- Is Stress Keeping You Up at Night?
- Stress & Insomnia: Help & Reasons
- Can Stress Cause Insomnia?
- Does Stress Always Cause Insomnia?
- Can Insomnia Cause Stress?
- What is the Relationship Between PTSD and Insomnia?
- How Do You Know if You Have Insomnia?
- How Do You Know if Insomnia is Caused by Stress?
- What Steps Can Help Address Insomnia and Stress?
- Consult With a Doctor and/or Psychiatrist
- Practice Relaxation Techniques
- Find Time to Exercise
- Boost Your Resilience
- Focus on Sleep Hygiene
- Sleep Disorders
- Anxiety Disorder or Sleep Disorder: Which Comes First?
- Health Risks
- Reduce Anxiety, Sleep Soundly
- Get Help
- Find Out More
- Other Resources
- 5 Ways to Keep Stress From Sabotaging Your Sleep
Is Stress Keeping You Up at Night?
Stress affects your feelings, your body, and the way you act. The right amount of stress can actually help you. It keeps you alert and full of energy. Too much, though, can harm your quality of life and keep you awake at night.
Even though you might feel frazzled, you may try to get by on less sleep than you need. But better sleep can help you fight infections, boost your metabolism, and cut your chances of getting diseases high blood pressure and diabetes. Controlling your stress can improve your rest. It's a win-win.
Stress can show up in different ways. Some common signs, besides sleep loss, include depression, tension, anxiety, and poor focus. You might feel physical signs, too, headaches, upset stomach, fatigue, appetite loss, and chest, neck, or back pain.
Find the source of your stress: Once you know what's causing your discomfort, you can take steps to deal with it. So identify the stress you have at work, at home, and in your relationships.
Get support: Spending time with people who care about you is a key buffer. You can confide in each other or do things that are fun.
Practice having healthy thoughts: What you think, how you think, and what you expect situations can affect how you feel. You can learn to change stressful thinking. One common mistake is to focus on the way things “should” be. (Example: “I should be more productive around the house.
“) Another mistake is to make broad statements one small fact. (Example: “I'm failing at my job because I had one food splurge.”) Many books can teach you how to improve your self-talk.
Certain types of counseling, including cognitive behavioral therapy, can help you focus on more empowering thoughts, too.
Get moving: Exercise eases stress by letting you blow off tension. Flexible muscles are also less ly to become tense when you're stressed. If you have a medical condition, are over age 45, or haven't been active for a while, it’s best to check with your doctor before starting an exercise routine, so you know what's OK for you to do.
Eat a better diet: You probably already know how smart it is to eat more fruits, vegetables, and whole grains, and less sugar, caffeine, and alcohol. When you make that shift, you'll have more energy to handle stress.
Lighten your load: Having too many commitments or responsibilities on your schedule can lead to stress. Start asking others for help, and find ways to free up more of your time.
Take steps to improve your sleep: Set a regular bedtime and waking-up time, and stick to them. Before you go to bed, wind down with meditation or relaxation techniques. Just sitting quietly for a few minutes can make a difference.
If your sleep problems persist, talk to a doctor. They can help you address your stress and help you figure out what's causing it.
American Psychological Association.
Harvard Health Publications.
National Association of Cognitive-Behavioral Therapists.
University Health Center, University of Georgia.
© 2019 WebMD, LLC. All rights reserved.
Stress & Insomnia: Help & Reasons
Lack of sleep has been a steadily escalating problem in America. Nearly one third of adult Americans say that they get insufficient sleep, and the CDC even went so far as to call the situation an epidemic.
There is no single cause behind this national sleep deficit, but insomnia is a driving factor. Insomnia is a sleep disorder that inhibits a person from being able to fall asleep when they want to (known as sleep onset insomnia) and/or stay asleep through the night (sleep maintenance insomnia).
At the same time, Americans report significant amounts of regular stress. The American Psychiatric Association’s annual Stress in America survey has continually found that people describe their stress to be well above what they perceive as a healthy level.
The fact that both stress and insomnia are significant problems appears to be more than coincidental.
As anyone who has spent a night tossing and turning with grief, worry, or anger knows, difficult emotions can have a direct bearing on sleep.
A growing body of research studies supports this anecdotal experience, finding that all types of stress can harm sleep quality and that sleep deprivation can fuel further stress and irritability.
