Why is My Anxiety Worse at Night?

We’ve all heard the chicken or the egg debate that can’t seem to be settled: Which came first? Well, the relationship between anxiety and difficulty sleeping poses a similar quarrel. Does poor sleep lead to anxiety, or does anxiety lead to poor sleep?

While the answer is not always clear, it is clear that there is a correlation, and sometimes causation, between the two. Anxiety and poor sleep go hand-in-hand.  

Putting Anxiety Under a Microscope

Nowadays, it is not uncommon to hear professionals calling anxiety an epidemic. In the United States alone, 19.1% of adults and 31.9% of adolescents are experiencing anxiety disorders. This does not account for all the unreported anxiety that people are battling alone and in silence. In the US, the most common mental illnesses that plague the country’s population are anxiety disorders. 

What is Anxiety Exactly?

According to the National Library of Medicine, anxiety is a feeling of "fear, dread, and uneasiness.” Anxiety is the anticipation of some stressful event or threat in the future. It is the natural response to a stressor or danger.

Just like most human responses and emotions, anxiety can benefit or protect you from time to time. However, when anxiety is chronic, it's activated in situations where it is not needed, which can lead to poor mental and physical health.

Those feelings of fear, dread, and worry can be accompanied by physical symptoms including:

  • Increased heart rate and blood pressure
  • Sweating
  • Trembling 
  • Fatigue and muscle tension
  • Other mental health disorders

The symptoms and intensity of these feelings can vary depending on the individual and the situation. Everyone will experience bouts of anxiety from time to time, but those with anxiety experience these feelings for an extended period of time, or feel them seemingly at random.  

Why is My Anxiety Worse at Night?

Anxiety strikes at different times for different people, and with different life events. It’s not uncommon for people’s anxiety to worsen when night rolls around. Nighttime anxiety can even be experienced by individuals that doN’T struggle with anxiety normally. 

There is no clear cut answer as to why anxiety can get worse at night, but there are a few factors that may contribute to the elevated levels of worry that arise in the dark. 

A Silent Night

During the day, most people have a thousand things to do and an abundance of distractions. This makes it easy to push worries and anxieties away and focus on other priorities. With nothing to do, and oftentimes no one to interact with, some people find it difficult to continue distracting themselves.

Everything is quiet, which gives your mind the perfect opportunity to run wild and free. So freely that it can become uncontrollable. Distractions during the day can help people escape or manage their anxiety. But at night, you’re often on your own.

Additionally, people with anxiety often seek reassurances from other people when those negative feelings arise. But when these other people are not around or unavailable, they can’t provide any solace. 

Physiological Imbalances

Avoiding anxiety and stress that comes up during the day is only a temporary, “band-aid” fix. Stress disrupts the natural hormone balance in your body. It puts your body into overdrive elevating certain hormones in order to prepare for the fight or flight response, leaving you alert and tense. The stress you deal with or distract yourself from during the day can make it more difficult for you to fall asleep when you are finally able to crawl into bed. 

At the end of a long day, people are often tired and fatigued. Fatigue makes it more difficult to properly and rationally deal with the worries in our heads. The lack of energy makes it challenging to put things into perspective, so what may start as a little worry can escalate into a lot of anxiety.  

Anxiety and Sleep Disorders

The quality and quantity of sleep has a bidirectional relationship with anxiety. This means that sleep and anxiety can turn into a vicious cycle where one is exacerbating the other. 

The inability to easily fall asleep can lead to anxiety about sleep itself. The mere thought of bedtime or action of getting in bed can spike anxiety because of fear that sleep will not come.  

Anxiety is linked to a number of sleep disorders. People who struggle with anxiety are more likely to have higher sleep reactivity. Several anxiety related sleep disorders include:

  • Anxiety Insomnia—Anxiety insomnia is a sleep disorder where people aren't able to fall asleep due to anxiety, regardless of whether or not they battle it during the day.
  • Parasomnia—Night terrors and nocturnal panic attacks are linked to parasomnia, or not being “paralyzed” during REM sleep. People who regularly have nightmares may fight falling asleep to avoid experiencing yet another bad dream. 

