This is how you can tackle your nighttime anxiety
If you find yourself frequently lying awake worrying, know you're not alone. Nighttime anxiety is a common problem that can make it harder to fall and stay asleep. Anxiety and sleep have a complex relationship. Anxiety can keep you from sleeping, and a lack of sleep can increase your anxiety.
Fortunately, there are several steps you can take to help calm worried thoughts and manage anxiety at night. Keep reading to learn more about why anxiety tends to increase during the nighttime hours and what you can do about it.
- Find out why ‘cricketing’ is the answer to good sleep
- Yawning all the time? Here’s when it could signal a health issue
What does nighttime anxiety feel like?
Clinical psychologist Dr Michael Wetter says patients often describe nighttime anxiety as a cycle of dread that begins well before bedtime. ‘Many report lying awake with racing thoughts, anticipating the frustration of another sleepless night, while others experience intrusive worries such as fears about work, school, or daily functioning.’
Everyone experiences anxiety differently, and symptoms may vary. Wetter says you may experience:
- Difficulty breathing
- Heart palpitations
- Feeling nervous or restless
- Uncontrolled or racing thoughts
- Difficulty falling and/or staying asleep
- Nightmares
- Gastrointestinal problems
- Panic attacks
What triggers nighttime anxiety?
You may wonder why you don’t spend the day dwelling on your troubles, but suddenly, as you try to wind down, anxious thoughts and feelings flood your brain.
It’s not that you weren’t stressed before, Wetter adds; it’s more that you’re finally noticing it at nighttime. ‘Your mind wasn’t focused on those issues before, but they’re coming up now because there might be some unresolved concerns or fears, or anything you may have suppressed throughout the day,’ he says.
This could be due to financial issues, work problems, running through your to-do list, or any other factor that causes you stress or worry.
There could also be some hormonal shifts at play, Wetter adds, which are specific to how our bodies prepare us for sleep. Typically, cortisol (the ‘stress’ hormone) spikes in the morning to help us wake up, but for some people, a spike in cortisol occurs in the evening when they’re getting ready to go to bed. That spike might make people feel more alert and anxious rather than prepared to drift off to dreamland.
Sleep anxiety vs. anxiety at night
Nighttime anxiety is similar to sleep anxiety in that they both take place at bedtime. But experts say sleep anxiety is distinct in that it’s about feeling anxious about your ability to actually sleep. ‘The anxiety is specific to fears of not being able to sleep well,’ Wetter explains, whether that’s due to existing insomnia struggles or recent nightmares.
Where sleep anxiety is more concerned with your sleep, nighttime anxiety is worry and concern about anything – it just happens to crop up at night. ‘Nighttime anxiety could be about a stressor that you have the next day. It could be you replaying something that happened that day, that you are getting frustrated about an interaction that maybe you had with someone,’ Wetter says.
Who is at risk for nighttime anxiety?
Dr Leah Kaylor, a psychologist specialising in sleep, says, ‘Individuals with pre-existing anxiety or mood disorders are at heightened risk, as their baseline worry levels are already elevated. Those with prior sleep difficulties such as insomnia or sleep apnoea are also more likely to develop sleep-related anxiety because they have already experienced disrupted rest.’
Adolescents and young adults may be especially vulnerable due to irregular schedules, screen exposure, and heightened academic or social pressures. In older adults, medical conditions or medication side effects can compound sleep concerns, increasing the likelihood of anxiety around rest.
Lifestyle adjustments for nighttime anxiety
There are few things more maddening than wanting to go to sleep, but having worries running through your head. Thankfully, there are plenty of expert-backed strategies for when nighttime anxiety strikes:
Set your intention early: Kaylor says the key to combating nighttime anxiety is setting an intention for relaxation earlier in the day.
‘If you tell yourself each day that you are determined to have a peaceful evening, you are more likely to actually experience it that way. At a certain point during your day, such as when you’re having dinner, take time to let go of work stress from that point forward and enjoy the rest of your evening. Regardless of what type of prompt works for you, get in the habit of setting your personal objective of how you want to feel each evening.’
