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4 Tips for Managing Nocturnal Anxiety

Reading time | 3 mins

“Why does my anxiety always get worse at night-time?” a friend asks me one Sunday afternoon as she’s tucking into roast potatoes and looking exhausted.

“I’ll be in bed, snug and warm, trying to drift off when BOOM, this sense of dread comes over me, followed by hundreds of negative thoughts about work, my family, or something I’ve said to a neighbour.” 

Her experience is far from unique of course. Often, the symptoms of anxiety can be more intense at night. Even people who don’t have the condition are more likely to “worry more” when the sun goes down.

It’s simple. We have fewer distractions and more time to worry at night. The world quietens down and our never-ending ‘to do’ lists stop. During the daytime our brains are engaged – with commuting, work, talking to others, taking care of people, cooking, eating, cleaning etc. Not to mention distractions like television, music, games, social media and so on. The time to reflect on worries is reduced.

But once we’re in bed our subconscious has centre stage. I like to think of it shouting: “Now it’s my chance. Let’s go!” Thoughts, concerns and even imagery that we didn’t realise had bothered us during the day come flooding out. Some more upsetting than others. Once you start worrying about something, these negative emotions can trigger a physical response, which in turn exacerbates feelings of anxiety.

It can be frustrating, but there are ways to combat it. 

Top tips for reducing nocturnal anxiety

Write down the key irrational thoughts that race in your mind

It doesn’t matter how ridiculous they seem, write those thoughts down. Writing negative thoughts down is great way to ‘break the cycle’. It’s like a mini Cognitive Behaviour Exercise. Reading some out loud might even make you laugh. Some of my more ludicrous ones include:

What if my boss is secretly looking for a way to sack me because I told her I hated Breaking Bad?

My best friend sounded ‘off’ on the phone earlier. What if I’ve done something? What if she never tells me what I’ve done, and we never speak again?

Of course, both of these concerns were inaccurate. Any concerns that seem genuinely rational, for example, I don’t like my job anymore can be logged and be dealt with during the bright light of day.   

Avoid caffeine after 3 p.m.

This one may sound obvious, but you’d be surprised by how many people still have that coffee or fizzy drink close to bedtime. Caffeine triggers cortisol and cortisol feeds anxiety. If possible, avoid anything with caffeine from the afternoon, as it can remain in the system for hours depending on your tolerance level. Instead, stick to decaffeinated or herbal tea, and non-caffeinated beverages.

If you are experiencing anxiety in bed, then don’t stay there

Fighting thoughts and feelings of anxiety will only make them more intense. Anxiety expert Dr. David Carbonell refers to this as: “fighting fires with gasoline.” The harder you try, the worse the anxiety gets. Instead, it’s better to get up and do something else for ten minutes. The change of scene is not only a distraction, but it can be soothing. I like to run the tap and pour cold water on my wrists, whilst really concentrating on the sensation – a mini mindfulness exercise if you will.

Develop a night-time routine

My brain responds very positively to ingrained routines and rituals. At first, they can seem like an effort, but in my opinion are very worthwhile. My gran has been having a bath every night at 10pm for over twenty years. She follows this with a cup of Horlicks and half an hour of knitting.

I like to get into my pyjamas and cleanse my face around 9 p.m. The facial massage is soothing and signals to my brain that it’s time to start shutting down. I then have a soothing herbal tea and rub some jasmine oil on my chest. My brain now associates the scent of jasmine with sleep. It took a while to make the connection, but now it works a treat.

A night-time routine doesn’t need to be complicated or expensive. Just choose a few things to do every night before bed that relaxes you and do them consistently.

Finally, if you’re regularly struggling to sleep because of anxiety, speak to your doctor about it.

UK/MED/20/0051 February 2020