How anxiety and depression affect your sleep
If you have ever wondered, can anxiety or depression cause sleep problems, you are not alone. Trouble falling asleep, waking up in the night, or feeling unrefreshed in the morning is very common when you live with ongoing worry or low mood. In fact, sleep issues are so closely tied to mental health that they are often one of the first signs that something is off.
You might notice:
- Lying awake with your mind racing
- Waking up too early and not being able to fall back asleep
- Sleeping a lot, but still feeling exhausted
Understanding how anxiety, depression, and sleep interact can help you spot patterns and take practical steps to sleep better.
The two‑way link between mood and sleep
Anxiety, depression, and sleep problems have what experts call a bidirectional relationship. That means each one can worsen the others.
- Poor sleep can raise your risk of developing anxiety and depression.
- Existing anxiety or depression can make it much harder for you to fall or stay asleep.
Research suggests:
- Most people with depression have some kind of sleep issue, including insomnia or daytime sleepiness (Sleep Foundation).
- Anxiety is the most common mental health condition in the United States, affecting about 40 million people, and most people with anxiety also experience sleep disruption (Cleveland Clinic).
So if you notice your mood slipping and your sleep getting worse at the same time, that pattern makes sense. The good news is that improving one part of the cycle, such as sleep, can also support the others.
How anxiety can cause sleep problems
When you feel anxious, your brain and body tend to stay on high alert. That state of hyperarousal can make falling or staying asleep a real challenge.
What anxiety‑related sleep problems feel like
You might notice:
- Lying in bed replaying conversations or worrying about tomorrow
- Feeling a rush of energy or nervousness at bedtime, even if you felt tired earlier
- Waking up in the night with a jolt of fear or a racing heart
- Having vivid, unsettling dreams or nightmares
Anxiety disorders are defined by ongoing worry and unease that interfere with daily life. That same mental overactivity often shows up at night as you try to wind down, which can lead straight to insomnia (Sleep Foundation).
Sleep anxiety and fear of going to bed
For some people, the anxiety is not just general worry, it becomes focused on sleep itself. This is often called sleep anxiety.
You may:
- Dread bedtime because you expect another sleepless night
- Check the clock repeatedly and count down the remaining hours
- Feel panicked if you are not asleep by a certain time
Sleep anxiety can make it harder for you to fall asleep, stay asleep, and feel rested, which then increases your daytime anxiety. This creates a loop where anxiety worsens sleep and poor sleep raises anxiety (Cleveland Clinic).
Nighttime panic and disturbed dreams
Chronic anxiety can raise your stress hormones in the evening, exactly when your body should be powering down. You might:
- Take a long time to relax enough to fall asleep
- Wake during the night with stressful or worrisome thoughts that keep you up
- Experience nocturnal panic attacks, which are sudden waves of fear that wake you from sleep (Cleveland Clinic)
Anxiety can also affect your rapid eye movement (REM) sleep. That is the stage of sleep when most dreaming occurs. Disturbing dreams and nightmares that wake you abruptly may be more common when your anxiety is high (Cleveland Clinic).
How depression can cause sleep problems
Depression and sleep are deeply connected. If you are living with depression, you are very likely to notice a change in your sleep pattern.
Insomnia and early morning waking
Up to 80% of people with depression experience insomnia, including difficulty falling asleep or waking up much earlier than intended and not being able to get back to sleep (Sleep Foundation).
You might:
- Lie awake for long stretches, even when you feel exhausted
- Wake up at 4 or 5 a.m., then feel unable to drift off again
- Notice that your sleep feels shallow or restless
These changes can make your mood worse. The less you sleep, the harder it becomes to concentrate, manage emotions, and feel hopeful, which then deepens depression.
Sleeping too much and still feeling tired
Not everyone with depression sleeps less. Some people sleep more than usual, a pattern called hypersomnia. About 15% of people with depression experience this, and many still feel drained during the day (Sleep Foundation).
You may:
- Sleep long hours at night and still need daytime naps
- Use sleep to escape difficult feelings
- Feel groggy and heavy even after what seems like plenty of rest
Depression can also be linked with other sleep disorders, such as obstructive sleep apnea. Around 20% of people with depression have obstructive sleep apnea, which can cause loud snoring, gasping during sleep, and severe daytime sleepiness (Sleep Foundation).
Changes in your body clock and brain chemistry
Sleep disturbances in depression are not just in your head emotionally. They also involve physical changes.
Research suggests that:
- Sleep problems can disrupt your circadian rhythm, which is your internal 24‑hour clock
- Your body’s stress systems can become overactive
- Serotonin function can be affected, which may raise vulnerability to depression (Sleep Foundation)
These changes can make it harder for you to fall asleep or stay asleep, and they can also deepen depressive symptoms, turning sleep issues into an ongoing cycle instead of a one‑time problem.
