How to Overcome Sleep Anxiety

Sleep anxiety can be frustrating, exhausting, and even scary when nighttime becomes the moment your anxiety hits hardest. If you find yourself dreading bedtime, lying awake with racing thoughts, or feeling tense as soon as the lights go out, know that sleep anxiety is common and treatable once you understand what’s causing it.

Below, we’ll explore why sleep anxiety happens and what you can do to break the cycle.

A woman in a blue shirt smiles while sleeping on a bed.

Tips for Overcoming Sleep Anxiety

Below are the practices I recommend to help retrain your body and mind to recognize when it is time to sleep.

Address Avoided Thoughts and Emotions

If anxiety spikes at night because you’ve been pushing emotions aside all day, therapy can help you process those feelings in a healthy, supported way. Suppression only intensifies the emotional load. Processing your thoughts and emotions can greatly reduce nighttime overwhelm.

Work Through Triggers With Trauma-Focused Therapy

If nighttime anxiety is linked to past trauma, trauma therapy approaches like Eye Movement Desensitization and Reprocessing (EMDR) or Internal Family Systems (IFS) can help neutralize the trigger. This work takes time, but it’s one of the most effective ways to restore a sense of safety at night.

Consult Your Medical Provider if Physical Factors Are Suspected

Medical conditions, supplements, or medication changes could be affecting sleep. I often recommend that clients get checked out by their doctor first to rule out any medical conditions affecting sleep. Getting a medical evaluation can prevent months of unnecessary or ineffective therapy when the root issue is actually physical. Medical issues need to be addressed by a primary care or sleep doctor.

Improve Sleep Hygiene With Consistent Habits

Small, consistent changes can be incredibly effective. Helpful practices include:

Going to bed and waking up at the same time every day
Creating a calming wind-down routine
Reducing screens before bed
Avoiding caffeine or sugar close to bedtime

What is Sleep Anxiety?

Sleep anxiety refers to worry, fear, or stress that makes it difficult to fall asleep or stay asleep. For some, it shows up as racing thoughts when their head hits the pillow. For others, it may feel like physical tension, restlessness, or a sense of dread about going to bed.

This anxiety can create a loop, causing you to worry about not sleeping/ This makes falling asleep harder, which increases the anxiety the next night. Understanding the underlying cause is the first step toward breaking that cycle.

What Causes Sleep Anxiety?

Sleep anxiety rarely has just one cause. In my work with clients, I see four primary causes that tend to show up again and again:

1. Avoidance of Unpleasant Emotions

Many people stay busy during the day as a way to avoid difficult thoughts or feelings. When those distractions fade in the evening, those emotions finally surface, sometimes all at once. This can lead to anxiety or tension that keeps the mind alert and unable to settle.

2. Triggers Connected to Nighttime or the Bedroom

For some people, something about bedtime brings up distressing memories or emotions from the past. It could be the quiet, the darkness, the sensation of lying down, or even the bedroom itself. When a part of the nighttime routine triggers the nervous system, falling asleep can feel unsafe.

3. Medical or Physical Factors

Sleep anxiety can also be influenced by medical issues, including:

Hormone changes
Caffeine or sugar intake
Recent medication changes
New supplements
Medical conditions that disrupt sleep

Before beginning therapy for sleep issues, I often recommend clients follow up with their primary care provider or a sleep specialist to rule out underlying medical causes. If the root cause is physical, we want to address that first to make therapy more effective.

4. Poor Sleep Hygiene

Even without emotional triggers or medical issues, inconsistent routines can make falling asleep difficult. Common contributors to poor sleep include:

Irregular sleep and wake times
Screen use before bed
No wind-down routine
Exercising late at night

These habits disrupt your circadian rhythm, signaling your body to stay alert instead of preparing for rest.

Anxiety Therapy in Ashburn, Virginia

If nighttime anxiety is affecting your quality of life or daily functioning, our team at Northstar Center is here to help! We provide trauma-informed, evidence-based care designed to help you manage anxiety with clarity and confidence. From the moment you reach out, you can expect responsiveness, reliability, and a supportive environment where you are treated with respect. Contact us to schedule an appointment.