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My anxiety is worse at night — I asked a neuropsychologist why and how to cope
Even if I’ve had the most relaxing day, when nighttime comes and I lie in bed with nothing to distract me, a reel of embarrassing and worrying memories and thoughts plays on repeat in my brain.
While I’ve always been prone to anxiety, it’s nighttime anxiety that I now struggle with the most.
Maybe it’s because I no longer have the distractions of the day to keep my mind busy, or maybe it’s down to a hormone change as my body prepares for rest.
This Sleep Week, to get to the bottom of why my anxiety is worse at night, I’ve asked Dr Sanam Hafeez, a NYC neuropsychologist and director of Comprehend the Mind for her opinion.
I'm also sharing expert tips on how to tackle anxiety at night and help calm your mind before bed so that you can enjoy stress-free sleep.
Dr. Sanam Hafeez is a New York City based Neuropsychologist and School Psychologist. She is also the founder and director of Comprehend the Mind. Dr Hafeez earnt her Master of Science in Psychology at Hofstra University. Following that she stayed at Hofstra to receive her Doctor of Psychology (Psy.D.) and later completed her post-doctoral training in Neuropsychology and Developmental Pediatrics at Coney Island Hospital.
What is nighttime anxiety?
For me, nighttime anxiety manifests itself in restlessness, a racing heart and a racing mind, but it could feel very different for you.
“Nighttime anxiety is when feelings of worry or fear become more intense as it gets dark or when you're trying to sleep,” explains neuropsychologist Dr Hafeez.
“It can involve racing thoughts, unease, or even panic about things that may not be important.” Other common symptoms include:
- Night sweats or feeling unusually hot
- Panic attacks or feelings of impending doom
- Trouble relaxing or calming down before bed
- Frequently waking up throughout the night with anxious thoughts
- A sense of isolation or loneliness, especially when everyone else is asleep
But what differentiates this from daytime anxiety?
“The quiet of the night often makes these worries feel bigger and more overwhelming,” says Dr Hafeez. “This can create a cycle where anxiety keeps you awake, and lack of sleep makes the anxiety worse.”
Why is my anxiety usually worse at night?
When I feel anxious during the day, there are many things I can do to either distract myself or address the situation, like watch a comfort TV show, call a friend or hang out with my husband.
At night, my usual go-tos are no longer an option and instead I’m forced to confront every thought that comes my way
However, at night, my usual go-tos are no longer an option and instead I’m forced to confront every thought that comes my way.
“During the day, we're usually occupied with tasks or social interactions, but when night falls, there's more time to reflect on worries and stressors.
“The quietness of nighttime can amplify feelings of isolation or uncertainty, making it harder to shake off anxious thoughts.”
However, it’s not just the lack of distractions. As we transition to a sleeping state, our physical state changes, too.
“Our bodies also experience natural changes in hormones, like a decrease in cortisol,” Dr Hafeez explains, saying this “can make us more sensitive to anxiety at night.”
5 ways to tackle nighttime anxiety
While it may feel impossible to shake off these feelings and keep a calm mind, there are ways to tackle this cycle of nighttime anxiety. Here are Dr Hafeez's top tips for coping...
1. Avoid distressing content before bed
An effective and calming nighttime routine is essential for drifting off to sleep with ease.
It helps prepare the mind and body for rest, switching from the sympathetic nervous system to the parasympathetic, which is responsible for relaxation and calm, instead of ‘fight or flight.’
One key feature of a good nighttime routine is avoiding too much stimulation, like watching or reading intensely emotional content.
“Stay away from news, horror shows, or anything that might stir up anxious thoughts before sleep,” cautions Dr Hafeez.
And, with the world currently as it is, it’s probably best to stay away from social media all together. It’s unlikely you’ll be able to scroll happily without distressing images seeping in.
2. Try aromatherapy or soothing sounds
Your sleeping environment is just as important as your mind and body. A cluttered, untidy and dirty bedroom will lead to a busy mind, while decluttering your bedroom and maintaining a calm sleep space will help you relax.
One way to transform your room into the relaxing haven you need is by considering all your senses and not just sight. Think lovely smells and soothing sounds.
“Using essential oils or listening to calming sounds (like white noise or rain sounds) can create a peaceful atmosphere that helps calm the mind,” says Dr Hafeez, and there’s studies to prove it.
The aroma of Lavender in particular has been shown to improve sleep hygiene and sleep quality.
3. Use a weighted blanket
One solution I found to be very effective when I’m feeling restless with anxiety is to use a weighted blanket for deep pressure therapy.
These are blankets that have tiny glass beads sewn into small squares in the lining to make it heavier, and you can often choose the weight you’d like, ranging from 10lbs to 20lbs.
“The gentle pressure from a weighted blanket can have a calming effect and help reduce anxiety,” Dr Hafeez explains.
This ‘pressure therapy’ simulates the feeling of a hug, helping the body relax and release calming, happy hormones like dopamine and serotonin.
Personally for me, the most useful thing about weighted blankets is that they stop me from tossing and turning. This makes my body physically more calm and less erratic, which has a knock on effect on my mind.
4. Practice deep breathing exercises
The way we breathe can have a huge impact on the nervous system. In fact, many studies have found breathing exercises to be significantly effective in reducing stress and anxiety, and we’ve found plenty of breathing exercises for sleep that have helped us fall asleep fast.
“Try techniques like the 4-7-8 breathing method, which can help slow down your heart rate and calm your nervous system before bed,” Dr Hafeez recommends.
The 4-7-8 breathing method requires you to breath in for 4 seconds through your nose, hold your breath for 7 seconds, then exhale through your mouth for 8 seconds making a ‘whooshing’ noise.
The benefit? It's supposed to activate your parasympathetic nervous system and calm your body and mind.
5. Limit naps during the day
If you're experiencing anxiety or depression, it can be exhausting. I personally find that if my mental health is struggling, all I want to do is sleep, especially if I'm missing out on quality rest at night.
However, Dr Hafeez warns against excessive napping. “Taking long naps can interfere with your sleep at night, making it harder to fall asleep and increasing nighttime anxiety,” she explains. And it’s true.
Napping can reduce sleep pressure, which is what we usually feel in the evening as our bodies are telling us it’s time to wind down for the night.
Alongside this, long naps may interfere with your circadian rhythm, throwing your body clock off and making it difficult for your mind and body to know when it should be sleeping and when it should be awake.
