Anxiety and Insomnia: What's the Connection?

It's frustrating when you can't fall asleep, and it becomes even more frustrating when you realize that your worries are part of the problem. You lie in bed with your thoughts racing, and the harder you try to relax, the more awake you feel.

If anxiety is keeping you up at night—or if poor sleep is making you more anxious during the day—you're dealing with a common problem. Anxiety and insomnia are closely connected. One can cause the other, and they often make each other worse.

But here's the good news: this cycle can be broken. Once you understand how anxiety and insomnia are linked, you can take steps to sleep better and feel calmer.

What does anxiety-related insomnia feel like?

When anxiety is affecting your sleep, you might notice thoughts like:

• I know I won't be able to fall asleep tonight.

• I'm going to be exhausted tomorrow.

• Why can't I just turn my brain off?

• I've been lying here for hours.

• Something must be wrong with me.

You might also notice physical symptoms when you're trying to sleep:

• Racing heart

• Tense muscles

• Shallow breathing

• Restlessness

• Upset stomach

These symptoms are signs that your body is in a state of stress, the opposite of what you need to fall asleep.

Can anxiety cause insomnia?

Yes. When you're anxious, your body stays on high alert. Your brain keeps processing worries, your muscles stay tense, and stress hormones like cortisol don't drop the way they should at night. 

Cortisol is supposed to decrease in the evening to help your body wind down. When it stays high, your body can't shift into sleep mode.

But the relationship goes both ways. Poor sleep can also cause anxiety. After a bad night, your brain becomes more reactive to stress. Things that wouldn't normally bother you feel harder to handle. You might feel more irritable, more worried, or more overwhelmed.

This creates a cycle:

1. You go to bed feeling anxious.

2. Your anxiety makes it hard to fall asleep.

3. You wake up tired and more stressed.

4. By bedtime, you feel even more anxious about sleeping.

5. The cycle repeats.

Also Read: What Is Sleep Anxiety? Signs, Causes, and Natural Ways to Find Relief

Which comes first—anxiety or insomnia?

It can be hard to tell. For some people, anxiety comes first, and sleep problems follow. For others, sleep problems develop first, and anxiety builds over time.

Research suggests that sleep problems may have a slightly stronger effect on anxiety than the other way around. A 2024 study of over 16,000 adults found that people with poor sleep were almost twice as likely to develop anxiety.

This means that improving your sleep might be one of the best ways to feel less anxious overall.

What causes anxiety-related insomnia?

Several things can contribute to the anxiety-insomnia cycle:

• Stress. Work pressure, relationship problems, financial worries, or major life changes can all trigger anxiety that follows you to bed.

• Poor sleep habits. Irregular sleep schedules, too much screen time before bed, or caffeine late in the day can make sleep problems worse.

• Medications. Some medications—including certain ADHD medications, asthma medications, and even some antidepressants—can interfere with sleep.

• Other health conditions. Conditions like sleep apnea, restless leg syndrome, acid reflux, or thyroid problems can disrupt sleep and increase anxiety.

• Caffeine, alcohol, and nicotine. All of these can interfere with sleep quality.

If you're not sure what's causing your sleep problems, a healthcare provider can help rule out medical issues.

Also Read: Keep Waking at 3 A.M.? Common Reasons and What to Do

What does inflammation have to do with anxiety and insomnia?

When you don't sleep well, your body makes more substances that cause inflammation. High inflammation can affect your brain and make anxiety worse. 

Chronic stress and anxiety can also increase inflammation in your body. This creates a cycle: anxiety leads to poor sleep, poor sleep raises inflammation, and higher inflammation makes anxiety harder to manage.

Some studies suggest that lowering inflammation may help improve both sleep and mood. You can reduce inflammation through lifestyle changes or by eating anti-inflammatory foods like Montmorency tart cherry, which may help with both sleep and mood.

How is anxiety-related insomnia treated?

Treatment usually involves a combination of better sleep habits, therapy, and sometimes medication or a natural sleep aid.

Good sleep habits

Small changes to your routine can make a big difference:

• Go to bed and wake up at the same time every day

• Keep your bedroom cool, dark, and quiet

• Avoid screens for at least 30 minutes before bed

• Skip caffeine after noon

• Don't drink alcohol close to bedtime

• Get sunlight and exercise during the day

• Use your bed only for sleep

Therapy

Cognitive behavioral therapy for insomnia (CBT-I) is the most effective treatment for ongoing insomnia. It helps you change the thoughts and habits that keep you from sleeping well.

CBT-I can help you:

• Stop associating your bed with stress and frustration

• Challenge negative thoughts about sleep

• Build a stronger connection between being in bed and being asleep

• Learn relaxation techniques

CBT-I usually takes 4-8 sessions. You can work with a therapist in person, use an online program, or follow a workbook.