While these are worrying trends, the good news is that there are ways to treat insomnia and better manage stress. Taking steps to address these problems can have positive impacts on mood and sleep. The following sections cover the key background so that you can be informed and empowered to make healthy changes to feel and sleep better.
Can Stress Cause Insomnia?
Stress has long been known to be linked with sleep problems. Most people have experienced this connection at some point in their life when difficult circumstances may have made it hard to get to sleep or fall back asleep after waking up in the night.
Researchers have verified this relationship in a bevy of studies across different cultures, age groups, and types of stressors. For example, a study in Sweden found that a stressful work environment significantly increased the risk of episodes of insomnia.
In Japan, employees with high stress levels, especially when working hard for limited rewards, were more ly to develop insomnia, and a study in South Korea found a strong correlation between job stress and insomnia even when controlling for variables work demands and limited rewards.
A study of college students in the United States found that stress from family life contributed to an increased risk of insomnia, and the risk was even higher when combined with stress from academic pressure. Stress can take a toll on children, raising their risk of insomnia as it does in adults. Worries about their social life and school can contribute to sleeping problems for adolescents and teens as well.
While there’s no shortage of experimental data confirming the connection between stress and sleep, recent developments in sleep science have offered a more robust understanding of the “why” behind this connection.
Stress induces a range of bodily reactions in the brain and nervous system, endocrine (hormone) system, and immune system.
Experts have increasingly come to identify the specific elements of the stress response that contribute to what is known as a state of hyperarousal in which the brain and body operate as if “on alert.”
Hyperarousal has come to be seen as a central underlying driver of insomnia. For people with insomnia, this state persists throughout the day, but at night, it manifests as the inability to fall asleep or to quickly get back to sleep after an unwanted awakening.
Different scientific models explain hyperarousal as a function of cognitive factors (such as worrying) and neurophysiological elements (specific reactions in the nervous or endocrine systems), but all of these models recognize the potential for various types of stressors to contribute to hyperarousal.
To make matters worse, once stress comes to affect sleep, it can kick off a downward spiral as the lack of sleep makes a person more irritable and emotionally reactive.
Sleeping problems themselves can become an added source of stress, and time spent lying awake in bed may induce further rumination and anxiety.
Taken together, hyperarousal is a key cog in the development of insomnia, and once insomnia has begun, the lack of sleep may facilitate an even more acute sense of hyperarousal.
Does Stress Always Cause Insomnia?
While stress can promote insomnia, not everyone who experiences stress suffers from sleeping problems. There are two main explanations for why this is the case.
First, not all stressors are the same. The nature of stress as well as its severity and duration can all play a part in how much personal impact is actually felt. In most cases, the presence of multiple stressors is an aggravating factor.
Second, every individual responds to stress in different ways. Even when facing the same stressor, some people are more negatively affected than others.
This is represented by the terms “emotional reactivity,” “stress reactivity,” or in more recent years, “resilience.” Resilience is a person’s ability to adapt and “bounce back” after stressful episodes.
It doesn’t mean that a person with high resilience never feels pain or experiences sadness, but they are able to navigate those emotions and move forward in a healthy way.
More and more, sleep experts are connecting resilience to sleep. The concept of sleep reactivity represents how ly a person is to suffer from symptoms of insomnia after a stressful event.
While this is still an emerging area of research, multiple studies have already found that people with low resilience are more prone to insomnia and that a focus on improving resilience may provide a viable avenue for helping to prevent serious sleeping problems.
It is not fully understood why some people have lower resilience and more sleep reactivity than others. Indications are that it may have a connection to genetics and a family history of insomnia.
Gender and exposure to external stressors are also believed to influence sleep reactivity.
While many of these factors are outside of a person’s control, experts also emphasize that virtually anyone can take straightforward steps to boost their resilience.
Can Insomnia Cause Stress?
Yes, insomnia can play a part in contributing to stress. Sleep deprivation affects mood, making someone more ly to be short-tempered, frustrated, and irritable. All of these things can create tension and heighten the risk of getting stressed out.
At the same time, insomnia can exacerbate stress because it creates a new stressor (sleeping problems) and because it provides a person with additional time — such as when they are lying awake in bed — to fret about the problems that they are facing, reinforcing their state of hyperarousal.
What is the Relationship Between PTSD and Insomnia?
