When Grief Keeps You Awake at Night

Grief insomnia — difficulty sleeping due to grief and loss — is common for many people, and it’s something that can be treated. But when you’re in the thick of it, feeling exhausted but unable to sleep, it can feel as if you’ll never recover. For older adults, grieving a spouse, partner, sibling, friend, or long-term companion, can feel worse at night than during the day. 

Why grief can disrupt sleep

Researchers don’t fully understand how sleeping problems are tied to the stress that grief can place on the body. But one theory is how your brain replays and reprocesses emotional memories (such as the loss of a spouse). 

During the REM (rapid eye movement) stage of sleep, where your brain is most active and you dream, this process of going over your memories helps to lessen the emotional pain tied to them. If REM sleep is disrupted in those nights spent tossing and turning, that processing can’t do its job properly. So instead of the emotional tie to a painful memory lessening over time, those memories continue to be emotionally intense or even get worse. 

Also, when your nervous system is on high alert, or you’re experiencing anxiety due to grief, these can make it more difficult for your body to relax at night for sleep. Your usual routines, such as going to bed together with your spouse, might be disrupted. Even the bedroom itself can change, if the person you shared that space with is no longer there. 

Grief insomnia can show up in different ways:

• You might struggle to fall asleep.
• You might fall asleep just fine, but then wake up in the night, and be unable to fall back asleep.
• You may wake up too early in the morning, from nightmares or dreams, or racing thoughts.
• You may sleep more hours than usual, but you’re still waking up tired.

All of these are a very real response to grief and loss, and they don’t mean you’re weak or overreacting. Grief insomnia symptoms deserve attention and treatment. 

Why grief often feels worse at night

Why is it that you can generally function well during the day, only to struggle at night? 

First, the daytime is full of distractions — errands to run, phone calls to make, and people to socialize with. But as the sun sets and you’re ready for bed, those distractions aren’t there, and you’re left alone with your thoughts. 

The house is quieter, and others are going to bed as well so you can’t always call them to talk. Plus, the bed feels a lot more empty than it used to. 

Sleeping alone after decades of sharing the night with a partner can disrupt your sleep routine. You might have anxiety about sleeping alone, or feel fearful of being alone in the house at night. Waking up in the middle of the night and forgetting that that person is gone can feel disorienting and you may feel that loss all over again. 

Grief can also feel worse at night because of anticipation: you can’t sleep, so you begin to dread bedtime because you’re mentally preparing for another sleepless night. It can become a vicious cycle. 

How long does grief insomnia last?

Just as with grief itself, there’s no timeline on how long grief insomnia lasts. Some people improve within a few days or weeks. Others can struggle for months. If yours is taking longer, it’s not a sign that something is wrong with how you’re grieving. 

But if your sleep troubles are persisting for weeks with no signs of improvement, it’s worth reaching out for help rather than waiting it out. Your sleep might even get better for awhile, but then becomes disrupted again around anniversaries, holidays, family milestones, or reminders of your loved one. 

It can also help to notice if you have other symptoms that are showing up alongside sleeplessness. This might include a persistent low mood, loss of interest in the things you used to enjoy, or the sense that the grief has become harder to bear over time, rather than getting easier. 

These can be signs of depression, anxiety, or complicated grief (when grief is long-term and debilitating). As the authors wrote in a 2011 study, “Grief can be complicated, much as wound healing can be complicated.” In some cases, the symptoms are more intense and they last longer. 

What can help when grief keeps you awake

The usual sleeping tips such as having a regular bedtime routine, and avoiding screens before bed may not be as helpful in this situation because the concern is grief preventing you from getting good sleep, not about your phone use or too much caffeine. 

Instead, some night-specific coping strategies for grief insomnia might include:

• Keeping a small notebook on the nightstand to jot down worries or memories that surface right before bed. This can give your mind permission to set these thoughts down for the night instead of swirling around your brain for hours.
• Incorporating comforting, but not activating, rituals. Finding comfort in a good book, listening to soft music, knitting, or mediating are non-screen activities that can help, rather than scrolling through old photos on your phone at night and experiencing fresh waves of grief.
• Using a fan or white noise machine. This can help if the silence of your room becomes too uncomfortable.
• Deciding in advance who to call if the night feels unbearable. Having that person and phone number in mind already can take the edge off the fear of being alone with your grief.  

