Waking Up Shaking? 5 Things Your Body's Trying to Tell You
Health ConditionsNeurological Disorders

5 Reasons You're Waking Up Shaking and What to Do About It

5 Reasons You're Waking Up Shaking and What to Do About It
Aleksandar Nakic/iStock
By
Tiffany Curtis
Updated on August 6, 2025
by

Ever wake up with tremors? Shaking or trembling in the morning can be a troubling experience, especially when you don't know what's causing it. And it might indeed be a sign of a more serious condition.

"There are lots of kinds of shaking (trembling, shivering, voluntary versus involuntary and violent versus subtle)," says Carl W. Bazil, MD, PhD, a neurologist and a professor of neurology at Columbia University Irving Medical Center in New York City. "It's also sometimes difficult to know whether movements began during sleep and caused awakening or if awakening happened first."

Here's what might be going on if you wake up shaking uncontrollably, and what you can do about it.

1. Your Blood Sugar Is Low

Low blood sugar could be the culprit for your morning shakes (or shaking when you wake up from a nap).

"It is possible to wake up feeling like you are having tremors if your blood sugar is low," says Margot Savoy, MD, MPH, a physician and the senior vice president of the American Academy of Family Physicians.

Also known as hypoglycemia, low blood sugar occurs when your glucose levels drop below normal.

In addition to shaking, other symptoms of hypoglycemia to look out for include:

  • An irregular or fast heartbeat
  • Hunger
  • Irritability
  • Tingling or numbness of the lips, tongue, or cheek
  • Anxiety
  • Fatigue
To address hypoglycemia, turn to fast-acting carbohydrates. You should eat or drink 15 to 20 grams (g) of foods the body can easily convert into sugar, such as fruit juice, glucose tablets, or gel.

If you don't have those on hand, soft drinks or candy could do the trick, but make sure they're not of the low-sugar or sugar-free variety.

Insulin and other diabetes medications may also cause your glucose levels to drop.

 Your doctor can help adjust the timing of your meals and medications to keep your blood sugar stable.

2. You're Having a Panic Attack

Panic attacks could be a possible cause for waking up with tremors, although it's not super common, Dr. Savoy says. Still, nighttime panic attacks can happen without an obvious trigger.

Symptoms of nighttime panic attacks are similar to those that occur during the day, and include:

  • Sweating
  • Trembling
  • Rapid heart rate
  • Shortness of breath
  • Flushing or chills
  • Sense of impending doom

Many of these symptoms are similar to signs of a heart attack, especially in women. If you think you might be having a heart attack, get immediate medical help by dialing 911.

If panic attacks are in fact the cause of your shaking, treatment options include cognitive behavioral therapy and medication.

 A therapist can help you address the underlying cause of your anxiety or panic attacks.

3. You Have Anxiety

While experiencing anxiety on occasion is a fact of life, if your shaking coincides with feeling anxious, it could be a cause for concern.

Some common symptoms of anxiety include:

  • Heart palpitations
  • Shortness of breath
  • Nausea
  • Muscle tension
  • Dry mouth
  • Numbness in hands or feet
  • Insomnia
  • Restlessness
  • Difficulty concentrating
  • Feeling irritable or on edge

There are many ways to ease anxiety. "Anxiety and panic attacks can be very limiting to enjoying life if they are left untreated, but you don't always need medication,” Savoy says. "Therapy and breathing or grounding exercises can make a huge difference."

4. It’s a Medication Side Effect

Certain medications may be to blame for feeling shaky after waking up. "Some medications can also make you feel jittery or shaky, like albuterol or caffeine," Dr. Savoy says.

Indeed, albuterol — which is often prescribed to people with asthma — has the following side effects:

  • Headache
  • Throat or nasal irritation
  • Muscle aches
  • Feeling nervous or shaky
Other drugs or medications that may cause you to feel shaky include:

  • Corticosteroids (like prednisone)
  • Certain antidepressants like Paxil, Prozac, Zoloft, Pamelor, and others
  • Nicotine
  • Alcohol (with chronic use)
  • Ritalin
  • Sudafed
  • Cyclosporine
If you suspect your medication is the reason for your shakiness, talk to your doctor.

5. You’re Drinking Too Much Caffeine

While too many cups of coffee can make you feel jittery, too much caffeine via soda, snack bars and energy drinks can also have side effects.

 And any amount of caffeine greater than 400 milligrams (mg) per day is considered excessive for adults (that's about four cups of home-brewed coffee).
But if smaller amounts of caffeine make you feel bad, then it's important to be mindful of your individual limits. Too much caffeine can cause the following:

  • Jitteriness
  • Sweating and restlessness
  • Anxiety
  • Nausea and diarrhea

Excessive caffeine intake can also cause irregular and fast heart rhythms in people with preexisting heart conditions.

If you wake up feeling shaky and you think too much caffeine is the cause, take a break from caffeine, make sure to drink enough water, replace your electrolytes (for nausea or diarrhea), and practice deep breathing.

When to See a Doctor

It's valid to be concerned if you wake up shaking or trembling. And if you regularly wake up shaking, it's best to see your doctor to get to the bottom of it.

To help make the most of your doctor visit, consider the following questions from Savoy:

  • How often does the shakiness happen and how strong is it?
  • Does it happen at other times of the day or just in the morning?
  • Are you having other symptoms like headache, blurry vision, or muscle weakness?
  • Did you eat and hydrate enough the previous day?
  • Have you started any new medications, vitamins or supplements?

Your answers to all the questions above can help your doctor determine (and treat) the reason for your shakiness, Savoy says.

The Takeaway

  • If you wake up shaking or trembling it might be a sign of a more serious condition, but that's not always the case.
  • Potential reasons for waking tremors include low blood sugar, anxiety, caffeine, and prescribed medications.
  • If shaking happens regularly, see your doctor to get to the bottom of it.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Mayo Clinic Staff. Hypoglycemia. Mayo Clinic. November 18, 2023.
  2. Mayo Clinic Staff. Nighttime panic attacks: What causes them? Mayo Clinic. December 21, 2024.
  3. Cleveland Clinic Staff. Anxiety Disorders. Cleveland Clinic. July 3, 2024.
  4. Mayo Clinic Staff. Albuterol side effects: Can I avoid them? Mayo Clinic. August 29, 2023.
  5. Campellone J. Drug-Induced Tremor. MedlinePlus. June 13, 2024.
  6. Raymond V et al. What to Do When You’ve Had Too Much Caffeine. UW Medicine. June 2, 2023.
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Jason Paul Chua, MD, PhD

Medical Reviewer
Castle Connolly Top Doctor

Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.

Dr. Chua’s primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease.

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Tiffany Curtis

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Tiffany Curtis is Everydayhealth.com's health writer. She is a Philadelphia-based writer and sexuality educator. She has previously written for brands like Cosmopolitan, Business Insider, The Philadelphia Inquirer, Refinery29 and more.

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