“There is no stressor, but the body is flooded with a sense that it needs to do something.”
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Anxiety always seems to be worse at night.
I can be dead tired, and yet the moment the lights go out, my brain will shift gears instantly. A simple noise down the hall or stray thought about something that happened in my day can send my mind reeling down a relentless rabbit hole of intrusive thoughts.
I’ll start beating myself up for choices I’ve made or I’ll agonize over decisions I have to make tomorrow.
I’ll replay events in my head and start asking “what if” over and over again.
I’ll start worrying about my son or my dog and before long, I’ll be convinced that they’re sick or start imagining ways they could get hurt overnight.
If I fall asleep, will I hear my son if he wakes up and cries? Will he try to crawl out of the crib if I don’t hear him? What if he falls while I’m asleep? What if he hits his head?
What if. What if. What if…
It’s relentless and exhausting.
Sometimes, I’ll be up for hours, paralyzed with fears, and completely unable to talk myself down from imagining the very worst things happening.
Once, I spent the entire night googling baby monitors that would alert me to a health issue while I watched my 3-month-old sleep.
Other times, my anxious thoughts will turn into a full-blown panic attack. I’ll feel dizzy, my heart will pound, and my chest will hurt. On those nights, I have no choice but to wake my husband and ask for help.
None of this is healthy or fun — but I’m far from the only one to have ever experienced this kind of nightly anxiety.
According to the Anxiety and Depression Association of America, anxiety disorders affect roughly 40 million adults in the United States. It’s the most common mental illness in the country.
Everyone has some anxiety, but it becomes a disorder when that excessive fear and worry persists beyond one stressful event. It will start popping up for months on end, interfering with daily activities, such as work, relationships, responsibilities, and, of course, sleep.
“An anxiety disorder is an overactive amygdala in the brain,” explains Lauran Hahn, a mental health counselor that specializes in anxiety and trauma therapy based in Orlando, Florida.
“The amygdala is responsible for sensing danger — it’s like the brain’s smoke detector,” Hahn says. “Once danger is perceived, the amygdala sends a signal to the body engaging the sympathetic nervous system, which I liken to a gas pedal. It gets the nervous system revved up and ready to take some action.”
That action is the fight, flight, freeze response, which prepares us for danger and causes our bodies to release stress hormones like cortisol or adrenaline. These, in turn, cause your heart rate to accelerate, your blood pressure to rise, and blood to divert from your internal organs to your limbs so you can better fight or flee.
“In a real threat or stressful event, this automatic process is brilliant,” Hahn says. “It naturally wakes up the brain and body and gives it the little extra boost it needs to handle the threat.”
The problem with an anxiety disorder though, is that there isn’t a true threat or stressor that needs attending to.
“It’s like the amygdala is stuck on ‘on,’” Hahn says, so you get easily triggered by an event, person, memory, seemingly random thought, feeling, or body sensation. “There is no stressor to overcome or life to save, but the body is flooded with a sense that it needs to do something.”
Anxiety can be worse at night in part because we have no distractions from our anxious thoughts like we might have during the day.
Well, first off, there’s no substitute for seeking help from a mental health professional.
An anxiety or trauma therapist, in particular, can help work with you to reduce your anxiety and panic symptoms.
According to Hahn, there are specific treatments, like EMDR or sensorimotor psychotherapy, which can be helpful in “resetting” your nervous system and settling your overactive amygdala that’s causing your anxiety disorder.
Take several slow, deep breaths and pay attention to the air entering and leaving your body. Try concentrating fully on what you’re doing in the immediate: What do you see, hear, or smell?
Julie Rich Hilton, a licensed clinical social worker based in Atlanta, also recommends a mind exercise she calls “File It.”
“As you lay in bed with eyes closed, visualize a table in front of you with lots of file folders spread out,” she says. “Be specific [about that table] — our minds connect with a picture.”
“Each file has written on it a thing that is racing through your mind,” she continues. “One for work tomorrow. One for the argument you had with your partner today. One with grief from a loss, regardless how long ago. Everything that pops up gets a file. Then, one at a time gently pick the file up, acknowledge how important it is (we are not throwing it away because it has importance if it is coming up), and File It for tonight into the cabinet next to you.”
“As you file everything that could possibly be on your mind, you are slowly giving your brain the indication that nothing is wrong, everything has been examined and deemed not a threat,” she adds.
“When you have gone through everything, it will feel like there is nothing left to be ‘prepped,’ for and the mind can relax,” she says.
Other therapists recommend scheduling a “worry time” where you sit down, let yourself worry, and make a plan on how you’re going to address some of those things. Just make sure this “worry time” is nowhere close to your bedtime.
Build a sleep routine to transition from day to night
What that routine looks like really depends on you and your needs. For some people, it’s meditation. For others, it’s as simple as taking a bubble bath before bed, lighting a scented candle, petting your cat, or reading a good book.
What’s important is that you take some time to wind down.
This means stepping away from stressful activities — like paying bills, listening to the news, talking about politics, scrolling through your phone — in the time leading up to you going to bed.
It’s especially important to limit your screen exposure because blocking blue light at night can help you sleep.
