What to Do When Anxiety Keeps You Awake

People with anxiety have a significantly higher incidence of insomnia, and insomniacs are at much greater risk of developing an anxiety disorder.

Insomnia disorder is common—affecting up to 30 percent of adults. Mental health experts generally define insomnia as difficulty initiating or maintaining sleep, waking too early, sleeping poorly, and reporting daytime impairment or distress. One of the most significant risk factors for insomnia is a co-existing psychiatric disorder, and insomnia is one of the diagnostic symptoms for both depression and anxiety.

If you suffer from anxiety, it's more than just worrying that keeps you up at night. People with mood disorders often have genetically triggered disruptions in the daily biological rhythms that regulate their sleep, body temperature, eating, and activity.

Fortunately, there are effective ways to relieve anxiety and insomnia.

Professional Treatment

Physicians usually prescribe Cognitive Behavioral Therapy (CBT), a type of psychotherapy, or prescription medication for patients with insomnia and anxiety.

There's mounting evidence that CBT and medication together offer patients more sustained relief. In one study, for example, when physicians added a short-term prescription sleeping pill to ongoing CBT, they found it was the optimal treatment for chronic insomnia. A year later, patients who received this combined therapy—rather than just CBT—had higher remission rates than patients who continued to take medication. Furthermore, mental health experts are finding that CBT in a group setting may even be better at maintaining sleep than medication alone.

Other research also demonstrates that combination therapy for insomnia and anxiety disorders significantly improves sleep and daytime functioning. Patients were more alert, better able to concentrate, and reported improved physical well-being. Individuals suffering from depression and insomnia also respond well to similar types of combination therapy.


In addition to seeking professional treatment for anxiety and insomnia, you can help yourself by establishing good sleep habits:

  • Go to bed only when you're tired.
  • Reserve your bed for sleep and sex.
  • Get up and move to another room for a while if you can't fall asleep after 20 minutes.
  • Wake at the same time every morning.
  • Establish rituals that signal it's time to go to sleep, such as brushing your teeth or drinking a cup of herbal tea.

Physicians who treat patients with insomnia emphasize that it's a 24-hour problem, not just a nighttime problem. Insomnia interferes in your ability to function during the day and increases the risk of accidents. Don't wait to seek treatment if your insomnia lasts more than a few days.




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Nierengarten, Mary Beth. "Better Sleep and Daytime Functioning With Combined Therapy for Insomnia and Anxiety." Medscape Medical News. Web. 14 June 2007. http://www.medscape.com/viewarticle/558233

Stein, Jill. "Group CBT Effective for Chronic Insomnia." Medscape Medical News. Web. 2 March 2010.

Anderson, Pauline. "Taper Medication, Continue Behavioral Therapy Best Long-Term Approach for Chronic Insomnia." Medscape Medical News. Web. 21 May 2009. http://www.medscape.com/viewarticle/703172

National Institutes on Health. National Institute of Mental Health. "Cell Networking Keeps Brain's Master Clock Ticking." Science Update. Web. 4 May 2007.

Roth, Thomas Ph.D. "Insomnia: Definition, Prevalence, Etiology, and Consequences." Journal of Clinical Sleep Medicine 3(5 suppl) August 15 (2007): S7-S10. Web. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/