Why Do I Wake Up Anxious?

Many patients seek psychotherapy because, among other things, they wake up anxious. There are many causes behind this feeling. Keep reading.

Written and verified by el psicólogo Gorka Jiménez Pajares.

Last update: 09 January, 2024

If you wake up anxious, there may be several factors that you should pay attention to. Waking up with anxiety is something that’s far from normal and can be caused by alterations in various areas of our lives. In this regard, it can occur as a consequence of a disorder, such as insomnia or nightmares, but also as a product of the overwhelming stress that occurs in certain periods of life.

It’s worth mentioning that when we sleep, our body goes through a series of phases that have classically been grouped under the umbrella of “sleep architecture,” which is why, before starting to talk about the possible causes of waking up with anxiety, we’re going to explain what sleep architecture consists of.

The architecture of sleep

Sleep is, according to Buela-Casal (2021), a “functional, reversible and cyclical state.” Some of the behaviors linked to sleep are immobility or waking up to external stimulation. From the body’s point of view, changes occur in various biological parameters, such as the secretion of hormones such as melatonin. Psychic activity is also characteristic because when we’re asleep, we can dream.

Among the factors that are linked to sleep quality, we can define four large blocks:

• The period of time in which we sleep, of the circadian type, that is, it’s limited to periods of 24 hours.
• How we sleep, which responds to factors such as our age, our sleep rhythms, the state of our body (healthy or with some illness), and the need we feel to sleep.
• The space in which we sleep, not only our bedroom, but also other factors such as temperature, lighting conditions, and noise.
• Behaviors that signal bedtime, which can promote or hinder both falling asleep and staying asleep.

When we fall asleep, we go through a series of stages or phases with their own characteristics, from light sleep to deep sleep and then to REM sleep. We do it in cycles of 90 minutes, meaning that for a standard sleep period of about 8 hours, we’ll go through these phases about four times (Belloch, 2022). Let’s see what the signs and functions of each of these phases are.

Phase 1

This is a phase characterized by drowsiness. Although the ability to perceive much of the stimuli that surround us remains intact, we find ourselves feeling sleepy. Among other changes, it decreases muscle tone and heart rate.

Phase 2

In this phase, the threshold necessary for us to wake up with some stimulus is higher compared to the previous phase. That is, a more powerful stimulation is necessary in order for us to wake up. When we’re in the second phase, we disconnect from our environment. This promotes light sleep, the prelude to rest. During this phase, there’s also a decrease in muscle tone and heart rate.

Phases 3 and 4

These two phases are called “deep sleep.” In fact, if we wake up during these phases, we feel confused and disoriented. During this period of sleep, night terrors or sleepwalking may occur. If you wake up during these sleep phases, you may feel anxious.

Phase 5

The fifth phase is known as REM sleep or “rapid eye movement” sleep. This is the period of sleep in which we dream. It represents approximately 20% of all the time we spend sleeping. In addition, REM sleep has been shown to promote healthy development and learning at all ages, but particularly in childhood.

Now that you’ve become familiar with some basic notions about the architecture of sleep, we’re going to delve into some of the possible causes that make us feel anxious when we wake up.

I wake up with anxiety: Possible causes

There are many factors that affect the way we perceive that we’ve slept well, that is, the quality of our sleep. On the other hand, the absence of rest can cause anxiety, irritability, and discomfort.

Insomnia

According to the American Psychiatric Association, insomnia is characterized by few hours of sleep or, despite getting enough sleep, feeling that the quality with which we sleep is insufficient. There are, broadly speaking, four forms of insomnia:

• At the beginning: It’s difficult for us to fall asleep.
• Conservation: We slept well but woke up frequently.
• Mixed: We have difficulty both falling asleep and staying asleep.
• Morning: We have a tendency to wake up early in the morning and are unable to fall asleep again.

As a temporary criterion, it’s worth mentioning that, in order to be considered insomnia, the symptoms must appear at least three days a week, for three months. Among the daytime consequences of insomnia, it’s worth mentioning that it causes fatigue, poor mood, irritability, anxiety, general malaise, and concentration difficulties. According to the APA, “Insomnia is usually a great friend of anxiety in general and of phobias in particular.” Likewise, suffering from anxiety is a risk factor for developing insomnia.

Nightmares

According to the American Psychological Association, nightmares consist of terrifying dream activity that’s well remembered after waking up. One of the nuclear characteristics of nightmares is that their contents are related to different threats that we’re unable to face. For the WHO, “nightmares are dreams loaded with anxiety or fear” that occur in the second half of sleep.

Normally, nightmares produce anxious symptoms when we wake up. This occurs because reactions and motor behaviors whose objective is to awaken us are set in motion. In addition, nightmares are a type of dream activity closely linked to periods of increased stress and anxiety.

Bruxism

Bruxism is a type of motor and masticatory activity. It’s characterized by the rhythmic behavior of the masseter and temporal muscles of the jaw. This produces contractions that force the jaw and cause friction on the teeth. It usually occurs during stage 2 sleep and occurs more frequently in people who have a family history of bruxism. Its consequences can be framed on a physical level (headache, drowsiness, and mental exhaustion) and a psychological level (anxiety, irritability, and fatigue).

Stress

Stress is a reaction of our body. It arises when we perceive that our coping abilities in the face of a certain stressor stimulus are insufficient. When we feel overwhelmed, we experience stress.

If you’re a woman, you have a family history of anxiety, and you’re also stressed, it’s likely that this is a cause of your anxiety when you wake up. In this regard, being a woman and having a history of anxiety is a risk factor. If this is your case, avoiding taking naps during the day, however small they may be, can help you have a better quality of sleep.

The importance of proper sleep hygiene

A good strategy to achieve good quality sleep is to practice proper sleep hygiene. In this regard, you should implement changes both in your lifestyle and in the environment in which you sleep. Sleep hygiene consists of educating people with the aim of acquiring behaviors, habits, and skills that are linked to the act of sleeping. Among the recommendations proposed, we can mention the following:

• Avoid contact with stimulating drinks (coffee, tea, energy drinks) at least six hours before going to sleep.
• Refrain from consuming alcohol or smoking in the three hours before bedtime.
• Avoid ingesting a large amount of food or drink.
• If you wake up, avoid going to the fridge for food.
• Make sure that the temperature in your room is optimal: Not too cold nor too warm. An environment of 68 degrees Fahrenheit is ideal.
• Reduce the light in the room, as well as the noise.
• Avoid exposure to screens before going to sleep.

One of the most curious measures that are recommended in the context of sleep hygiene is to remove any clock from your sight. Interestingly, it has been seen that if we wake up and look at the clock to check the time, our anxiety is likely to increase because we establish thoughts that prevent us from falling asleep. For example, we say things like, “I’ve been awake for an hour,” or “It’s 5:00 am, and I have to wake up shortly. I’m not going to perform well today,” “if I don’t fall asleep in half an hour, I’m going to be tired all day,” and so on.

Likewise, to solve the fact that we feel anxious when we wake up, we can put meditation exercises into practice, such as mindfulness or Jacobson’s progressive muscle relaxation. At the same time, it can be potentially beneficial for you to consider going to your trusted medical professional and telling them what your symptoms are.