In Clearbrook Treatment Centers Massachusetts, Mental Health

While it’s normal to have the occasional night of tossing and turning, struggling to fall asleep every night can be exhausting and frustrating for anyone. If you’ve ever struggled with sleep anxiety, then you may understand what it feels like to watch the hours tick by, knowing you’re going to wake up exhausted the next day. Anxiety and sleep deprivation are connected in several ways. In fact, 50% of individuals attribute their sleep deprivation to anxiety.1 If you’re one of these people, the mental health experts at our Massachusetts rehab have compiled tips for sleeping with anxiety that can help.

What Is Sleep Anxiety?

Sleep anxiety refers to the feeling of fear or stress about falling or staying asleep. Sleep problems and mental health go hand-in-hand, and plenty of people with disorders like depression and anxiety struggle to maintain a healthy sleep pattern. One often makes the other worse, so it can feel like a continuous cycle.

Not getting enough sleep negatively impacts mood, contributing to irritability and sometimes depression. Plenty of vital functions occur during different stages of sleep, as well, and a lack of sleep deprives our bodies of the rest they need to function properly throughout the day.

If you’ve experienced this, you’ve probably wondered, “Why does my anxiety get worse at night?” Usually, your anxiety is worse at night because there aren’t as many things to keep you distracted at night as there are during the day. Daily stressors, poor sleep habits, and other health conditions can also contribute to anxiety and panic attacks at night.

How to Sleep With Anxiety: 13 Tips That Can Help

As exhausted and ready for bed as you might feel on the couch watching TV, sometimes the moment you lay down, your anxiety seems to spark. A simple noise down the hall or a stray thought about that one thing you said that day that you think offended your coworker could send your mind reeling down a rabbit hole of intrusive thoughts.

You might beat yourself up about something you did or didn’t do that day, or maybe you’re agonizing over all of the things you have to do tomorrow. You might replay the day in your head and go over numerous “what ifs.” You probably start worrying about your loved ones to the point that instead of lying down and trying to sleep, you’re Googling that one spot that suddenly seemed to appear on your dog’s stomach.

If you’re this person, then you understand how unpleasant it feels to wake up the next day with virtually zero hours of true rest under your belt. Well, enough is enough. Below is more on how to get a good night’s sleep with anxiety:

  1. Limit your screen time before bed: One of the most common tips to help you sleep when you have anxiety is to avoid screen time before bed. Watching videos and TV before bed keeps you distracted and awake. It’s also important to keep in mind that fear and anxiety, though different, are linked. It explains why coming across something negative online before bed could potentially trigger your anxiety.
  2. Don’t do any major physical activity right before bed: Exercise gives you a momentary energy boost, which can keep you wired at night and make falling asleep more difficult.
  3. Don’t eat a heavy meal before bed: Although it’s normal to feel sleepy after meals, avoid eating large meals right before bed to avoid a stomach ache or discomfort that can prevent sleep.
  4. Limit your naps to 20 minutes once a day: If you’re a napper, then consider shortening your nap time to one 20-minute nap per day. Shorter naps help prevent you from falling into a sleep cycle, which can make you feel groggy. Also, you don’t want to sleep so much during the day that you aren’t ready to fall asleep at night. Eventually, you might not even need to nap as your nighttime sleep patterns improve.
  5. Exercise during the day: As long as it’s not right before bed, daily exercise can deplete your body with any excess energy or jitters that may keep you awake at night.
  6. No caffeine at or near bedtime or after a certain time in the day: While coffee’s ability to wake you up is beneficial at the start of the day, having caffeine too late in the day can make it more difficult for you to fall asleep. It’s not just coffee, as there are other caffeinated drinks, including many teas and sodas.
  7. Sleep in a cool and dark bedroom: Most people like to fall asleep in a cool room cuddled up under blankets. Having a dark room also keeps any light or movement from distracting you. If there is light coming into your room that you can’t block, use an eye mask.
  8. Follow a consistent bedtime routine: Start winding down for the night at the same time every day. Make sure you’re ready for bed by 9 P.M. at the latest, or earlier if you have to wake up early the next day. Rule of thumb – give yourself at least an hour to lay in bed and fall asleep. You can also take a warm bath, have a warm drink, read, or do anything else that might promote sleep.
  9. Use a weighted blanket: The weight of the blanket offers an additional source of comfort and security that’s becoming popular among people with anxiety. These blankets lower your heart rate by activating your parasympathetic nervous system. They work similarly on adults and children as swaddling does on infants.
  10. Keep your room tidy: A cluttered room promotes a cluttered mind, and nothing is more stressful than trying to sleep in a messy room. Plus, having to move things off or around your bed just to lay in it can disrupt any sleepiness you might have felt on your way to bed.
  11. Try the best position to sleep with anxiety: The best sleeping position for anxiety is on your back with your limbs splayed out, otherwise known as the ‘shooting star’ position or supine position. While you may feel tempted to curl on your side, this position causes muscle tension rather than relaxation. You could also do some gentle belly breathing while on your back. Use belly breaths, which are when you fill your belly up with air when inhaling rather than your chest.
  12. Use a sound machine: Also known as white noise or sound therapy, using a sound machine is a common approach to improving sleep quality. Sound machines emit a consistent background noise that can help mask disruptive sounds and create a more soothing environment for sleep.
  13. Leave tomorrow’s tasks for tomorrow: Perfectionism and anxiety are also interconnected, as a major component of anxiety disorders is the desire to do or control something that isn’t in your power to control. For this reason, it’s common for individuals with anxiety to keep tomorrow’s tasks from letting them rest. To combat this feeling, before you go to bed, make a to-do list for the next day and then put it away until then.