Post-Traumatic Stress Disorder (PTSD) is a specific stress-related condition that is closely connected to insomnia. PTSD can arise after someone is exposed to one or more traumatic events, many of which are violent, emotionally painful, and/or life-threatening.
People with PTSD often experience symptoms including hyperarousal, negative emotions, avoidance, flashbacks, fatigue, and headaches.
Sleeping problems are also common; research has found that between 70% and 91% of people with PTSD report having issues falling asleep or staying asleep.
How Do You Know if You Have Insomnia?
The only way to know for sure if you have insomnia is to talk with a doctor. During your appointment, the doctor will ly ask a number of questions to better understand your sleeping problems.
You may be asked to keep a sleep diary that shows how much and at what times you sleep over a period of a week or more.
Depending on your situation, the doctor may order other tests including blood work or an overnight sleep study (polysomnography).
These steps are necessary because insomnia is a sleep disorder that has specific diagnostic criteria laid out in sleep classification systems such as Third Edition of the International Classification of Sleep Disorders (ICSD-3) and the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Your doctor utilizes your sleep diary and other tests to determine whether your situation meets the formal criteria for insomnia or any other sleep disorder.
How Do You Know if Insomnia is Caused by Stress?
While stress can be a major driver of insomnia, it’s certainly not its only cause. In addition to stress, some of the other possible factors related to insomnia include:
- Poor habits around sleep such as inconsistent sleep times, excess caffeine, or behaviorally-induced insufficient sleep syndrome
- Mental health conditions including depression, bipolar disorder, and anxiety disorder
- Chronic pain, arthritis, and other health conditions
- Other sleep disorders such as obstructive or central sleep apnea or Restless Leg Syndrome
- Circadian rhythm sleep-wake disorders including those related to jet lag and shift work
Some people are affected by more than one of these causes of insomnia, so it is not always simple to determine exactly why a person has insomnia. However, if your sleeping problems started during an especially stressful period or seem to be heightened during periods of difficulty in your work or personal life, it may be a sign that they are tied to your stress levels.
What Steps Can Help Address Insomnia and Stress?
Unfortunately, many people accept sleeping problems insomnia as normal or an unchangeable issue. The reality is that most people can meaningfully improve their sleep and shouldn’t accept sleep deprivation as a fact of life.
The best way to address insomnia depends on the person and their specific situation, but there are a number of methods that can go a long way to getting better sleep including if your sleeping problems are related to stress.
Consult With a Doctor and/or Psychiatrist
When sleeping problems are affecting your everyday life, it’s important to see a doctor who can do a thorough evaluation to help identify the possible causes. Following the established diagnostic process can determine if there are any more serious underlying health issues that need to be addressed and can guide the doctor in identifying the most appropriate therapy to meet your needs.
In many cases, it can be meaningful to work with a psychiatrist or counselor as well. These trained professionals can work with you to reduce stress levels, build resilience, and promote emotional well-being. Your doctor can usually make a referral to a qualified counselor for an appointment.
Practice Relaxation Techniques
Relaxation techniques are a useful tool for managing stress and hyperarousal that hinder sleep. These are techniques that you can use throughout the day, including at bedtime. Keep in mind that what helps one person relax may not work for other people. For that reason, the best bet is to try out different approaches to find the ones that offer you the greatest benefit.
- Meditation: research has found that meditation, including mindfulness meditation, can deliver meaningful health benefits with virtually no downside. Not only is it useful in managing stress, but studies have shown that it can help fight insomnia as well.
- Deep breathing: one of the simplest ways to relax is to control your breathing. Just ten deep breaths can have a positive effect, and more involved deep breathing exercises are available for enhanced relaxation.
- Progressive muscle relaxation: this is a technique that involves tensing and releasing muscles throughout the body in a specific sequence. It can help relieve both mental and physical stress and may be beneficial before bedtime.
Find Time to Exercise
Getting daily exercise can help reduce stress and make it easier to get quality sleep. This doesn’t mean you need to run a marathon; even just moderate exercise can be a boon to your mood and sleep, especially if it’s consistent. Exercise offers a bevy of other benefits for other aspects of your health as well.
Boost Your Resilience
Becoming more resilient doesn’t necessarily happen overnight, but with some practice, you can work to optimize your response to stress. Science-based strategies reframing your thoughts, carefully facing your fears, employing self-compassion, meditating, and practicing forgiveness can all provide a noticeable boost to your resilience.