A nocturnal panic attack is a sudden awakening caused by feelings of fear and worry that are typically accompanied by a number of physical symptoms identical to those accompanying a panic attack that occurs while someone is awake. 

They can be terrifying to experience, they come out of nowhere. Someone who suffers from nocturnal panic attacks might think the only way they can control them is by staying conscious and avoiding sleep.  

Reducing Nighttime Anxiety

Just as there is no one explanation as to why someone’s anxiety is worse at night, there is no one treatment for it. However, there are a few things that can be done to reduce, or even eradicate, nighttime anxiety and improve sleep. 

Practice Good Sleep Hygiene 

Creating a nighttime and morning routine can help you wind down and tell your body that it is time to go to sleep. Going to bed and waking up at the same time each day helps your body naturally recognize when it is time to sleep and when it is time to wake up.

When your body is adjusted like this, it won’t take long to fall asleep and you won’t wake up feeling groggy since a routine helps to reinforce your circadian rhythm.

Other nighttime rituals can look like self-care, or calming activities such as: 

  • Drinking a cup of tea
  • Doing a face mask
  • Reading a book

Regardless of what your consistent routine looks like, ensure you give yourself ample time to do it, so you don’t feel more stress  as you try to meet your “deadline.”

Calm and Relaxation

Find activities you enjoy that you can do at night that are calming and relaxing. Things like yoga, a bath, listening to music, or taking a leisurely walk outside can help organize your thoughts and quiet your mind.  

If anxiety is keeping you awake, there are a number of breathing and mindfulness techniques that can be used to get yourself out of your head and help reduce anxiety. 

Additionally, while it may not be a calm activity, exercising during the day helps improve sleep as well.

Write your Feelings Down 

Journaling before bed is a great way to wind down at night and release your thoughts and worries. This can be a part of your nighttime or morning routine. If that’s not really your thing, keep a notepad and a pen on your nightstand to jot down thoughts and feelings when a racing mind is keeping you up. 

Writing out anxieties and worries can help relieve stress and clear your mind. 

Avoid Things That Keep You Up

Even if anxiety isn’t the thing keeping us up, it can still set in when we’re lying in bed awake for too long.  Avoid caffeine and alcohol at night as it can negatively impact your sleep.

Looking at screens can also throw off your sleep because the blue light reduces or delays the production of melatonin that helps with sleep. Try to limit your time on social media and watching TV before bed. 

Additionally, for some people, it is helpful to avoid or limit things such as the news, your work email, or other anxiety-inducing activities in order to allow relaxation before bed.  

Get Up

When you are experiencing anxiety that won’t go away and keeps you tossing and turning without being able to fall asleep, at some point it is actually better to get up. A good rule of thumb is if you are trying to go to sleep and are still unable to 15-20 minutes later, get up and do something else.

Try to keep it calm, doing a relaxing activity has the potential to take your mind off of whatever is worrying you and allow you to fall asleep, but a high energy activity will only make it harder for you to sleep.

Treating Nighttime Anxiety at Sequoia Behavioral Health

Anyone with anxiety can greatly benefit from receiving help from a caring professional. Talk therapy, cognitive behavioral therapy, and medication are all common and helpful tools when it comes to combating nighttime anxiety. 

Anxiety disorders are the most common mental health challenges people face today, but they are also some of the most treatable. If your sleep is suffering because of anxiety, or your anxiety is worsening because of your sleep, know that there is a way to break the vicious cycle.

While there are many actions you can take as an individual, help from a professional can kick-start your journey back to well rested nights free of worry and fear. Sequoia Behavioral Health has trained and experienced professionals to personally help you or connect you to the proper resources in order to get you nights, and days, back on track. Reach out today to learn more.