness that you carry around with you a majority of the time (six months or longer), involving situations, or just a general feeling about something that doesn’t make sense to feel uncomfortable or worried about.”

What Are Anxiety Disorders?

According to the Anxiety & Depression Association of America (ADAA), anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults every year.

Anxiety disorders are influenced by several factors, including environmental, psychological, and developmental, says the American Psychiatric Association.

However, genetics is one of the biggest influencing factors behind anxiety disorders, as anxiety disorders can run in families, according to the APA. The hereditary element makes it important to note any family history of mental illness and share it with your physician.

Unique characteristics define each anxiety disorder. Below are some of the most common anxiety disorders and their traits:

  • General Anxiety Disorder (GAD)– “General anxiety disorder is when a person has constant and excessive worry that impacts daily functioning,” says board-certified psychiatrist Divyansu Patel. “These worries can lead to physical symptoms of restlessness, feeling on edge, tiredness, problems with concentrating, muscle tension, and problems with sleep.”
  • Panic Disorder– “Panic disorder is when a person has overwhelming psychological and physical distress,” Patel tells SleepMoment. “This distress can lead to an increased heart rate, sweating, chest pain, feeling dizziness, numbness, hot flashes, nausea, shortness of breath, shaking, fear of dying, and losing control. These symptoms typically last between five to ten minutes.”
  • Phobias– “Phobias occur when a person has constant and excessive fear of a specific situation, activity, or object,” Patel says. “Individuals with phobias know the fear is excessive, but it is hard for them to combat it. Because of this, they tend to avoid these fears as much as possible.”
  • Post-traumatic Stress Disorder (PTSD)– “PTSD is when a person has experienced or witnessed a traumatic experience (natural disaster, war, serious accident, death or sexual or physical violence),” says Patel. “This person can have disturbing thoughts and feelings related to a traumatic event or may re-experience the event through flashbacks or nightmares. They also may have a range of emotions including sadness, anger, or fear, and tend to avoid situations or places that remind them of the trauma.”

Anxiety Symptoms

Anxiety symptoms can vary from person to person. However, there are some key overlapping symptoms you’ll want to keep an eye on, according to the ADAA. These include:

  • Nervousness
  • An impending sense of danger
  • Increased heart rate
  • Hyperventilating
  • Weakness
  • Tiredness
  • Difficulty concentrating
  • Difficulty sleeping
  • Experiencing gastrointestinal problems

The Connection Between Anxiety and Sleep

Sleep and anxiety can form a vicious cycle, says Patel. Anxiety often keeps people awake. Meanwhile, someone who hasn’t slept well the previous night may experience higher anxiety.

However, sleep issues aren’t limited to anxiety. People with other mental health disorders (particularly depression) can also struggle.

A survey sponsored by SleepMoment found that those with depression sleep an average of 24 minutes less than those without any of the mental health or sleep disorders listed in the survey: attention deficit hyperactivity disorder (ADHD), bipolar disorder, depression, general anxiety disorder (GAD), panic disorder, phobia(s), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), sleep apnea, and sleep paralysis.

Moreover, nearly 20 percent of those with depression reported feeling extremely stressed (compared to 5 percent of those with none of the listed conditions).

Likewise, anxiety and insomnia are also intertwined, according to Patel.

“Insomnia is when a person has a hard time falling asleep or staying asleep,” she says. “It can impact your daily activities and make you feel sleepy throughout the day. Insomnia can also lead to anxiety, as a person tends to worry about going to sleep, and fear of not being able to fall asleep.”

Patel warns that insomnia can seriously impact a person’s ability to function. For example, it can lead to poor job or school performance, change in mood, falling asleep while driving, and socialization problems with friends and family. You can learn more about insomnia and sleep deprivation here.

How Are Sleep and Anxiety Disorders Treated?

As debilitating as anxiety and sleep disorders can be, their symptoms are treatable. Below are some common treatment options.

Behavioral and Lifestyle Changes

Numerous behavioral and lifestyle changes can improve sleep quality and alleviate anxiety. These include changing diet, exercising, and practicing stress-reduction techniques.

Alternative Avenues

Nutritional and herbal supplements may also help, according to a 2010 study published in the Nutrition Journal.

These include herbs such as passionflower and kava (a plant known as Piper methysticum), which have been shown to ease anxiety.

Illustration of woman in talk therapy

Similarly, a 2020 study published in Evidence-Based Complementary and Alternative Medicine found that some plant extracts can promote better sleep. These include valerian root and lavender extracts.

However, before taking any supplements, consult with a doctor. Sometimes, treatments beyond supplements may be necessary.

Psychotherapy or Cognitive Behavioral Therapy

Since anxiety can cause emotional distress, psychotherapy administered by a licensed psychologist or psychiatrist can help alleviate anxiety. Psychotherapy encourages supportive talks and can identify emotional problems associated with anxiety disorders.

Cognitive-behavioral therapy (CBT), a different approach to therapy, can also help manage anxiety. In CBT, a practitioner uses strategies to help patients change their thought patterns.

CBT has been used to treat many mental health disorders, including depression, anxiety disorders, eating disorders, substance abuse, and personality disorders.

Anxiety Medications

Some anxiety patients respond best to medication. These medicines are prescribed by a board-certified psychiatrist and are often used alongside psychotherapy.

Common anxiety medications include antidepressants, benzodiazepines, alpha–delta calcium channel anticonvulsants, and beta-blockers and azapirones.

Sound Mind, Sound Sleep

Sleep and mental health often go hand-in-hand. Fortunately, many mental health conditions that affect sleep—including anxiety and depression—are treatable through a combination of lifestyle changes, medication, and therapy. Ask a doctor to help form a plan that will ease your mind and help you sleep.