Feeling Anxious That You Can’t Fall Asleep? Try These 8 Pro Tips for Relief

It’s a miserable cycle: You’re wide awake in bed, panicking about being wide awake in bed, which keeps you wide awake in bed. The comforting news? Sleep anxiety can happen to anyone—and it’s rooted in something totally normal. 

“Evolution figured out a long time ago that if you’re stressed and you need to do something about the problem, maybe you don’t need to sleep as much right now,” says Michael Grandner, PhD, a licensed clinical psychologist at the University of Arizona, where he directs the Sleep and Health Research Program. “If you’re running from a bear in the woods and it’s bedtime, we have lots of systems in our body that protect ourselves by foregoing sleep.”

But if what’s keeping you awake isn’t a wild animal but a fear of poor sleep, that evolutionary instinct isn’t so useful—especially when it persists night after night. Here’s what experts say about what causes sleep anxiety, what to do when it strikes, and how best to prevent it entirely. 

What Is Sleep Anxiety? 

Sleep anxiety is stress or fear related to going to sleep, according to the Cleveland Clinic. You might feel physical symptoms ahead of bedtime, like digestive issues and a rapid heart rate, and emotional symptoms once in bed, like feelings of overwhelm or impending doom. 

Sleep anxiety is different from somniphobia, or the fear of sleep itself. In that case, the Cleveland Clinic says, people may be afraid to drift off because they worry something bad will happen once they do. With sleep anxiety, however, people want to sleep so badly that they can’t.

“You’re creating a situation where sleep is incompatible with your effort, and so that creates more stress,” Grandner says. Eventually, your brain and body start to associate bedtime with stress, which perpetuates the dreaded loop.

What Causes Sleep Anxiety?

Sleep anxiety usually starts as a worry about something else. Maybe you’re nervous about a race the next day, or ruminating over something your partner said. When the original concern morphs into concern about the sleep you’re missing—boom, you’ve got sleep anxiety. 

“Often what happens is when people have insomnia for a normal reason that will go away on its own, they start panicking about it, and the panic creates all kinds of behaviors and things that end up not working, which creates more panic and feeling of helplessness,” Grandner says. “And that creates its own anxiety about sleeping.”

While anyone can experience sleep anxiety, some people, like those with an anxiety disorder or a sleep disorder, can be more susceptible, the Cleveland Clinic says. “People who tend to fixate, people who tend to worry, people who might have other types of health anxiety” can be prone to sleep anxiety, Miller finds. 

People who are overly tied to their sleep trackers might be unintentionally setting themselves for sleep anxiety as well. In a 2017 article in the Journal of Clinical Sleep Medicine, researchers coined this phenomenon “orthosomnia,” or an unhealthy obsession with getting good sleep.  

Lead study author Kelly Baron, PhD, a clinical psychologist who’s trained in behavioral sleep medicine, says that the growing media attention on the importance of a solid slumber may also be perpetuating the issue. Increasing press coverage on sleep is “exciting and really good,” Baron says—but for some, there are drawbacks. If you’re not getting as much sleep as you’d like, constantly hearing how crucial rest is could lead to increased sleep and health worries, “and that becomes a source of anxiety,” says Baron, also a professor in the University of Utah’s Department of Family and Preventive Medicine.

That can be especially true for people with a family history of Alzheimer’s or dementia, Baron finds, since research has shown that consistently not sleeping enough can contribute to the development of the diseases. “Many of my patients have been caregivers for their parents who had Alzheimer’s, and so … it hits them really hard when they don’t sleep,” she says. “They want to be doing everything they can to promote their health.” 

The Impacts of Sleep Anxiety

When sleep anxiety is a regular occurrence, the consequences can be significant. For instance, prolonged poor sleep and anxiety can raise the risk of health conditions like diabetes and heart disease, the Cleveland Clinic says. On a shorter-term basis, sleep anxiety may affect your training and sports performance, with research showing that a lack of quality sleep among athletes is linked to an increased risk of injuries, including concussions, as well as poorer mental health.

But usually, the repercussion is simply feeling a bit tired the next day, says Annie Miller, a licensed therapist and owner of DC Metro Therapy, which specializes in treating chronic pain, insomnia, anxiety, and trauma. “I’ve had clients where [the next day] does actually turn out pretty negatively, and then they worry about it and then it turns into a bigger problem,” she says. “But the reality is, it’s generally not a big deal.”

Tips for Managing Sleep Anxiety

You can break the cycle of sleep anxiety. Here’s what the pros recommend: 

1. Give Up 

First, stop forcing it. “Nobody got to sleep by trying hard,” Grandner says. Similarly, Baron says, “you can’t command yourself to sleep. You have to accept that either you sleep or you don’t sleep; that when you feel drowsy enough, you will sleep. But the more that you lie there and force yourself, it gets worse.”

