If you’re waking up with anxiety as soon as your alarm sounds, it’s definitely not part of an idyllic morning of sunshine, birds chirping, and hot coffee.
Waking up with worry on your mind can make mornings hard, but it’s actually pretty common for people to have periods of morning anxiety.
Why am I waking up with anxiety in the morning?
Morning anxiety technically isn’t a medical term and is a general way to describe feeling stressed or anxious when you wake up. Some reasons you might wake up worried include:
- stress
- illness
- mental health conditions
- sleep disorders
- alcohol or substance use
Physical and mental health symptoms of anxiety can build or appear suddenly. With morning anxiety, you wake up in the a.m. with those anxious feels, or they appear soon after waking.
It’s totally normal to experience temporary anxiety in the morning in response to what’s going on in your life. However, when anxiety is a constant, you may have generalized anxiety disorder (GAD). Starting the day with anxiety may be a sign that you have GAD.
According to the National Institute of Mental Health, the main symptoms of GAD include:
You just got back from Dream Town, so why is anxiety worse in the morning? A natural process called cortisol awakening response could be at play.
Cortisol (aka the stress hormone) rises in the first 30 to 45 minutes after you wake up. Researchers think this rise in cortisol helps your brain prepare for any activities you’ll face that day.
But it’s possible underlying stress and anxiety can make your cortisol levels rise too high. Let’s look at some factors that might impact your waking anxiety levels.
Stress
Stress and anxiety are practically BFFs. Facing one or more life stressors — like money worries, illness, job dissatisfaction, and relationship trouble — may add up to anxiety.
Plus, cortisol levels are generally higher any time you’re stressed. So, they may be even more pronounced during that a.m. spike right after you wake up.
Physical health
Anxiety and sleep disruption are common symptoms of many health conditions. Here are a few that may cause you to sleep poorly and wake up anxious:
- injuries and chronic pain
- heart disease and high blood pressure
- cancer
- diabetes
- asthma
- psoriasis
- hormone changes due to premenstrual syndrome (PMS), premenstrual dysmorphic disorder (PMDD), pregnancy, or menopause
Mental health conditions
GAD can lead to both poor sleep and waking up anxious. Other mental health conditions have similar symptoms, including depression, post-traumatic stress disorder (PTSD), and bipolar disorder.
PTSD can also cause nightmares or trauma flashbacks that make you wake suddenly in a panicked state. If you have a psychiatric diagnosis and notice an increase in anxiety or trouble sleeping, talk with your doctor or therapist about it.
Sleep disorders
Sleep disorders like insomnia, sleep apnea, and narcolepsy can contribute to anxiety.
Episodes of sleep paralysis may also cause intense fear when waking, and sometimes include hallucinations of an intruder in the room. This intense sleep disruption happens during REM sleep when you are partially awake, but your muscles can’t move, and may lead to anxious feelings in the a.m.
Folks with anxiety disorders, past trauma, or people who use alcohol are also more likely to experience sleep paralysis.
Alcohol or substance use
Alcohol and other substance use can worsen anxiety. And drinking alcohol before bedtime is also associated with poor sleep.
According to the Anxiety and Depression Association of America (ADAA), about 20 percent of Americans with alcohol or substance use disorder also have anxiety or a mood disorder.
Bottom line: Anxiety and alcohol aren’t a good mix. If you experience alcohol or substance use disorder and anxiety, reach out to your therapist or doctor. They can help you find the best treatment option for your situation.
If you’re dealing with anxiety or a panic disorder during the day, it’s also possible to wake up with a panic attack at night.
Research estimates about 44 percent to 71 percent of people with a panic disorder will have a nighttime panic attack episode (aka nocturnal panic attacks). Nocturnal panic attacks usually occur in the first few hours after falling asleep.
The Sand Man may also be to blame. Intense and frightening dreams may cause you to wake suddenly in a panic.
Night terrors can also cause you to wake up terrified, which can feel like a panic attack. Night terrors are often associated with fever, illness, excessive caffeine and alcohol consumption, and emotional stress.
If you think GAD is behind your restless sleep and anxiety, speak with your doctor about your symptoms. They can assess your health history and may do further tests to rule out a physical cause for your symptoms. The doctor may also refer you to a therapist or psychiatrist for treatment.
GAD is usually managed with therapy (like cognitive behavior therapy) or medications. Some medications used to treat anxiety include:
- Antidepressants. There are several classes of antidepressant drugs that also have anti-anxiety effects.
- Benzodiazepines. These are sedative medications that calm anxious episodes and panic attacks.
- Beta-blockers. They may reduce the physical symptoms of anxiety, like rapid heart rate.
- Buspirone. It’s anti-anxiety medication that is not sedative or habit-forming like benzodiazepines.
Some of these medications may cause side effects like worsening anxiety, panic attacks, or nightmares. Keep your doctor in the loop if your symptoms get worse when taking a new medication.
There are also several steps you can try to improve sleep and manage anxious feels in the morning:
- Optimize your sleep sitch. Keep a regular bedtime, and sleep in a dark, cool, quiet environment.
- Put down the coffee and booze. Limit caffeine and alcohol before bedtime.
- Get a workout in. Exercise can help reduce anxiety. It also produces endorphins that lower stress and help you sleep better.
- Relax and unwind. Combine meditation, journaling, or visualization to get in a positive state of mind before you sleep and when you first wake up.
- Breeeeathe. Try breathing exercises to reduce anxiety when you wake up feeling on edge.
- Schedule out your worry time. Plan 5 to 10 minutes where you’re “allowed” to worry, and then mentally put that negativity in a box for the rest of the day.
Slipping off to dreamland should be your sanctuary from waking worries, so it’s a big bummer to have your sleep interrupted by anxiety and panic.
Life stresses, illness, or an anxiety disorder may be the reason you wake up anxious. Generalized anxiety disorder can be treated with therapy and medication. Plus, there are plenty of lifestyle changes you can try to lower stress and sleep better.
