Anxiety vs. Insomnia

Medically Reviewed by Poonam Sachdev on September 19, 2023
6 min read

Anxiety is when you feel tense and worried. It's natural to have these feelings from time to time. But if you feel this way often, it can be an anxiety disorder. It can cause intense attacks that speed up your heart rate, raise your blood pressure, and make you sweaty or dizzy. Anxiety can also affect your sleep.

Insomnia is when you have trouble falling or staying asleep. If this happens to you at least three times a week for more than 3 months, it’s called chronic insomnia. It can eventually make you more likely to have other health conditions, including an anxiety disorder.

Constant worry during the day often carries over into night. That can cause “mental hyperarousal,” which can keep you from falling asleep.

Sleep disturbances such as these, like insomnia, can be a symptom of an anxiety disorder.

Once you do get to sleep, an anxiety disorder also can prevent you from staying asleep long enough to feel fully rested. Anxiety can be compared to your body’s alarm system -- it can help keep you safe and out of potentially dangerous situations. But if that alarm goes off all the time and for no real reason -- as it does with an anxiety disorder -- it can keep you from getting enough deep sleep.

All of this can create stress over not being able to get to sleep or get enough sleep. And that can lead to even more anxiety.

Researchers have also found evidence that a chronic lack of sleep can also affect your emotional health. Studies show that people who have obstructive sleep apnea, which causes you to have episodes of pauses in your breathing and wake up continually through the night, are more likely to have mental health conditions like anxiety, panic disorder, and depression.

Chronic insomnia is defined as when you have trouble falling or staying asleep for a specific time frame that can't be explained by another health concern. But an anxiety disorder is harder to diagnose.

In addition to ongoing tension, worry, and trouble with sleep, other signs of an anxiety disorder include:

  • Steering clear of situations that trigger your fears
  • Nervousness, restlessness
  • A sense of impending danger
  • Increased heart rate or breathing
  • Sweating or trembling
  • Trouble concentrating
  • Digestion problems
  • Having trouble controlling worry

See your doctor if you have these symptoms or your level of worry has drastically changed your lifestyle or is affecting work or school. Call 911 if you start having thoughts of hurting yourself or committing suicide.

Anxiety about sleep can cause somniphobia. Somniphobia is an extreme fear of sleep that can stem from a variety of sources including previous trauma or fear of sleepwalking. If you have sleep anxiety, you may worry about getting enough sleep. But if you have somniphobia, your fear is more intense, you may be scared to sleep, and you may focus on what could happen when you fall asleep. 

Symptoms of somniphobia

If you have somniphobia, you may experience distress when you think about sleep or try to go to sleep. Other symptoms can include feeling irritable, having a lack of focus because of thinking about sleeping, putting off going to bed as long as possible, and leaving the lights and/or TV on while trying to sleep.

Other physical symptoms of somniphobia include panic attacks, chest pain, hyperventilation, and heart palpitations.

Causes of somniphobia

Doctors are unsure as to what causes somniphobia but believe it can come from a few sources, including:

Tossing and turning (insomnia). Often, dreading sleep is the result of a sleep disorder.

One in three adults worldwide have symptoms of insomnia, which is the most common cause of this fear. When people don’t get the sleep they need, they become concerned.

If you have insomnia, worrying about sleep only worsens the condition. You may be worried about sleep, so you can’t sleep.

Chronic nightmares. Chronic nightmares are another troublesome sleep disorder that can cause fear. Children are especially vulnerable, but adults, especially those who have post-traumatic stress disorder, have nightmares, too.

Fear of dying while sleeping. You may worry about sleep because you have a health condition. If you have obstructive sleep apnea, for example, you may sometimes fear that you’ll stop breathing in your sleep. While this fear is rare, it may occur when someone learns that they have sleep apnea and are waiting for a CPAP (continuous positive airway pressure) device to treat it. Once the apnea is under control, some people have increased alertness and less daytime sleepiness.

Fear of dying during sleep can also occur if you have heart issues such as sudden cardiac arrest, stroke, seizure, or sedative overdose. Your risk for sudden cardiac arrest during sleep is higher if you have heart disease, lung disease, or obstructive sleep apnea.

Repeated sleep paralysis. Sleep paralysis is when you are unable to move while falling asleep or waking up. This paralysis can sometimes occur with hallucinations and can be hereditary. It can create nervousness about falling asleep.

Sleep and anxiety disorders are treatable.

Some options that can help to eliminate the fear of sleep include: 

Practicing good sleep hygiene.

  • Go to bed at the same time every night and wake up at the same time every morning.
  • Create a bedtime routine, including the same restful activities every night like playing soft music.
  • Don’t eat or drink any caffeinated or alcoholic beverages before bed.
  • Steer away from napping during the day.
  • Only go to bed when you feel sleepy.
  • Get regular exercise.
  • Avoid long-term use of sleep medications.
  • Keep your bedroom cool and dark.
  • Limit your bedroom activities to sleep and sex.
  • Maintain a healthy weight.

Getting medical help. If you have a sleep disorder that doesn’t let up, such as insomnia or chronic nightmares, talk to a sleep specialist for counseling.

Insomnia can be treated with cognitive behavioral therapy or sleep medications. Chronic nightmares may require imagery rehearsal therapy or similar treatments like exposure, relaxation, and rescripting therapy, which involves rewriting and rehearsing a new version of the nightmare during the day. It can also be treated with various prescription medications. 

You should also talk to your doctor if you think you have sleep apnea or another condition that’s disrupting your sleep.

If you have an anxiety disorder, your doctor may recommend options similar to those available for sleep concerns, including: 

  • Psychotherapy. A mental health specialist may suggest relaxation techniques. Cognitive behavioral therapy, which is the most effective form of psychotherapy for anxiety disorders, can also be used to effectively treat anxiety by helping you understand and better control your emotions and behavior.
  • Medication. A doctor may also recommend medications, including certain antidepressants and anti-anxiety medications, or short-term use of sedatives or beta-blockers.

You can also do a few things to help break the cycle between anxiety and insomnia:

  • Practice meditation.
  • Prioritize and delegate your to-do list.