Try to go to bed around the same time every night, even on weekends
“Each of us are equipped with a 24-hour internal body clock known as our circadian rhythm that tells our mind when to rest and when to be alert, but it craves consistency,” says Bill Fish, a sleep science coach and general manager at The Sleep Foundation.
“If you made a concerted effort to go to bed within a 20-minute window each night, get your 8 hours of sleep, and wake within the same 20-minute window each morning, you will gradually train your body, and will make it much easier to get to sleep each night, especially when dealing with anxiety,” Fish says.
It’s important to wake up at the same time every day too, even if you have a bad night’s sleep.
“We often think we should ‘catch up’ on sleep over the weekend or if we have a bad night of sleep,” says Annie Miller, a licensed social worker and behavioral sleep medicine provider based in Washington, D.C. “But in fact, that can make insomnia worse by creating what’s called social jetlag.”
“It is important to keep your wake time consistent and understand that you may be tired in the short term, but this will build up sleep drive and eventually allow you to fall asleep faster,” she explains.
Don’t lie in bed awake
Lying awake will only give your brain time to start another firestorm of worries and anxieties.
If you can’t fall asleep after 20 minutes or so, try restarting that bedtime routine.
Don’t turn on bright lights, of course, but go do a low-stress activity — like pet your cat or drink a cup of tea — for a few minutes to help give your body another chance at winding down for the night.
Consider getting some products to help you de-stress
Of course, there’s no magic cure-all product for nighttime anxiety. But there are some products out there that can help you relax and help you as you build your healthy nighttime routine.
Weighted blankets are amazing: They can reduce anxiety in both adults and children because they help “ground” you — i.e. their weight gently pushes down on you, reducing the levels of the stress hormone cortisol in your body.
Research has also shown that they help reduce autonomic arousal, which is what causes symptoms of anxiety, such as increased heart rate.
Mosaic carries a full line of weighted blankets for adults and kids in a variety of fun colors and patterns. Prices vary depending on the blanket size and weight you get, but start at around $125.
Full disclosure: The Rest+ is technically designed for kids but hear me out. When I used it, it helped me sleep better than it helped my son sleep.
My brother bought it for my son for Christmas and at the time, my son was still sleeping in a bassinet in our room, so I set up the Rest+ near my bed and it didn’t take long for me to become dependent on it.
I found the sound machine features (particularly the ocean noises) incredibly soothing, though other people might find the white noise feature more soothing.
Sound machines can give your brain something for your racing thoughts to focus on and listen to as you lay down to sleep.
The color night light might also be helpful, as you can program it to match your bedtime routine and program the light to slowly dim as you drift off to sleep.
If you prefer not to get a product meant for kids, the company also recently came out with the Hatch Restore aimed at adults specifically. It has many of these same helpful features to create a bedtime routine without any of the baby-focused ones.
Everyone has heard that chamomile tea can help you sleep. Why? Well, it’s commonly called a mild tranquilizer and has an antioxidant called apigenin, which binds to specific receptors in your brain that may decrease anxiety and help make you sleepy.
This sleepy tea takes chamomile up a notch by also adding in lavender, another ingredient that has been used for centuries to help calm nerves. The tea is also naturally caffeine free and, well, it’s simply delicious.
Aromatherapy is a great self-care tool because it’s said to help improve pain levels and relieve stress.
In particular, while research is somewhat limited on essential oils, lavender oil is one that’s generally considered a natural sleep aid. For example, one older study found that lavender increased the amount of slow and deep wave sleep.
That’s why this diffuser and essential oil set is a great tool to help you work aromatherapy into your nightly routine. Plus, the wood diffuser will look cute on your bedside.
Sense a pattern here? Products that give you something calming to focus on before bed are a great idea because they help take your mind off your worries.
Lighting a scented candle before bed is a great way to do that.
Homesick makes a whole line of candles designed to evoke the smells of your home state or specific memories (like Grandma’s kitchen) so it’s pretty easy to find a scented candle that you’ll find calming.
Taking a warm bath before bed is a good way to decompress and start winding down for the night.
Warm baths can do a lot, like reducing pain, improving breathing, lowering blood pressure, reducing heart attack risk, and improving blood sugar control.
To help you settle down for the night, Lush’s Deep Sleep and Twilight bath bombs are great choices because both have lavender oil in them.
Lots of therapists recommend body pillows because hugging something, even if it’s a pillow, can sometimes help you feel safe and comforted. Body pillows can also sometimes ease aches and pains, helping you sleep.
This body pillow is designed to not lose its shape and can help with your posture, making it super comfortable to hug as you drift off to sleep.
Lots of folks find it calming to read a book before bed, but if you struggle to focus on the page, there’s an alternative: audiobooks.
Plus, if you were ever read to as a child, you’ll also know that there’s definitely something comforting about being read to as you doze off for the night.
That’s why Audible is a great choice. With a subscription, you’ll get one or two books a month, plus a discount on any additional audiobooks you want to buy.
The Audible app also allows you to set a sleep timer so you don’t have to worry about the book playing all night long, losing your place.
Many of the therapists I spoke to for this article recommended a relaxation or meditation app to help you settle down before going to sleep.
Headspace is an app that helps make meditation simple by teaching you mindfulness skills in just a few minutes every day.
Right now, Headspace is offering 1 year free if you were recently laid off by your employer due to the ongoing pandemic.