Focus on Sleep Hygiene
It can be easy to lose sight of how our daily habits influence our ability to sleep well. The concept of sleep hygiene focuses on how to use your habits and routines to your advantage when it comes to sleep. It also includes optimizing your sleep environment so that you can relax and rest easy when you turn in for the night.
There are myriad ways to upgrade your sleep hygiene, but some key examples include:
- Avoiding caffeine or other stimulants in the late afternoon and evening when they could make it hard to get to sleep.
- Setting a consistent sleep schedule so that your body and circadian rhythm work to your benefit.
- Following the same bedtime routine every night to help you mentally and physically wind down in preparation for sleep.
- Making your bed comfortable and supportive and your bedroom free of excess external light or sound that might be disruptive.
- Minimizing the use of electronic devices, including mobile phones, in the hour leading up to bedtime because they create mental stimulation and emit blue light that can suppress the body’s production of melatonin, a hormone that promotes sleep.
- Stopping the common practice of tossing and turning. If you can’t fall asleep within about 20 minutes of going to bed, get up and do a low-key activity ( reading) in dim light until you start to feel drowsy.
Many of us toss and turn or watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine.
More than 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million report sleeping problems occasionally, according to the National Institutes of Health.
Stress and anxiety may cause sleeping problems or make existing problems worse. And having an anxiety disorder exacerbates the problem.
Sleep disorders are characterized by abnormal sleep patterns that interfere with physical, mental, and emotional functioning. Stress or anxiety can cause a serious night without sleep, as do a variety of other problems.
Insomnia is the clinical term for people who have trouble falling asleep, difficulty staying asleep, waking too early in the morning, or waking up feeling unrefreshed.
Other common sleep disorders include sleep apnea (loud snoring caused by an obstructed airway), sleepwalking, and narcolepsy (falling asleep spontaneously). Restless leg syndrome and bruxism (grinding of the teeth while sleeping) are conditions that also may contribute to sleep disorders.
Anxiety Disorder or Sleep Disorder: Which Comes First?
Either one. Anxiety causes sleeping problems, and new research suggests sleep deprivation can cause an anxiety disorder.
Research also shows that some form of sleep disruption is present in nearly all psychiatric disorders. Studies also show that people with chronic insomnia are at high risk of developing an anxiety disorder.
The risks of inadequate sleep extend way beyond tiredness. Sleeplessness can lead to poor performance at work or school, increased risk of injury, and health problems.
In addition to anxiety and mood disorders, those with sleep disorders are risk for heart disease, heart failure, irregular heartbeat, heart attack, high blood pressure, stroke, diabetes, and obesity.
If you suspect you have a sleep disorder, visit a primary care physician, mental health professional, or sleep disorders clinic. Treatment options include sleep medicine and cognitive-behavior therapy, which teaches how to identify and modify behaviors that perpetuate sleeping problems.
Treatment options for an anxiety disorder also include cognitive-behavior therapy, as well as relaxation techniques, and medication. Your doctor or therapist may recommend one or a combination of these treatments. Learn more about treatment options.
Reduce Anxiety, Sleep Soundly
To reduce anxiety and stress:
- Meditate. Focus on your breath — breathe in and out slowly and deeply — and visualize a serene environment such as a deserted beach or grassy hill.
- Exercise. Regular exercise is good for your physical and mental health. It provides an outlet for frustrations and releases mood-enhancing endorphins. Yoga can be particularly effective at reducing anxiety and stress.
- Prioritize your to-do list. Spend your time and energy on the tasks that are truly important, and break up large projects into smaller, more easily managed tasks. Delegate when you can.
- Play music. Soft, calming music can lower your blood pressure and relax your mind and body.
- Get an adequate amount of sleep. Sleeping recharges your brain and improves your focus, concentration, and mood.
- Direct stress and anxiety elsewhere. Lend a hand to a relative or neighbor, or volunteer in your community. Helping others will take your mind off of your own anxiety and fears.
- Talk to someone. Let friends and family know how they can help, and consider seeing a doctor or therapist.
To sleep more soundly:
- Make getting a good night’s sleep a priority. Block out seven to nine hours for a full night of uninterrupted sleep, and try to wake up at the same time every day, including weekends.
