Anxiety and Sleep: Why Do You Lie Awake Thinking?

Why Does Night Feel Like This?

During the day our attention is mostly outward: work, people, screens, to-dos. At night the lights go down, the sounds fade, movement stops and attention turns inward. The thoughts you put off all day arrive in the first empty space. That is why anxiety can feel like it is “growing” at night; part of it is less that anxiety truly rises and more that the outer noise has gone.

Two Layers: Thoughts and Thoughts About Sleep

• Postponed thoughts: the day replaying and the “what if” sentences become audible in the quiet.
• Thoughts about sleep: sentences such as “if I don’t sleep now I’ll fall apart tomorrow” or “it’s 3 a.m., I only have three hours left” keep the body on alert; when the body is on alert sleep does not come, and staying awake seems to prove the thought right.
• Trying to sleep: checking the clock, working out the hours left and trying harder are ways of forcing sleep, and sleep can drift further away the more it is forced.
• The bed–wakefulness link: spending a lot of time awake, tense and thinking in bed can link the bed with tension for the body.
• The day after a rough night: cancelling plans with “I can’t do anything today” makes the day smaller, and the evening pressure of “I’ve done nothing, at least let me sleep” grows.

Anxiety and Sleep Affect Each Other

The link runs both ways: anxiety can disturb sleep, and a hard night can raise anxiety the next day. A systematic review examines the evidence for this two-way link between sleep disturbances, anxiety and depression. High anxiety after a rough night does not mean you are weak; it shows a loop is running. Sleep is largely a process that runs by itself when we are not doing anything, and treating it as a performance to succeed at can make you more awake.

Sleep can drift further away the more it is forced; the aim is not to succeed at sleep but to loosen the effort that feeds night-time anxiety a little.

One Small Step You Can Try Once

This step may not suit everyone; you do not have to force it. The module “Anxiety at Night” (7 sessions) in Calm Anxiety: Blisswell works on this through small trials: a short morning note, giving worry a place away from sleep, not fighting when awake in bed and doing one small thing you care about the day after a rough night. The module opens with a short safety question; if any of the situations below applies to you, the rise-time and getting-out-of-bed experiments are not done on your own. The foundation for giving worry a place is the worry time in the module “Solving the Problem, or Circling in Worry?”.

When to Get Support

If sleep problems last longer than a few weeks, happen several nights a week and affect your daytime functioning, mood or relationships, it makes sense to see a doctor or a mental health professional. According to the NHS, insomnia lasting three months or longer is called long-term insomnia; common causes include stress and anxiety, and also alcohol, caffeine and nicotine. If your mood is sinking, or thoughts of harming yourself get stronger at night, do not leave them for the next day: share them today with someone you trust or a professional and call your local emergency number (911 or 988 in the US, 999 or 116 123 in the UK, 112 in Europe).