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Why Does Anxiety Worsen At Night And What Can You Do About It?

If you experience night-time anxiety, don’t fight it. Resistance can make it worse. Read on to rest your racing thoughts and learn about what is keeping you up at night.

By D Tejaswi
03 Jul 2021

1. What is Ashwagandha?

“Because the dark has a life of its own. In the dark, all sorts of things come alive.” These lines from classic film, The Bad And The Beautiful ring true for anyone who suffers from anxiety attacks at night. Your mind paints vivid scenarios of unnerving experiences. You get up from the bed, drink water and attempt reasoning with yourself. If this seems like something you’ve gone through before, anxiety is probably to blame, and you should seek anxiety treatment. “Stress and anxiety affect sleep. Some factors that influence our sleep system include genetics, family history of insomnia, mood disorders, environmental stress and anxiety,” says Dr Savita Date Menon, Ph.D., a Mumbai-based psychologist.


How Anxiety Affects Sleep

When you undergo stress or anxiety at night, the neurobiological and psychological systems of the body become overactive, contributing to difficulty falling asleep or staying asleep. “There is a bidirectional relationship between cognitive-emotional reactions and sleep, points out a study in Nature and Science of Sleep. Anxiety activates the hypothalamic-pituitary-adrenal (HPA) axis, and the activation of the HPA axis leads to arousal and sleeplessness, says a research paper titled

HPA Axis and Sleep. Sleep loss further increases activity in the amygdala, the emotional rapid-response center of the brain—causing you to be more intensely reactive, and contributing to anxiety at night. While in extreme cases, you should seek a personalized anxiety treatment from a professional, here’s
what Dr Menon says on how to cure anxiety disorder and get back to normal patterns of sleep.

Role Of Cognitive-behavioral Therapy (CBT) In Controlling Night-time Anxiety
Research in Journal of Depression and Anxiety acknowledge on how to cure anxiety disorder with Cognitive Behavioural Therapy. CBT is a psychotherapeutic treatment that identifies and changes underlying thought patterns that contribute to mental anxiety. It addresses emotional difficulties by altering destructive and disturbing thought patterns. Instead, these are replaced by more objective, practical thoughts. However, it’s just a minor part of the solution, adds Dr Menon.

Professional psychologists often prescribe some self-help remedies (see below), or medications such as benzodiazepines (tranquilizers) or anti-depressants (used for a fixed period of time),” says Dr Menon.


Anxiety Due To Medical Conditions

If you have anxiety at night, it might also be due to underlying medical conditions such as diabetes, coronary artery disease (CAD), asthma, or osteoarthritis. It is important to rule out the presence of these chronic illnesses before one goes to a psychologist. “Accurate diagnosis of these medical illnesses is essential in understanding the true cause to find the right solution for night-time anxiety,” says Dr Menon.


Role Of Maintaining Overall Health And Wellbeing

Studies find that when endorphins are released as a part of relaxation techniques, it helps control anxiety and improve sleep. “Seek simple ways to relieve stress and anxiety such as yoga, walking, jogging,” says Dr Menon. Activities that involve repetitive movements of large muscles help to reduce stress and anxiety. “Also, you can spend some quality time with your friends and family to build a sense of belonging and self-worth,” says the doctor. “Watch a feel-good movie, funny cartoons, a comedy show to find humour in everyday life.”

Dr Menon says that she believes that exercise and relaxation methods such as guided imagery, repetitive prayer or affirmations , breath focus act as long-term aids to control night time anxiety. Exercise increases the sense of self-efficacy and promotes better ability to cope with physiological challenges including night time anxiety, says The BMC Health Services Research.
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How to Cope With Anxiety At Night

  • One of the easiest anxiety treatments is to have a light dinner. It gives a break to your digestive and gastrointestinal systems.
  • Set an intention for your sleeping time. You can do box breathing to bring your awareness to the present moment. Or you could even write down your worries and record small wins of the day.
  • Practice restorative yoga customised to help sleep better.
  • Listen to some soothing, light music. The repetitive, calm tone of the music can help increase melatonin concentrations, a hormone that plays a role in the natural sleep-wake cycle.
  • Limit your screen time. Avoiding work right before bed time gives time to quiet your mind.
  • Include healthy sleep habits such as a consistent sleep schedule. Embrace a relaxing bedtime routine such as taking a warm bath or book reading just before you go to bed.
  • Modify your sleep environment. Use a comfortable mattress, pillow, and bed linen. Keep your room comfortably cool, quiet and dark.
  • Seek help from a counsellor, therapist or professional. They help you design an action plan to avoid anxiety and sleep well.




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