- Establish a regular, relaxing bedtime routine. Avoid stimulants coffee, chocolate, and nicotine before going to sleep, and never watch TV, use the computer, or pay bills before going to bed. Read a book, listen to soft music, or meditate instead.
- Make sure your bedroom is cool, dark, and quiet. Consider using a fan to drown out excess noise, and make sure your mattress and pillows are comfortable.
- Use your bedroom as a bedroom — not for watching TV or doing work — and get into bed only when you are tired. If you don’t fall asleep within 15 minutes, go to another room and do something relaxing.
- Regular exercise will help you sleep better, but limit your workouts to mornings and afternoons.
- Avoid looking at the clock. This can make you anxious in the middle of the night. Turn the clock away from you.
- Talk to your doctor if you still have problems falling asleep. You may need a prescription or herbal sleep remedy.
Find a Therapist who treats anxiety disorders.
Find a sleep disorders clinic.
Find Out More
American Sleep Association
Sleep Disorders Health Center (WebMD)
Can’t Sleep? Sleep Expert Has the Answers
ADAA Member Philip Muskin Discusses Sleep (CBS News)
For more information about sleep disorders, BetterHelp has more information on the subject.
5 Ways to Keep Stress From Sabotaging Your Sleep
Kai/Aflo / Getty Images
Are you stressed enough over finances, your job, relationship conflict or other stressors that you're experiencing insomnia? You're not alone! While sleep researchers generally agree that insomnia prevalence statistics vary because of the criteria used to define insomnia, at any one time about one-third of adults sampled will experience some form of insomnia, either difficulty going to sleep, trouble staying asleep, or insomnia so severe that it disrupts daytime activities. New diagnostic criteria for insomnia released in 2020 reinforce the connections between insomnia, anxiety, and depression. Although not always stress-related, these associations with mental health and the pace of daily living make insomnia an important topic for us to discuss here.
Because sleep is so important to overall health, insomnia can affect your life in many ways. A sleep deficit can make you feel mentally slower and more emotional, which can exacerbate your experience of stress.
Dealing with lasting insomnia can cause stress, too, which can lead to more stress-related insomnia. And, if your insomnia is stress-related to begin with, being overly tired and stressed does nothing to help solve the problems creating the stress in the first place.
Here are a few things to try if you are dealing with stress-related insomnia.
Tension in your body can make it difficult to sleep. While people often don't even realize when they're stressed about something, their bodies are feeling the stress, and are tensed up as a result.
Progressive muscle relaxation has been an accepted evidence-based treatment for insomnia for twenty years. PMR is a great tool for de-stressing your body.
If you find yourself waking up in the night because you can't stop thinking about something that's causing you stress during the day, journaling may be an effective technique for you.
The act of journaling carries several health and stress management benefits. In this context journaling can help you clear your mind, process strong emotions that are causing you to lose sleep, and brainstorm and construct plans that can help you manage the situations causing you stress.
If you're losing sleep due to anxiety, you may be able to relax and get better sleep with a change of perspective.
Anxiety, including the type that keeps you up at night, is often a natural response to situations that need some sort of action.
Viewing your situation as a challenge to be faced, rather than a threat, can help you get into an active, decision-making mode rather than remain in an anxious, passive state.
Looking at a situation from different angles can help you see opportunities you may have missed. Cognitive restructuring can help you change your perspective on a stressful situation.
As mentioned, when losing sleep becomes a regular occurrence, bedtime itself can become stressful. If you've reached this point, there are a few things you can do to take the stress off insomnia.
First, if you're having trouble sleeping, you might want to get up and do something after a few minutes, when you're sure that sleep is a long way off. (This helps take the pressure off watching the clock for hours, and can help you feel more in control of your time as you engage in other activities.)
It's also a good idea to use your bedroom primarily for sleep so that you associate your bed and your bedroom with sleep and not stress. Think of getting up and reading a book, getting things done around the house, and doing other not-too-stimulating activities that can help foster sleep when you're ready. Also, avoid caffeine during the afternoon and evening.
Many people who suffer from insomnia do not seek help. This is unfortunate because several interventions can help with insomnia, including cognitive-behavioral therapy and medication, and can help you take charge of stress-related insomnia.
If you're experiencing persistent insomnia, consider talking to your doctor about your options.
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