2. Get Up 

Once you’ve accepted the night’s reality, get out of bed. Grandner likens it to hunger: If you’ve lost your appetite, do you force yourself to stare at a big meal? Or, do you excuse yourself and trust your appetite will return? 

“If you’re in this situation and you actually start to have anxiety about going to sleep, automatically get up and do something else,” Miller says. “We really want to just cut off the thought process, and being in bed worrying exacerbates it.”

Once you’re up, do something low-key like folding laundry, reading, listening to a podcast, or meditating. If you start to feel sleepy, get back in bed.

3. Put It In Perspective 

Your body can handle a bad night of sleep. “You’re going to feel tired, and it’s probably not going to be the best day ever, but nothing bad is gonna happen,” Miller says. “The anxiety comes in when the story becomes, ‘This is terrible and something bad is going to happen because of this.’” She even recommends journaling about what happens the next day to remind your future self that it typically all turns out OK. 

Baron also works with sleep-anxious patients to consider and work on their overall health—not just their sleep. “There are some things about sleep that aren’t controllable,” she says. “Even when you do everything right, you can have a bad night and still be healthy.” 

So while sleep is indeed a pillar of health, it’s not the only one. Focusing on other healthy habits, like eating healthfully, exercising regularly, and maintaining strong social connections can be easier to control. “You have to focus on sleep enough,” Baron says, “but if you over-focus on it, it tends to get worse.”

4. Schedule Worry Time 

Try to make your bedroom a worry-free zone. “It’s often harder to do than it is to describe: If you’re gonna be anxious anyway, and you can’t control whether or not you’re anxious, just don’t do it in bed,” Grandner says. (Of course, that’s easier said than done, but trying to disassociate stress from your bedroom can help if you deal with sleep anxiety.)

Similarly, Miller recommends people carve out a little time in their days to work through the concerns that threaten to keep them awake at night. That could look like venting to a friend or journaling. “If you do that earlier, it’s like, what am I afraid of by the time the evening comes?” she says. “If [night] is your typical time to worry, you’ve kind of already done that.”

5. Avoid Next-Day Naps 

Rather than trying to make up for a bad night’s rest with a nap the next day, try to build up what experts call “sleep drive” by keeping yourself deprived. It might sound backwards to stay awake when your body’s craving a midday snooze after a rocky night of sleep, but it can really help future-you: “When we have a poor night of sleep, we typically bounce back and have more sleep drive and sleep better the next night,” Miller says. “That fact alone can be really, really soothing for a lot of people.”

6. Ditch the Trackers

If your sleep tracker or news about the benefits of sleep is becoming counterproductive, take a break from those devices and sources. “A lot of times we’ve done a disservice by reading about how destructive it is for you not to sleep,” Miller says. “And really, we all have poor nights of sleep. There really isn’t anything to live in fear of.”

7. Work with a Professional  

If you reach a point where your sleep anxiety is leading to life-disrupting insomnia at least three nights a week for three months or more, it’s important to seek a higher level of care, Baron says.

Cognitive behavioral therapy for insomnia, or CBT-I, for one, is the top-line treatment for insomnia—considered better than pharmaceuticals—no matter what’s driving the insomnia in the first place.

The intervention is usually delivered by a therapist and helps people learn strategies to enhance sleep (like reserving the bedroom for sleeping or building up their drive for sleep) and challenges their unhelpful beliefs around sleep. “If you can find cost-effective therapy options, it’s short-term, it’s not forever, and there’s a real benefit to it,” Miller says. 

8. Try a CBT-I App

If you can’t access or afford a therapist who specializes in sleep, free CBT-I apps like one developed by the US Department of Veterans Affairs may help you develop slumber-supporting strategies too. They’re not designed to replace therapy, but “there’s more and more evidence and support for the use of these technology solutions,” Baron says. 

Is It Possible to Prevent Sleep Anxiety? 

Most of the solutions for sleep anxiety can also work to prevent it in the first place: Get up if you start to ruminate, avoid heavily relying on tracking devices, and accept that imperfect nights of sleep are a part of life. Other general sleep hygiene tips like getting up and going to bed at the same time each day; sleeping in a cool, dark room; and avoiding screens about an hour before bed can help too. 

The key, Grandner says, is trying to stop the occasional nighttime worry from spiraling into fears about a lack of good sleep itself. “It’s self-correcting; your body will return to balance on its own if you do nothing,” he says.