Relaxation techniques

When your body is stuck in a stressed state, relaxation techniques can help shift it back to calm:

• Deep breathing. Breathe in slowly for 4 counts, hold for 7, breathe out for 8. This activates your body's relaxation response.

• Progressive muscle relaxation. Tense and release each muscle group, starting from your toes and working up.

• Worry time. Set aside 10-15 minutes earlier in the day to write down your worries. When they pop up at night, remind yourself you've already dealt with them.

Medication

In some cases, a healthcare provider may recommend medication. Options include:

• Sleep aids like zolpidem (Ambien) or eszopiclone (Lunesta), which help you fall or stay asleep

• Low-dose antidepressants like trazodone which can help with both sleep and anxiety

• Melatonin-like medications like ramelteon (Rozerem), which work with your body's natural sleep cycle

Medications are usually most helpful when combined with therapy and good sleep habits.

Natural sleep aids

If you're looking for a natural alternative to melatonin supplements or prescription sleep medications, you can try Sip2Sleep®. It's a drinkable supplement made with two natural ingredients: Montmorency tart cherry extract and Rafuma Leaf (Venetron®).

In our observational study, participants using Sip2Sleep® experienced:

• Better sleep quality

• Less severe insomnia symptoms

• Lower anxiety levels

• Improved daytime alertness

Montmorency tart cherry extract is a natural source of melatonin. It also helps increase the availability of tryptophan, an amino acid your body uses to make serotonin. Research from Louisiana State University found that older adults with insomnia who drank tart cherry juice twice daily for two weeks slept nearly 90 minutes longer per night.

Rafuma Leaf (Venetron®) is a plant extract that supports serotonin levels and has a calming effect through the GABA system. Unlike St. John's Wort, it doesn't interfere with the CYP3A liver pathway, which means it's less likely to interact with other medications.

Together, these ingredients help address both the anxiety and sleep sides of the cycle without causing next-day grogginess or risk of dependency.

When should you see a healthcare provider?

Consider talking to a doctor if:

• You've had trouble sleeping at least 3 nights a week for several months

• Your sleep problems are affecting your work, relationships, or daily life

• You're using alcohol regularly to fall asleep

• You want to rule out other conditions like sleep apnea

A healthcare provider can help figure out what's causing your sleep problems and recommend the right treatment.

Why does treating anxiety and insomnia matter?

Sleep affects almost every part of your health. When you don't sleep well over time, your risk increases for:

• Depression

• Heart disease

• High blood pressure

• Type 2 diabetes

• Weight gain

Poor sleep also makes it harder to concentrate, remember things, and manage emotions. And because poor sleep makes anxiety worse, leaving it untreated keeps the cycle going.

The bottom line

Anxiety and insomnia often go hand in hand. Anxiety makes it hard to sleep, and poor sleep makes anxiety worse. But this cycle can be broken with good sleep habits, therapy like CBT-I, and natural sleep aids like Sip2Sleep®. If your sleep problems are affecting your daily life, talk to a healthcare provider about your options.

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. If you have concerns about your sleep or mental health, talk to a healthcare provider.

Frequently asked questions

Can anxiety affect your sleep?

Yes. Anxiety keeps your body in a stressed state, which makes it harder to fall asleep and stay asleep. Racing thoughts, muscle tension, and elevated stress hormones can all interfere with sleep.

Why is anxiety worse at night?

During the day, you have distractions, work, conversations, and activities. At night, when things are quiet, your mind has more space to think about worries. Your body's stress hormones can also stay elevated if you're anxious, making it harder to wind down.

What is the 3-3-3 rule for anxiety sleep?

The 3-3-3 rule is a grounding technique. When you feel anxious, you name 3 things you can see, 3 things you can hear, and move 3 parts of your body. It helps shift your focus away from anxious thoughts and back to the present moment. Some people find it helpful when racing thoughts keep them awake.

How do you deal with insomnia due to anxiety?

Start with good sleep habits, consistent sleep times, a dark and cool bedroom, and no screens before bed. Relaxation techniques like deep breathing can help calm your body. If the problem continues, cognitive behavioral therapy for insomnia (CBT-I) is the most effective long-term treatment. Natural sleep aids, like Sip2Sleep®, can also help.

What helps with anxiety at night?

Deep breathing, progressive muscle relaxation, and grounding techniques like the 3-3-3 rule can help. Setting aside "worry time" earlier in the day can also reduce racing thoughts at bedtime. Avoiding caffeine, alcohol, and screens in the evening makes a difference, too.

Can I cure anxiety without medication?

Many people manage anxiety without medication. Therapy—especially cognitive behavioral therapy (CBT)—is very effective. Regular exercise, good sleep habits, relaxation techniques, and natural supplements can also help. For some people, medication is still the best option. A healthcare provider can help you figure out what's right for you.

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