When anxiety and depression show up together
Anxiety and depression often overlap. Nearly half of people with depression also have an anxiety disorder, which means you might be dealing with both at the same time (Sleep Foundation).
If that is the case, your sleep might be affected in several ways at once:
- Hard time falling asleep because of worry
- Restless, light sleep with frequent awakenings
- Early morning waking and difficulty going back to sleep
- Either sleeping much less or much more than usual
Co‑occurring anxiety and depression can intensify sleep problems and make them feel more stubborn, so it is especially important for you to get support.
Why these sleep problems rarely fix themselves
If your insomnia is closely tied to anxiety or depression, it might not fully improve until you address the underlying mental health condition.
According to the Mayo Clinic, mental health conditions like anxiety and depression can disrupt sleep and lead to insomnia, and insomnia related to these conditions may not get better without targeted treatment (Mayo Clinic).
Ongoing sleep loss can also:
- Increase the risk that your anxiety or depression will worsen
- Make it harder for you to manage stress and daily responsibilities
- Raise your risk for other health issues over time (Mayo Clinic)
This is why taking sleep problems seriously, especially when you already struggle with mood or anxiety, is an important part of caring for your overall health.
Treatment options that can help you sleep
The encouraging part is that effective treatments exist for both mental health conditions and sleep problems. Often, addressing both together works best.
Cognitive behavioral therapy (CBT and CBT‑I)
Cognitive behavioral therapy, often called CBT, is a structured form of talk therapy that helps you change unhelpful thought patterns and behaviors.
It has been shown to:
- Reduce anxiety symptoms
- Improve sleep problems linked to anxiety and depression (Sleep Foundation)
For long‑term insomnia, including insomnia related to mental health, a specific form called CBT for insomnia (CBT‑I) is recommended. CBT‑I focuses on sleep habits, routines, and beliefs about sleep, and unlike sleeping pills it targets the root causes of insomnia, such as negative thoughts and worries at night (Mayo Clinic).
You might work on:
- Setting a consistent wake‑up time
- Limiting time in bed to reset your sleep drive
- Replacing stressful pre‑sleep thoughts with more realistic ones
If you have already treated your anxiety but still struggle with severe insomnia, CBT‑I can be especially helpful (Sleep Foundation).
Medication and professional care
Medications can sometimes play a role in improving both mood and sleep. These may include:
- Antidepressants for depression or anxiety
- Short‑term sleep medications, if needed, while other treatments take effect
Because some medications can either help or hinder sleep, it is important that you work with a qualified healthcare professional who understands your full picture, including your sleep difficulties.
A mental health provider or sleep specialist can:
- Help you identify whether your sleep problems are mainly due to anxiety, depression, a specific sleep disorder, or a mix
- Suggest a tailored treatment plan
- Adjust approaches over time based on what you notice is working
Improving your sleep habits
Good sleep hygiene will not treat anxiety or depression by itself, but it can make it easier for you to fall and stay asleep while you work on other parts of your health.
You can start with a few manageable changes:
- Keep a steady sleep and wake schedule, even on weekends
- Build a wind‑down routine with calming activities like reading, gentle stretching, or breathing exercises
- Limit screen time and bright light in the hour before bed
- Avoid heavy meals, caffeine, and alcohol close to bedtime
- Reserve your bed for sleep and intimacy so your brain associates it with rest rather than stress
These habits reinforce your natural sleep rhythm and can support other treatments like therapy or medication.
When to talk to a doctor or therapist
You do not need to wait until your sleep is completely disrupted before reaching out for help. It is a good idea to talk with a healthcare professional if:
- You have trouble falling or staying asleep at least 3 nights a week for more than a month
- Your sleep problems are affecting your work, relationships, or daily functioning
- You notice ongoing symptoms of anxiety, such as excessive worry, restlessness, or panic
- You notice symptoms of depression, such as persistent sadness, loss of interest, or changes in appetite or energy
Also seek immediate support if you ever have thoughts about harming yourself. A mental health professional, crisis line, or trusted medical provider can help you find the support you need.
Small steps you can take tonight
If you are asking yourself, can anxiety or depression cause sleep problems, the research makes it clear that the answer is yes. The connection between your mental health and your sleep is strong and two‑way, but that also means that improving one can benefit the other.
To get started, you might try:
- Choosing a consistent wake‑up time and sticking with it for a week
- Setting a 30‑minute wind‑down period before bed with calm, screen‑free activities
- Jotting down worries earlier in the evening so they feel less intense at bedtime
- Making an appointment with your doctor or a therapist to talk about both your mood and your sleep
You do not need to fix everything at once. One small, steady change can begin to shift the cycle toward better sleep and better mental health.
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