Nighttime anxiety is relatable to many people. Around one in four Australians will experience anxiety in their lifetime, according to research. Psychologists and sleep specialists explain why worries can feel more intense at night and how to manage them.
Experts point to several reasons why anxiety often worsens at night. Natalie Solomon, a psychologist board-certified in sleep medicine at Stanford University School of Medicine, says “our emotional regulation decreases at night, so you might have the same stresses or worries during the day, but they really seem to sharpen at night.”
Candice Alfano, a psychology professor at Stony Brook University, adds that with fewer distractions at night, people have “more space for thinking about the things you’re either concerned about or worried about.” This can elevate anxiety. A 2022 study called this the “mind after midnight” phenomenon, suggesting that being awake during times you want to be asleep negatively affects decision-making and increases negative moods.
Solomon says there seems to be a bidirectional relationship between anxiety and sleep. She explains that anxiety revs up the fight-or-flight system, making sleep more difficult, and lack of sleep then makes one more vulnerable to anxiety, so the cycle continues. Grandner says anxiety carried into the bedroom can become anxiety about sleep, which can itself become a barrier to sleep. He also says expecting sleep disruptions can make sleep “predictably stressful.”
To manage nighttime anxiety, experts recommend scheduling a “worry time” during the day, writing down concerns and listing what can and cannot be controlled. A wind-down routine of 30 to 60 minutes before bed, with screens off and calming activities, can help shift the body into rest mode. Going to bed when sleepy and, if possible, following the natural clock, while maintaining consistent bedtime and wake-up times, are also suggested. Avoiding caffeine and alcohol close to bedtime is advised.
If nighttime anxiety regularly strikes despite these measures, Alfano suggests seeing a therapist or sleep specialist. Hoge says they can determine whether someone has a mental health or sleep disorder and recommend appropriate treatment. For insomnia, the mainstay treatment is cognitive behavioural therapy for insomnia, which aims to change thoughts and behaviours around sleep. Grandner notes that fixing sleep problems will usually improve anxiety as well.
Analysis
Why This Matters
- Nighttime anxiety can disrupt sleep, creating a cycle that harms both mental and physical health.
- Understanding the reasons helps people normalise their experience and adopt evidence-based strategies.
- With high prevalence, these insights have broad relevance for public health and well-being.
Background
Anxiety affects a significant portion of the population. Research shows anxiety symptoms can peak at different times, with racing thoughts generally increasing in the evening. The “mind after midnight” phenomenon highlights how being awake during preferred sleep hours impairs cognitive function and mood.
Key Perspectives
Natalie Solomon (psychologist, Stanford School of Medicine): “Our emotional regulation decreases at night, so you might have the same stresses or worries during the day, but they really seem to sharpen at night.”
Candice Alfano (psychology professor, Stony Brook University): Fewer distractions at night give “more space for thinking about the things you’re either concerned about or worried about.”
Elizabeth Hoge (psychiatry professor, Georgetown University): Worrying and racing thoughts can wake people overnight and make it hard to return to sleep.
Michael Grandner (director, Sleep and Health Research Program, University of Arizona): “Sleep becomes predictably stressful” when anxiety accompanies bedtime.
What to Watch
- Growing integration of sleep science into mental health treatment protocols.
- Potential for workplace wellness to include sleep hygiene education.
- Expanded research into the “mind after midnight” phenomenon and its clinical applications.
Checked
12 claims in this story checked against 1 source: 10 supported.
Show each claim
- SupportedThe headline says anxiety can feel worse at night and asks what to do about it.WA Today - Latest News: “Why anxiety can feel worse at night and what to do about it.”
- SupportedThe summary says sleep and psychology experts explain nighttime anxiety and offer ways to manage it.WA Today - Latest News: “There are several reasons anxiety often worsens at night. Here’s what to know, how to handle it and when to seek help.”
- Partly supportedAround one in four Australians will experience anxiety in their lifetime, according to research.WA Today - Latest News: “Around one in four Australians will experience anxiety in their lifetime.”
- Partly supportedSolomon says emotional regulation decreases at night and the same stresses or worries can sharpen then.WA Today - Latest News: “Our emotional regulation decreases at night, so you might have the same stresses or worries during the day, but they really seem to sharpen at night for many people.”
- SupportedAlfano says fewer nighttime distractions leave more space to think about worries.WA Today - Latest News: “But at night, there are fewer distractions, giving you “more space for thinking about the things you’re either concerned about or worried about,” says Candice Alfano”
- SupportedA 2022 study called the effect the “mind after midnight” phenomenon and suggested that being awake when one wants to be asleep affects decision-making and increases negative moods.WA Today - Latest News: “A 2022 study referred to this as the “mind after midnight” phenomenon and suggested that being awake during times you’d like to be asleep negatively affects the brain’s decision-making, rational thinking and risk-reward processing, and increases negative moods.”
- SupportedSolomon describes a bidirectional relationship between anxiety and sleep: anxiety can make sleep harder, and lack of sleep can increase vulnerability to anxiety.WA Today - Latest News: “There seems to be a “bidirectional relationship” between anxiety and sleep, Solomon says. In other words, anxiety revs up your fight-or-flight system, which tells your body to activate and become alert, which makes it more difficult to sleep. Lack of sleep then makes you more vulnerable to anxiety, and so the cycle continues.”
- SupportedExperts recommend a wind-down routine of about 30 to 60 minutes, with screens off and calming activities.WA Today - Latest News: “About 30 minutes to an hour should suffice. During this time, Alfano says to turn off your screens and do something calming, like listening to music, reading, meditating or taking a bath.”
- SupportedExperts suggest going to bed when sleepy, following one’s natural clock if possible, and keeping bedtime and wake-up times consistent.WA Today - Latest News: “Instead, she suggests going to bed when you feel sleepy and following your natural clock, if possible. Also, try to set consistent bedtime and wake-up times”
- SupportedAlfano advises avoiding caffeine and alcohol close to bedtime.WA Today - Latest News: “Avoid caffeine and alcohol close to bedtime, as both will keep you awake and disrupt sleep, Alfano says.”
- SupportedAlfano suggests seeing a therapist or sleep specialist if nighttime anxiety regularly persists despite the suggested measures.WA Today - Latest News: “If nighttime anxiety regularly strikes, despite implementing the above, Alfano suggests seeing a therapist or sleep specialist.”
- SupportedFor insomnia, cognitive behavioural therapy for insomnia is the mainstay treatment and aims to change thoughts and behaviours around sleep.WA Today - Latest News: “The mainstay treatment is cognitive behavioural therapy for insomnia, which involves working with a therapist to change your thoughts and behaviours around sleep.”