Establish a bedtime routine: Counsellor Shilpa Shah says, ‘Establishing a bedtime routine lets you focus on taking proactive steps for yourself instead of ruminating in your anxiety.’
Try to avoid including activities that may be too overstimulating, such as scrolling through social media or watching TV. Instead, make your routine calming and quiet, leading up to you falling asleep. This will signal to your brain that it is time to rest and allow you to fall asleep without an upset and anxious mind.
Prepare for the next day: Shah says, ‘Many people find it anxiety-provoking to think about all that they need to do the next day. Being prepared is one of the best things to do to avoid this type of anxiety.’
Get as much ready as you can, like having your clothes picked out, lunches and bags packed, and your alarm set. Putting a small amount of effort into preparation can help keep evening anxiety under control.
Write in a journal: Psychologist Dr Greg Gomez says, ‘Journaling can help reduce nighttime anxiety. Numerous studies have demonstrated this. It helps a person escape worrying thoughts that interfere with sleep. And they can deal with them tomorrow instead of right now at this moment.’
Perform some breathing exercises: Shah says breathing exercises are another strong weapon against nighttime anxiety. ‘Box breathing, or four-square breathing, is a simple relaxation technique that involves a four-part breath cycle: inhale for a count of four, hold your breath for four, exhale for four, and hold again for four. This is a technique employed by Navy SEALS to stay calm under pressure and triggers the parasympathetic nervous system to counteract the anxiety-driven production of adrenaline.’
Practice progressive muscle relaxation: Gomez says, ‘Learning to tense and relaxing muscles in the body one group at a time is another technique that promotes relaxation. This technique is commonly used to treat panic attacks, excessive worry, and insomnia. Breathing exercises and progressive muscle relaxation can also be used together.’
If you’re struggling to wind down, get out of bed: It sounds counterintuitive, but Kaylor says getting out of bed and doing something else will give your brain a chance to calm down, and also prevent you from associating your bed with stress and restlessness. ‘Read a book, or even do some light cleaning – something to help you turn your mind off,’ Kaylor says.
Avoid screens and blue light, which she says amplify your alertness and anxiety symptoms.
Exercise: This is linked to better sleep, but timing matters. Early morning or afternoon workouts are most effective, while late-night, intense exercise may raise body temperature and cortisol levels, making it harder to wind down.
Try a weighted blanket: An academic study published in 2020 found that individuals with sleep issues experienced numerous improvements – from better sleep quality to faster sleep onset – when using a weighted blanket.
What’s more, participants reported feeling 13% less stressed at bedtime and 17% more relaxed while trying to fall asleep. Ultimately, those participants who reported improved sleep using a weighted blanket not only slept better once asleep, but the process leading up to sleep was also a lot more blissful.
Take magnesium supplements: Magnesium glycinate is easily absorbed by the body and is known for its calming properties, potentially promoting relaxation and improved sleep.
Research shows that magnesium supplements may help relax the mind and body, potentially reducing stress and anxiety that can interfere with sleep.
Kaylor says, ‘At least 400mg of magnesium glycinate works on the brain's GABA receptors to promote muscle relaxation and, in turn, can help with sleep if taken consistently around the same time daily.’
Therapy for nighttime anxiety
If you’ve tried everything, and it’s still not helping your nighttime anxiety, you may need to call in a professional. The good news is that therapy for nighttime anxiety is well established and highly effective.
Kaylor says cognitive behavioural therapy for insomnia (CBT-I) is considered the gold standard for this type of issue.
According to Kaylor, ‘This structured, evidence-based approach helps patients identify and change unhelpful thought patterns, break the cycle of anticipatory worry, and establish healthier sleep behaviours. Key elements include retraining the brain to associate bed only with sleep, not with worry, sleep restriction (limiting time in bed to increase sleep efficiency), and relaxation training. When these techniques are used together, as many as 70% to 80% of patients with sleep issues experience improvements.’
Read more:
