It’s not uncommon for anxiety to be severe – so difficult to manage, that a person struggles with their day to day life. But for others, anxiety is “manageable” in the sense that they can hold a job, maybe even maintain a relationship, they just often struggle with anxiety throughout their time in a way that hurts their quality of life.
During the day, when we’re busy, it’s easier to distract ourselves from anxiety. The problem, however, is that a lot of people with manageable anxiety during the day find that they experience a lot of anxiety at night, especially right before falling asleep. They may feel like their heartbeat is speeding up, their thoughts are racing, they may even have more worries than ever before, keeping you awake no matter how tired you may feel.
You need sleep to manage anxiety, and yet anxiety at night keeps you from getting sleep.
What causes this?
And, perhaps more importantly, what can you do about it?
We’ll start by going in depth into the science, because the more you understand why you feel anxious before falling asleep, the easier it is to control it. But scroll down if you’re only looking for tips.
Who Am I?
My name is Audrey Jung. I am a therapist in the Phoenix area (Chandler, AZ, specifically) that works both in person locally and throughout Arizona and California remotely. My specialty is anxiety, and I have worked with sports franchises, celebrities, and everyday individuals that have struggled with anxiety, stress, and related conditions.
Why the Brain Becomes Overactive and Anxious at Night
Anxiety before going to sleep does not have one cause, but many, and they all interact with each other. One thing you may notice is that your mind becomes overactive at night in a way that it doesn’t during the day. This overactivity at night actually has several causes including, but not limited to:
- Daytime Processing – Our brains are always functioning behind the scenes, and one thing our brains do when we’re going to bed is being to process the events of the day. Often, a person with anxiety did not have an opportunity to fully and thoroughly process their anxious thoughts. This processing starts subconsciously before we even start to fall asleep, and it can lead to these anxious thoughts being brought into our minds and causing us to think about our worries.
- Lack of Distractions – Throughout the day, all five of our senses are always working to process what is around us. We hear noises, we are focused on work, we are in the middle of conversations, etc., all of which make it hard to focus on our anxiety. But at night, the stillness and quiet can amplify and emphasize our intrusive thoughts, and make it harder to prevent these thoughts from racing and spiraling out of control. All of this is occurring right at a time when nothing else is going on and we’re trying to slow our brains down so we can sleep.
- The Default Mode Network (DMN) – Relatedly, in brains is a series of interconnected regions that all activate when we are not focused on external stimuli. These are the brain regions responsible for day dreaming, introspection, memory retrieval, and more. When we’re anxious, those brain regions are already primed for anxious thoughts, and they’re specifically activated when we are trying to go to sleep.
Let’s also take a moment to think about this from a danger perspective. Remember, anxiety is the activation of our “fight or flight” response, which is designed to keep us safe from harm. The problem is that it’s misfiring.
Imagine you were getting tired but you really were in danger. The last thing you would want to do is fall asleep in that moment. So these anxious thoughts before sleep could have had a survival value at some point, and the only issue is that we’re experiencing it when we’re not in danger.
The Physiology of Pre-Sleep Anxiety
Now that we’ve discussed some of the reasons for anxiety, let’s also add what’s going on in the body when you have anxiety during the day.
When you’re getting ready for sleep, your body *should* naturally shift into a state of relaxation, guided by the parasympathetic nervous system (also known as the “rest and digest” system). However, for people who experience pre-sleep anxiety, the sympathetic nervous system (which controls the “fight or flight” response) often remains overactive, preventing the body from fully winding down. This is caused by several factors, such as:
- Increased Cortisol and Nervous System Activation
Cortisol, the body’s primary stress hormone, plays a significant role in regulating the sleep-wake cycle. Normally, cortisol levels drop in the evening, signaling to the body that it’s time to relax.
However, when you’re anxious, cortisol levels remain elevated, which increases heart rate, raises blood pressure, and makes it difficult for the body to transition into a relaxed state. This heightened physiological state can cause muscle tension, rapid breathing, and a general feeling of restlessness, making it harder to fall asleep, and when you’re more alert, you are going to be more prone to the Default Mode Network issues mentioned earlier.
- Hyperactive Brain Activity and the Amygdala
When cortisol is high, another part of the brain is activated, known as the amygdala. The amygdala’s job is to perceive threats. During the day, distractions may keep you from focusing on those threats, and when you’re awake you may also have better coping skills to manage it.
But at night, when there is nothing else going on, your amygdala is trying to figure out what to be stressed about, creating an anxiety loop: increased anxiety heightens amygdala activity → the amygdala signals danger → cortisol levels rise → sleep becomes more difficult.
- Heart Rate Patterns
When the sympathetic nervous system is engaged, heart rate and breathing patterns increase. Shallow breathing and a racing heartbeat make it harder for the body to transition into the slower, more regulated state necessary for sleep. This physical arousal can cause a sensation of feeling “on edge” even when you consciously know there’s no immediate threat.
In essence, for all of these issues, pre-sleep anxiety happens because the body’s natural transition into a relaxed state is interrupted by stress hormones and an overactive fear response. This misalignment between the body’s physiological state and the brain’s desire to rest creates a state of hypervigilance, making it harder to fall asleep.
