Your question: Why do I wake up with anxiety in the middle of the night?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy.

As strange as it sounds, anxiety is necessary in small doses. Anxiety is that warning signal our body has that tells us to take quick action to deal with a potential danger. For example, thanks to anxiety, your body knows that you should run away from a dangerous and violent situation, or that you should prepare well for a difficult exam in college.

The problem is when anxiety becomes too recurrent and intense, causing problems in your daily activities. Some people suffer from eating problems when they have anxiety, others see their work or academic performance deteriorate. Many people suffer from anxiety-related sleep problems.

It has been shown (1) that anxiety is linked to difficulties in getting healthy sleep. Insomnia, nightmares, night terrors, sleep paralysis and startled awakening are some of the most common sleep problems associated with anxiety.

When you wake up with anxiety in the middle of the night, it is a sign that you are experiencing intense worries in your daily life. Anxiety manifests itself through thoughts that evoke fear or worry. For example, anxious thoughts about work, health, money or relationships.

These anxious thoughts accumulate and keep you in a constant state of anxiety, which can cause you to wake up startled in the middle of the night, or at dawn. Our brains are more active when we sleep than when we are awake, so even during the sleep period, we are thinking and imagining problems from our day to day lives, whether we are aware of it or not.

Waking up anxious or scared in the middle of the night is then common, and it is not your fault in any sense as no one chooses to have anxiety. However, you have the power to make a change in your life. Already by seeking information about your problem you are taking a valuable step.

By understanding the source of your anxious thoughts and learning how to regulate them, you will be able to improve your quality of sleep, and in general, your quality of life.

Why do you wake up with anxiety in the middle of the night?

Waking up anxious in the middle of the night is a side effect of anxiety. Some people report waking up at exactly a certain time, such as 3 am, but it doesn’t really matter what time it is.

The problem is that waking up with anxiety abruptly interrupts your sleep rhythm and makes it difficult for you to fall back to sleep for the rest of the night. This becomes a problem, because when your sleep is affected, so is your whole life.

Some common causes for waking up in the middle of the night are:

Caffeine

Drinking coffee before bed increases the likelihood that you will wake up with anxiety in the middle of the night. This happens because caffeine is a nervous system stimulant, and it puts your body in a state of alertness similar to anxiety. Caffeine stays in your system, causing you to feel abrupt energy impulses that can appear while you are sleeping or trying to fall asleep.

Daily stress

Many people believe that when they sleep they “disconnect” from the world. This is false, in fact, most brain activity occurs when people are sleeping. Daytime worries such as work, money, school and relationships cause anxiety and can cause you to wake up scared in the middle of the night.

Nightmares or night terrors

The link between nightmares and anxiety has been extensively studied (2), in particular the distress generated by nightmares and night terrors. Nightmares and night terrors can cause a person to wake up in the middle of the night startled, often screaming, sweating and in intense agitation. While there is no single cause that determines the origin of nightmares and night terrors, they are commonly associated as an additional consequence of the intense anxiety that people experience when they are awake.

How can you avoid waking up with anxiety?

There are several strategies you can consider to cope with anxiety, specifically the anxious feeling you experience when you wake up abruptly in the middle of the night. These strategies should be supplemented with the help of a professional, such as a psychologist or sleep physician.

Breathing and relaxation

Breathing exercises before bedtime are quite helpful. Close your eyes and inhale for 4 seconds, then exhale for another 4 seconds. As you do this, feel the tension in your body decrease. It is also useful to repeat calming phrases to yourself, and imagine relaxing scenarios before going to sleep. For example, you can say to yourself mentally or out loud “this is your time to rest, whatever is worrying you now, you will deal with it tomorrow”.

Exercise

Light stretching exercises before bedtime are useful to help you fall asleep. By doing so, it helps your sleep period to regularize, thus avoiding the annoying abrupt and anxious awakening.

Decrease caffeine

When you drink coffee or caffeinated beverages all the time, you tend to be hyperstimulated. This chemical stimulates the brain and keeps it in a constant state of wakefulness waiting for a jolt, so reducing the levels you consume on a daily basis will help.

In my experience…

Waking up with anxiety is common, because anxiety keeps your body in a state of intense worry. By learning to regulate your thoughts and emotions, you are coping with anxiety and the sleep problems it causes. It is also necessary to seek professional help from a psychologist or sleep doctor, who can help you employ specific strategies for you if your situation does not improve. 

It may seem like an impossible problem to solve, but you have the ability and determination to deal with it and feel better about yourself. Habits are difficult to unlearn, so if you have felt night anxiety for some time, it will be an uphill task at the beginning.

Don’t give up, every process of personal improvement takes time and perseverance. By seeking help, even virtual help, you are taking an important step towards improving your quality of sleep, and therefore, your quality of life.

References