Anxiety and sleep

Anxiety and sleep problems form a two-way relationship in which worry makes it harder to fall or stay asleep and poor sleep in turn amplifies anxiety.

A racing mind at bedtime, heightened physiological arousal and hypervigilance can delay sleep onset and cause nighttime awakenings. Insufficient or fragmented sleep then reduces the brain's capacity to regulate emotion, so the next day's stressors feel larger and the cycle repeats. The overlap is common: many people with anxiety disorders report insomnia, and chronic insomnia raises the risk of developing an anxiety disorder.

Assessment usually involves sleep diaries, questionnaires such as the Insomnia Severity Index and anxiety scales, and sometimes overnight sleep studies to rule out other disorders. Addressing one side of the cycle often improves the other, and cognitive behavioral approaches address both. Cannabidiol has been examined in observational reports and small controlled studies that measured anxiety and sleep together, and the findings carry important limitations in size and design.