There are few situations quite as frustrating as going through your whole day in a state of exhaustion, only to find yourself completely wide awake at bedtime—a state of affairs that gets only worse when trying to fall asleep also makes you anxious.
Anyone who has struggled to drift off knows that when you’re staring at the ceiling at 2 a.m., the thoughts that pop into your head tend to be anything but rosy. You might start off considering something as innocuous as your to-do list for the next day, but even this can quickly spiral into concerns about your wildest fears, embarrassing memories that no one else possibly cares about or remembers, and terrifying hypotheticals.
Your brain doesn’t care that you’re safe in your bedroom under your coziest blanket—it’s busy hanging out in crisis mode over random worries in your waking life.
What’s insomnia panic really like—and how normal is it?
“Generally what we see is the person attempting to go to sleep, then they begin to ruminate about what they have to do tomorrow, or what they didn’t get done today,” says Ginger Poag, MSW, LCSW, licensed therapist at Brentwood Wellness Counseling in Nashville, Tennessee.
“This can lead to the frantic thoughts, increased heart rate, and difficulty breathing. It’s a vicious cycle—because of the rumination they don’t sleep, and the lack of sleep makes everything feel worse, and then the person becomes anxious and fearful that they will not sleep another night, and then the cycle starts all over again.”
Sound familiar? That lack of sleep can increase your susceptibility to anxiety, which just makes you that much more likely to struggle with the same symptoms again the next night.
According to the Sleep Health Foundation, about one in three people have at least some form of insomnia, which is defined as a regular difficulty in falling or staying asleep. Panic symptoms, like a racing heart and difficulty breathing, are a separate issue—but it’s not uncommon for them to show up alongside insomnia. Panic and anxiety can be terrifying, but they’re treatable, and understanding where they come from is a good first step.
Why is this even happening?
If you’ve got more responsibilities than you can count, you’re more likely to experience panic symptoms as you attempt to juggle it all. Women are particularly susceptible.
“I often see panic issues in clients who are very strong and prone to placing a lot on their shoulders,” says Kelsey M. Latimer, Ph.D., L.P., a licensed psychologist and assistant director of the Center for Discovery. “In a sense, they are asking their minds and bodies to hold an incredible amount—without an opportunity to release it.”
According to Latimer, this phenomenon is why panic and anxiety often show up when our guard is down—like when we’re trying to fall asleep. “Before clients understand that, they often get scared because it seems so counterintuitive to feel panic in times of relaxation,” Latimer says. “However, knowing that we can predict the panic in itself gives it less power and makes it easier to control in a healthy way.”
When panic and insomnia show up together, it can be tough to define the relationship between the two. Sometimes, anxiety is part of the cause of your insomnia. Other times, anxiety and panic show up as a result of the insomnia-induced exhaustion you’re feeling.
So what can you do about it?
Seeing a medical professional is an important step in feeling better, but there are also some practices you can try at home in tandem, like developing mindfulness habits.
“Panic is often based in the shame and blame of the past or worries of the future,” Latimer says. “Basically, anywhere but the present moment. Simple mindfulness practices, which focus a person on the here-and-now, are incredibly effective at reducing anxiety symptoms.”
Practice letting your thoughts just be, rather than engaging with them. “I suggest not fighting the thoughts, but focusing on your breathing to help center yourself,” says Robert Goldman, a New York-based psychiatrist. “Fill your belly with air, hold it for two seconds, then exhale. This is called diaphragmatic breathing and has been proven to reduce anxiety and relax you at the same time.”
Also try to practice good sleep hygiene. You’ve heard this advice a million times before, but that’s because it can really make a difference: Avoid looking at glowing screens before bed, exercise earlier in the day rather than later, and keep work assignments out of the bedroom.
Another easy trick is to keep a notebook and pen next to your bed to capture late-night thoughts. “I teach my patients to write down their thoughts or concerns as they present in their minds,” says S. Frances Robbins, MSN, PMHNP, a psychiatric mental health nurse practitioner and author of The Complete Insomniac’s Workbook to Restorative Sleep. “Having a place to dump their thoughts allows their brains to rest. The notepad will be there in the morning and can be reviewed then.”
So the good news is that these symptoms aren’t a life sentence—you can feel better with proper care. “Insomnia and anxiety are treatable; they are not a character flaw or a problem that can be ignored,” Robbins says.
When you work with a doctor or therapist, you can get to the root of the issues and find a treatment method that works for you—and you’ll get started on a path toward the good night’s sleep you deserve.
Claire Hannum is an NYC-based writer, editor, and traveler.