How to get better sleep with anxiety or stress, in 5 different ways

To sleep with anxiety or stress, it’s important to practice good sleep hygiene by having a set bedtime routine each night.
You can also try exercising in the day, meditating before bed, or taking melatonin in order to get better sleep.
Anxiety, stress, and insomnia are closely related, and it may be worth seeking professional help if you often feel anxious and can’t sleep.
This article was medically reviewed by Alex Dimitriu, MD, psychiatrist and founder of Menlo Park Psychiatry and Sleep Medicine.
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Anxiety can make it difficult to fall asleep and stay asleep. This is true both for people with anxiety disorders, and for anyone who is under a large amount of stress.

A 2017 survey found that 45% of Americans reported being kept awake by stress within the past month. At the same time, sleep deprivation can make feelings of anxiety worse.

Here’s what you need to know about the relationship between sleep and anxiety, and how to get better sleep when you’re feeling anxious or stressed.

How to sleep with anxiety

Most adults need 7 to 9 hours of sleep each night, according to the National Sleep Foundation. However, the Centers for Disease Control and Prevention (CDC) says that one-third of adults don’t get enough sleep.

Not sleeping enough can make anxiety worse, research has found. "There is a pretty strong correlation between sleep troubles and anxiety," says Mayra Mendez, Ph.D., a licensed psychotherapist.

However, there are ways to get a good night's sleep even if you are dealing with anxiety, Mendez says. Here's how:

Practice good sleep hygiene. This means going to bed and waking up at roughly the same time every day. You can also have a bedtime routine that includes calming activities, like taking a bath or reading a book. Avoid screens, since research has found that people who use screens select a later bedtime, and feel more drowsy in the morning. Don't do any stressful activities, like managing your finances, in the hour before bed. "If you're thinking about it close to bedtime, there's a stressor," Mendez says.
Exercise. Getting any sort of physical activity during the day can help you sleep better at night. A 2017 scientific review found that exercise "increased sleep efficiency and duration regardless of the mode and intensity of activity."
Try mindfulness meditation. Mindfulness - being aware of what is happening to and around you right now - is helpful, particularly when anxiety hits at bed time or during the middle of the night. "Being aware that you're spinning in worries, fears, or stress can then manage those thoughts," Mendez says. Research has found that mindfulness meditation can help older adults who have trouble sleeping. If you wake up in the middle of the night with anxiety, but aren't used to meditating, Mendez recommends a guided meditation.
Consider taking melatonin. Melatonin is a naturally-occurring hormone that begins rising about two hours before bed and causes a feeling of sleepiness. Although there isn't yet conclusive evidence, some research has indicated that taking a melatonin supplement can help with insomnia. Melatonin has also been found to help with the anxiety before a surgical procedure. Mendez recommends talking to your doctor before starting melatonin, but says, "It can be very helpful to break that cycle of negative anticipation" over lack of sleep.
Know when to get up. Sometimes, sleep troubles can build anxiety because you know you should be asleep. If you haven't fallen asleep within 20 minutes, get out of bed. "It's better to not fight it," Mendez says. "Get up and do something soothing, allowing your brain to calm." Follow the same guidelines for the hour before bed, avoiding screens or other stimuli and opting for quiet, calm activities like reading or drawing.

Anxiety, stress, and insomnia are closely related

When it comes to anxiety and sleep, there's a bit of chicken and egg situation: it's hard to know which problem came first.

However, research has found that insomnia and stress are closely related. Studies have shown that stress causes lack of sleep, and that lack of sleep, in turn, "activates many stress-related pathways" in the brain.

Because of this, treating one condition can help with the other. According to Mendez, getting enough sleep is part of an overall care plan for managing anxiety, with or without a formal diagnosis. On the other hand, for people with anxiety disorders, treatment with medication and therapy can help address sleep issues.

"If you've tried all these practical, non-invasive strategies, there is no crime in seeking out medical help," Mendez says.