What Is the 3-3-3 Rule for Anxiety Sleep?

The “3-3-3 Rule” is a relaxation technique that can be used for sleeping with anxiety. This technique is designed to help calm your mind and reduce racing thoughts that often accompany anxiety, making it easier to fall asleep. Here’s how it works:

1. Practice 3 minutes of deep breathing:

  • Find a comfortable position in bed.
  • Close your eyes and take a deep breath through your nose, counting to three as you inhale.
  • Hold your breath for a count of three.
  • Exhale slowly through your mouth for a count of three.
  • Repeat this deep breathing pattern for three minutes. Focus on your breath and try to clear your mind of other thoughts.

2. Try 3 minutes of progressive muscle relaxation (PMR):

  • Continue to lie comfortably in bed.
  • You will start at your toes and work your way up through your body, one muscle group at a time.
  • Tense each muscle group for a count of three and then release, allowing the tension to melt away.
  • Pay attention to the physical sensations as you tense and relax each muscle group.
  • Spend about three minutes going through this process, progressively relaxing your entire body.

3. Finish the routine with 3 minutes of visualization:

  • With your body relaxed and your mind calmer, engage in positive visualization.
  • Imagine yourself in a calm and peaceful place, such as a beach, forest, or any location that brings you comfort.
  • Use all your senses to immerse yourself in this mental scene, focusing on the details and sensations.
  • Spend the final three minutes before sleep to visualize this tranquil place.

The 3-3-3 Rule combines deep breathing, progressive muscle relaxation, and visualization to help reduce the likelihood of anxiety while sleeping and prepare your mind and body for sleep. By following this routine, you can create a more relaxed mental and physical state that may foster better sleep.

It’s essential to practice the 3-3-3 anxiety rule regularly to see its full benefits. Additionally, if you continue to experience significant anxiety or sleep difficulties, consider consulting a healthcare professional or therapist for more support.

Can Lack of Sleep Cause Anxiety?

Unfortunately, yes, lack of sleep can cause anxiety. Sleep deprivation and anxiety are closely interconnected, with one worsening the other.

Below are some reasons why lack of sleep can cause anxiety:

  • Altered brain function: Sleep plays a critical role in maintaining proper brain function, including emotional regulation and stress management. When you’re sleep-deprived, your brain may become less capable of coping with stressors and regulating emotions effectively, which can exacerbate or lead to anxiety.
  • Impaired cognitive function: Sleep deprivation can impair cognitive functions like decision-making, problem-solving, and emotional processing. This can lead to heightened anxiety as individuals may find it difficult to manage daily stressors or responsibilities.
  • Negative thought patterns: A lack of sleep can contribute to negative thought patterns and increased rumination (repetitive thinking), making anxious thoughts more frequent and difficult to manage.
  • Physical symptoms: Sleep deprivation can also manifest in physical symptoms such as muscle tension, fatigue, and irritability. Any of these can worsen or contribute to anxiety.
  • Stress hormone levels: Sleep deprivation can lead to an increase in stress hormones, such as cortisol. Elevated cortisol levels are associated with heightened anxiety and can make you more susceptible to unease and nervousness.
  • Vicious cycle: Sleep deprivation and anxiety often create a vicious cycle, as anxiety can make it difficult to fall asleep or stay asleep, causing sleep deprivation, which can then lead to anxiety.

Remember that very few things change in a day, so be patient with yourself and your mind as you navigate how to deal with sleep anxiety. Moreover, as many tips for sleeping better with anxiety as there are out there, nothing replaces professional support.

If you’ve struggled with anxiety for a while or have experienced worsening symptoms lately, the behavioral health specialists at our rehab in Massachusetts can help. Our facility offers mental health treatment that can address the various symptoms and levels of anxiety.

For more information about our residential mental health care or addiction treatment services, call Clearbrook Treatment Centers today at 570-536-9621.


  1. National Library of Medicine – A Test of the Effects of Acute Sleep Deprivation on General and Specific Self-Reported Anxiety and Depressive Symptoms: An Experimental Extension
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