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Recognising nighttime anxiety

April 29, 2024
Marcia Sharp

You get into bed and settle down to go to sleep, but your mind has other ideas. The next thing you know, you’re going through tomorrow’s to-do list, reliving an embarrassing moment or worrying about a future event. Hours go by and you start to panic about how little sleep you’re going to get, but you’re no closer to drifting off. If this sounds familiar, you might be experiencing nighttime anxiety.

What is anxiety?

Anxiety is a feeling of unease, worry or fear. When we feel anxious, our mind perceives this as if we are in a threatening situation. It triggers our threat system and our body releases the hormones, cortisol and adrenaline which increase our heart rate, tense our muscles and cause our thoughts to race. Even if we’re not in any real danger, our mind’s auto-response to anxiety is to ensure that we’re wide awake and vigilant in order to protect ourselves.  

Why do I feel anxious at nighttime?

During the day, we tend to be busy, whether we’re working, spending time with people or going about our daily routine. However, when we’re trying to fall asleep, there are no distractions - it’s just us and our thoughts. So, if there’s something that’s worrying us, it’s likely that it will come to the forefront of our mind at bedtime.  

How does anxiety affect sleep?

Needless to say, a whirring brain and heightened senses are the opposite of relaxing. So, even if we’re mentally drained, feelings of anxiety can make it difficult for us to switch off. This can lead to sleep problems, like insomnia, where we either can’t sleep, struggle to stay asleep or wake up too early before we’re fully rested.  

Anxiety and sleep problems often go hand-in-hand. Research shows that between 24% to 36% of people with insomnia have an anxiety disorder. A lack of sleep has a negative impact on our mental health; sleep helps us to process our thoughts and emotions, so that we can stay calm and rationalise more easily. When we miss out on sleep, this can create a vicious cycle, where feeling anxious means that we have trouble sleeping, but if we sleep badly, we’ll feel more anxious.

How to manage night-time anxiety

  • Keep a journal

It can be helpful to have a ‘brain dump’ where you write down any thoughts or feelings that are bothering you. This will help you to release your emotions and empty your mind. You could also use the time to make a to-do list which can help you to feel more in control and less stressed. Keep a notebook by your bed, so if you wake up worrying or suddenly remembering something, you can write it down and (hopefully) go back to sleep.

  • Breathing exercises

Breathing techniques are a powerful tool when you’re feeling anxious. Focused breathing can help to ease your symptoms; it slows your heart rate, relaxes your body and brings your attention to the present moment. Try breathing in slowly and deeply through your nose, then breathe out slowly and deeply through your mouth. It can be helpful to count from 1-5 on each breath.

  • Wind down  

In addition to breathing exercises, there are other ways that you can wind down and prepare yourself for sleep. It’s a good idea to avoid blue light from screens too close to bedtime, or food and drinks that are high in caffeine or sugar as these things can stimulate your brain, rather than quieten it. Be mindful that alcohol can affect how well you sleep too.

You could have a warm bath before bed or try doing muscle relaxation exercises to loosen up. Tense each part of your body in turn and then relax it, starting with your toes, and moving upwards. Pay attention to how it feels - this gets the brain focused on the body, which can help the mind to switch off.

  • Talking therapy

If you’re experiencing sleep problems as a result of anxiety or vice versa, you might benefit from trying cognitive behavioural therapy (CBT). CBT can help to treat sleep issues, anxiety and other mental health disorders by helping you to understand and challenge unhealthy or unhelpful ways of thinking and behaving.

At ieso, we offer typed CBT where a patient can ‘speak’ to one of our therapists by typing back and forward via our secure online portal. Our service is flexible and non-judgemental, plus it’s free for some NHS patients. Find out your eligibility here.

ieso Online Therapy
This blog has been written by a member of the clinical team at ieso.
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