Anxiety and Quality of Sleep: Pathways for Managing Sleep Disturbances

By: Suzanne Feinstein, PhD

Between 50 and 70 million Americans have a sleep disorder. Approximately one in three–or 84 million–adults do not get the regular sleep they need to protect their health. 

There are many causes of insomnia and other sleep disorders. One of the most common is anxiety. As much as one-fifth of the U.S. population suffers from some type of anxiety disorder. 

The good news is that there are many effective treatments for anxiety and related sleep issues. The first step is a proper diagnosis. 

This article explains the relationship between anxiety and quality of sleep. Keep reading to learn more about this dynamic, as well as effective treatments for addressing it. 

Sleep Disorder Basics

There are many different kinds of sleep disorders. One example is narcolepsy which is a chronic neurological condition that causes excessive daytime sleepiness and suddden brief attacks of daytime sleep. Restless leg syndrome (RLS) is another type of sleep disorder that is caused by unpleasant sensations in the legs that create a relentless urge to move the legs, subsequently disrupting one’s quality of sleep. Sleep apnea is a third example of a disorder that can disrupt sleep or cause poor sleep patterns. It is a disorder which causes breathing to stop and start throughout the sleep cycle and can lead to serious health concerns.

There are also a host of mental health conditions, including anxiety, that can cause insomnia, or the inability to go to sleep or stay asleep. In fact, insomnia is one of the most common symptoms of anxiety

How Does Anxiety Disrupt Sleep?

Many people experience anxiety associated with particular events. For others, anxiety is an ongoing, recurring (if not incessant) condition.  

Anxiety can impact sleep because it produces a state of mental hyperarousal. It can result in the person ruminating about various concerns while in bed, which keeps them from falling asleep. 

Stressful life circumstances can bring about or exacerbate sleep reactivity. Someone with an anxiety disorder is more likely to have sleep disrupted by daily stressors than someone who does not have the condition. 

There is also an insidious, cyclical relationship between anxiety and insomnia. In short, not getting quality sleep can make anxiety worse, which in turn worsens the insomnia.  

How to Treat Anxiety and Insomnia?

There are many different ways to approach anxiety and related sleep disorders. It begins with a proper diagnosis. 


One of the first steps to addressing anxiety’s impact on sleep is to receive an evaluation by a mental health professional. In addition to insomnia, they will look for some of the following symptoms:

  • Headaches
  • Muscle tension
  • Digestive issues
  • Excessive worrying
  • Low self-esteem
  • Difficulty concentrating
  • Irritability
  • Increased heart rate 

A variety of different anxiety disorders are seen to impact sleep quality. A sleep specialist can perform an in-depth evaluation to properly determine the specific types of anxiety involved. These may include:

  • Generalized anxiety disorder
  • Panic disorder
  • Social anxiety disorder
  • Phobia-related disorders, including somniphobia (the fear of falling asleep)
  • Post-traumatic stress disorder (PTSD)

A proper diagnosis is important because the treatment regimen for someone with generalized anxiety or social anxiety disorders would be much different than for someone with PTSD. Likewise, an individual with sleep anxiety would need treatments distinct from a patient with a panic disorder.  


Just as the causes of anxiety are varied, so are the related treatments. The most common and effective treatment for anxiety is psychotherapy. Typical approaches include cognitive-behavioral therapy, dialectic behavior therapy, and exposure therapy. 

Cognitive-Behavioral Therapy and Dialectic Behavior Therapy

Cognitive-behavioral therapy (CBT) and dialectic behavior therapy (DBT) overlap in their goals. DBT is a form of CBT that is designed for people who strongly experience thoughts or emotions. 

Both try to address faulty or unhelpful thought patterns that cause or worsen anxiety. This is based on the idea that psychological problems are in part learned patterns. 

Someone with anxiety can be taught to identify distortion in thinking. CBT helps them reevaluate motivations and learn coping skills for external stressors. 

In short, patients learn healthier ways of addressing thoughts and feelings. This, in turn, alleviates anxiety and related insomnia. 

Exposure Therapy

Another CBT technique commonly used to treat anxiety is exposure therapy. It involves a technique known as “systematic desensitization.”

This involves the clinician exposing patients to anxiety-inducing objects or situations in a safe setting. The individual then practices relaxation techniques that they can use during real-world scenarios.

Interpersonal Therapy

Interpersonal therapy is another effective way to combat anxiety. It focuses on conflicts with family members, friends, coworkers, or others. 

In particular, it helps address avoidance and communication problems. It also teaches healthier ways to relate to others. It can be very useful for people with anxiety that stems from relationships.   


Another, separate aspect of anxiety and insomnia treatment is self-care. This refers to lifestyle changes people can make to help diminish the effects of anxiety and insomnia.  

These can include things like working to limit caffeine or nicotine, and getting plenty of exercise. It could also entail making time to do things you enjoy, including hobbies or spending time with family or friends. Socialization can help build a support network for the individual, which can greatly benefit mental health.

The individual might practice mindfulness or start doing yoga. They can work to improve their sleep environment or try different sleep positions.


In many cases, medication and sleep aids can help control or eradicate anxiety and improve quality of sleep. This can be particularly useful in breaking the cycle mentioned above. 

For people with anxiety-related insomnia, medical treatment is usually combined with other treatments. That is because the goal is to get to the root of the issue, not simply mask the symptoms.

Find Treatment Near You

Now that you understand the relationship between anxiety and quality of sleep, you can take steps to address this issue. A qualified mental health professional can further advise you on the best treatment options to ensure success. 

Since 1995, Advanced Behavioral Health has been treating clients with a range of conditions, including anxiety, insomnia, depression, mood-related disorders, obsessive-compulsive disorder, and many other conditions. We are located in Midtown Manhattan and specialize in cognitive behavior, dialectic behavior, and other mindfulness-based therapies. Reach out to us today to schedule an appointment to discuss treatment for anxiety and insomnia.

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