Be cautious with alcohol or sedating medications as a way to fall asleep. For older adults especially, these can increase the risk of falls or next-day confusion. If you’re considering medication for sleep, talk with your healthcare provider about it first. 

When grief insomnia needs more support

If your sleep problems are persisting for more than a few weeks, making it difficult to function the next day, come with panic at night, or are giving you persistent nightmares, don’t wait to get support. 

The same is true if you’re noticing signs of depression; thoughts of not wanting to live; or signs of complicated grief such as a hyperfocus on the loss of your loved one, numbness or detachment, or intense longing for your loved one. 

None of these things mean you’re failing. They just mean you could use additional help and support. Even the best therapist can’t make the grief go away completely. What therapy can do is help break that grief and poor sleep loop. 

For older adults on Medicare, receiving therapy through phone or video calls can be a lower-stress way to get help when sleep, grief, anxiety, or depression are becoming too much to manage alone.

How therapy can help you rest again

Therapy can help with grief insomnia by reducing nighttime fears and anxiety, processing the grief and feelings of loss, rebuilding a new routine, and even working through feelings of guilt or regret. A therapist can also work with you to help you feel less alone with the pain you’ve been living with. 

Some people may benefit from a more targeted form of treatment for their sleeping difficulties known as cognitive behavioral therapy for insomnia (CBT-I), in addition to grief therapy. CBT-I approaches sleeping problems by helping you replace unhealthy sleeping habits, reframe your thinking around sleep, and training your body to get better sleep.

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How Sailor Health can help when nights are hard

When grief makes nighttime feel empty and exhausting, getting better rest often starts with having support for what you’re carrying during the day. Therapy gives you a space to process the weight of loss, ease nighttime anxiety, and break the cycle of grief-related sleep disruption.

When you’re already drained from sleepless nights, finding the energy to travel to a clinic or sit in a waiting room can feel like too much to manage. Sailor Health makes care easier to access by providing therapy entirely from home over video or phone call, including landlines.

Our therapists are experienced older adults themselves who understand the unique emotional weight of later-life loss, as well as how grief, depression, and anxiety show up as we age. We’ll match you with a therapist who fits your needs and preferences without a long waiting list, and you may be able to begin therapy as soon as 24 hours after signing up.

All of our providers accept Medicare, and most of our Medicare patients have a $0 copay. If grief is keeping you awake at night, support may be easier to reach than you think. Reach out when you’re ready, and we’ll help you take the first step.

Grief insomnia FAQ

Can grief cause insomnia even if I’m exhausted?

One of the frustrating aspects of insomnia is your body and brain can feel exhausted, but sleep is still hard to come by. Grief can cause insomnia due to stress hormones, a nervous system on edge, loneliness, or disrupted routines. 

Is it normal for grief to feel worse at night?

Many people notice their grief feels worse at night when the house becomes quiet, there are fewer distractions, an empty bed, and less support from others, making the loss feel louder.

Why do I wake up at 3 or 4 a.m. after a loss?

One way grief insomnia can show up is waking up in the middle of the night and being unable to fall back to sleep, even if you were able to fall asleep fine. 

How long does grief insomnia usually last?

Grief insomnia doesn’t have a timeline. Some people can improve in a matter of days, but some take longer — several weeks or more. 

When should I get professional help for grief insomnia?

If grief and sleeping troubles have been persisting for more than a few weeks, it’s a good idea to seek out professional help for grief insomnia. Untreated, grief can become more serious and lead to depression, anxiety, or complicated grief. 

Does Medicare cover therapy for grief-related insomnia?

Medicare covers therapy for grief-related insomnia. Therapy can help work through grief, and work to create healthy habits surrounding sleep by using different techniques such as CBT-I. 

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References

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