When Stress Wakes You Up at Night

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Sometimes middle-of-the-night insomnia can be traced back to something you ate, a medical problem, or a change in hormones. And sometimes, stress is to blame. In fact, about 40 percent of adults say that stress keeps them up at night.

Stress can also interfere with the quality of your sleep. It can make it difficult to reach the deepest stage of sleep, which is necessary for restorative sleep and making you feel well rested the next day.

Insomnia itself can be the source of your stress, trapping you in a vicious cycle. If you can't sleep, your mind may start to race because you're anxious about not being able to drift off. That anxiety can then stand in your way of being able to fall back asleep.

Whether your stress is due to trouble at home, work, difficulty sleeping, or another reason, it's important to do everything you can to put your anxiety to bed. That's because both chronic stress and impaired sleep can increase your risk of depression and more serious health issues, jeopardizing your overall well-being. Here's what you can do to keep stress from keeping you up. 

Try Cognitive Behavioral Therapy

With cognitive behavioral therapy (CBT), you'll work with a therapist to get to the root cause of your stress and difficulty sleeping. You'll learn skills and behavioral changes that will make a difference in your sleep disturbances. For instance, you may learn a variety of relaxation techniques such as meditation, deep breathing, or progressive muscle relaxation, in which you tense and release one muscle group at a time.

You may also learn how to reprogram negative thoughts that add to your anxiety—such as "I'm never going to be able to fall asleep"—with more soothing ones. Working with a therapist on a weekly basis for two to three months can make CBT as effective as prescription medication for treating insomnia.

De-stress During the Day

Try these strategies during daylight hours to reduce stress, quiet your mind, and help you stay asleep when nighttime comes:

  • Say no. Only take on as much as you can handle in your life. Say no to those things that will cause you too much stress.

  • Make a list. A to-do list can help keep you organized and prioritize what's most important. This way you can decide what needs your attention today and what can wait until tomorrow.

  • Stretch. Releasing tension in your muscles can help release tension in your mind.

  • Stay active. Make time for physical activity. It helps improve symptoms of depression and anxiety and also aids sleep.

  • Talk it out. Let a friend or family member know how you're feeling. Sometimes they can offer a new perspective on your challenges and come up with solutions that hadn't occurred to you.

  • Relax before bed. Plan quiet, relaxing activities such as reading a book before bedtime. Establish a specific bedtime routine. This will help you unwind before you try to fall asleep. Taking a hot bath can also help you relax and prepare the body for a restful night of sleep.

  • Skip that nightcap.  Bedtime alcohol may make you drowsy but hours later you'll reawaken from chemicals released as your body breaks down that alcohol.

Key Takeaways

  • About 40% of adults say that stress keeps them up at night. And in a vicious cycle, insomnia itself can be the source of your stress.

  • One treatment option is cognitive behavioral therapy, which involves working with a therapist to uncover the cause of your stress and difficulty sleeping.

  • Other strategies include making a to-do list to help you prioritize, exercising regularly, and doing a relaxing activity before bedtime.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Apr 29

  1. Stress and Your Health Fact Sheet. U.S. Department of Health and Human Services Office on Women’s Health. http://womenshealth.gov/publications/our-publications/fact-sheet/stress-your-health.cfm

  2.  Understanding Chronic Stress. American Psychological Association. http://www.apa.org/helpcenter/understanding-chronic-stress.aspx

  3. How Is Insomnia Treated? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/inso/treatment.html

  4. Your Guide to Healthy Sleep. U.S. Department of Health and Human Services. http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf

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