Sleep Deprivation as its Own Trigger
Finally, sleep deprivation itself acts as a catalyst for more pre-sleep anxiety in several ways. You may have heard the term “overtired.” When you’re extraordinarily tired, your body is naturally in a stressed state, and all these physiological issues we mentioned earlier (such as increased cortisol levels) become activated.
Also, when you are consistently having trouble sleeping, it’s not uncommon to feel anxious *about your ability to go to sleep*. For example, you become worried you won’t be able to sleep and that you’ll be tired the next day, triggering an anxiety response that keeps you awake.
Remember, while you may have anxious thoughts, much of this is a process your body activates entirely on its own. It is preventable with therapy and lifestyle changes, but it is not typically something you are causing or controlling on your own.
How to Stop Pre-Sleep Anxiety
Now that you know and understand more about what pre-sleep anxiety is, it’s time to look at ways to stop it. First, let’s look at some things that you need to try to avoid, and why:
- Screen Time/Stimulation Before Bed – It’s not uncommon to feel like we’re relaxing by scrolling our phones before we sleep. But while our brain may feel like it’s shutting down from the boredom of scrolling, it is actually being overstimulated through light, color, sound, and movement. That “shutting down” feeling may actually be digital overload. It excites your mind and it wakes you up. Perhaps worst of all, it becomes a routine for your brain. Even if you do not get screen time one night, your mind may wake up naturally because it expects a screen is coming. Try to avoid your phone, computer, and TV before bed.
- Staying Awake On Purpose – We spoke about how sleep deprivation can create an anxiety before bed cycle, especially for those prone to anxiety. As a result, you want to do what you can to avoid triggering that cycle on purpose. You have to try your best to go to sleep at a reasonable time every night, and – at least until you feel like it’s under control – make sure you’re not staying up “once in a while” by choice, otherwise you might be sleep deprived and trigger the cycle again.
- Get Done What You Can – In therapy, part of what we do together is work on reduce the effects of things like unfinished tasks have on our anxiety levels. But it’s still helpful to be productive if you can. Do your best to motivate yourself to get your tasks done throughout the day, and try not to procrastinate on purpose if it’s preventable. We know that there will be many tasks that will not be able to be completed, and we’ll talk about that together, but it’s still helpful to be proactive where you can be.
You also need to recognize that pre-sleep anxiety will take time to address. Don’t put pressure on yourself. Give yourself some grace to try your best for several weeks without expecting an immediate difference. Remember, part of this is a habit, where you get used to anxiety as you sleep and it triggers more anxiety. It will take time to break that cycle.
With that in mind, here are some additional practical strategies you can use:
- Journaling – The human mind does not want to forget things, and get stressed when it’s worried a thought might be forgotten. If you’ve ever felt stressed after losing your train of thought, you understand this reaction. Journaling is one way we can ease its stress. By writing out our thoughts – no matter what they are – we tell our minds “don’t worry, it’s here in a permanent place” while also helping process our thoughts better in a way that helps them move to other parts of the brain. Journaling can be a great tool for easing anxiety and helping you sleep.
- Create a Sleep Hygiene Routine – One way to break a cycle is to create a new, relaxing one. You should consider creating a 30 minute routine that you go through that is free of stresses and screens (no phones, no computers, no TV) that involves slow, methodic things you need to do before bed. This primes your mind for relaxation, so that you’re used to sleeping after a specific set of activities, and your brain learns that now is the time to go to bed.
- Relaxation Exercises – Calming yourself through relaxation exercises can help some people, taking the focus off their anxiety and relaxing their body. Progressive muscle relaxation is popular. You squeeze one muscle at a time starting from your foot to your head. After squeezing, your muscle becomes tired and more relaxed. You can also try slow, deliberate, diaphragmatic breathing. We can talk about these things in therapy as well.
- Non-Distracting Distraction – While you shouldn’t be on technology, some find that a very low volume noise can be helpful. For example, a podcast or an audiobook played at a level you can barely here. This gives you something to focus on besides anxiety, but is at a low enough volume that you can easily fall asleep.
- Exercise Early in the Day – Exercising at night can keep you awake, which we’re trying our best to avoid. But during the day, exercise can be useful. It triggers “good mood” hormones and can tire your muscles and body so much that, when you go to bed, your body feels more relaxed and you have an easier time feeling tired and falling asleep.
And, of course, because much of anxiety before sleeping is triggered by anxiety during the day, working on your anxiety disorders can also be very helpful.
Speaking with a Therapist for Anxiety
Anxiety at night, right before you fall asleep, is a normal phenomenon for those with anxiety. It has a wide range of causes, from physiological to cognitive to lifestyle to sleep deprivation. But, no matter the cause, you can address it.
There are some techniques you can do on your own to help reduce this type of anxiety and find your way to falling asleep. But the single best thing you can do is see a therapist. Therapy is a proven way to reduce and address anxiety, allowing you to build connections and coping tools that decrease cortisol and help you fall asleep.
My name is Audrey Jung. I’m a therapist in Chandler, AZ, serving people in the Phoenix area locally and licensed in both Arizona and California for those that are in need of help. If you’re looking for a therapist to help you with anxiety, please reach out to me today.