How to Deal with Anxiety at Night: 2 Essential Skills

Anxiety at night can be brutal, you just want to lay down, rest, go to sleep, and your brain is like “Hey, let’s do a quick review of everything stupid you’ve ever done” and you’re like “What? No!” and your brain is like…ok, point number 1…”
Or it’s like- hey, let’s try to imagine every awful thing that could happen. You’re relaxing, let’s worry for a little bit, doesn’t that sound like fun? Nighttime anxiety can be so painful, but you don’t have to just suffer- let’s talk about 2 really powerful skills to turn down anxiety at night and sleep better.
For many people their anxiety is the worst at night. Things get quiet, there’s less distractions, there’s less to do, you’re left with your thoughts. And so your brain is like, “Finally it’s time to do the update, and deal with these anxious issues.” And that of course leads to the following night time anxiety issues.

Laying in bed worrying about the future or rehashing the past
You can’t fall asleep- because your mind is racing
You develop Sleep Anxiety. This is anxiety about not being able to fall asleep, then you’ll be so tired the next day, which leads to more worries and catastrophizing.
Waking up in the middle of the night
Waking up to panic attacks
Feeling a desperate urge to leave the house, to avoid bed

What to do about sleep anxiety: So yes, nighttime can be really difficult for some people with anxiety. But there are two simple steps that you can take to decrease your anxiety at night, relax, and sleep better.

Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.

Copyright Therapy in a Nutshell, LLC

[dr.karidouglas]

Anxiety happens when you think you have to figure out everything all at once . Breathe . You're strong . You got this . Take it day by day .

[kieransoregaard-utt]

About 1-2 hours before bed almost every night, I become plagued with tormenting thoughts about how much I’ve failed, how I’m not good enough, how I’ve wasted my life and how no one likes me. No matter how tired I am, it keeps me up. I’m looking for help anywhere I can get it. Thank you for these tips.

[sineadbradyfan]

I love all Emma's videos, but this one had the best opener, by far. EVERYBODY can relate to what she's describing.

[jacquimg]

As soon as the sun goes down I get anxious and sad. I don’t know what to write down because I don’t know why I’m anxious and sad. I’m not saying bad things don’t happen to me. But nothing in particular materializes as the anxiety producing culprit. This is a real problem for me.

[juliakbrown]

A couple of things that (sometimes, not always) help me: (1) literally talking to my brain as though it were another person, saying “I know you’re really worried about this, but it’s time to sleep now, I promise we’ll talk about this tomorrow” - but then you have to follow through and do the daytime worrying thing or your brain learns that it can’t trust you. (2) I had really bad insomnia for a couple of years, but with therapy and meds got it mostly under control. But it’s important that it not get out of control again, so if I have more than one night where I can’t sleep, I take a sleeping pill, because the “training your brain “ thing is real, and I find it’s crucial to not let my brain re-learn that bed is for worrying. Note all the comments here about trauma etc are very valid, this advice is more for less serious anxiety.

[flowerchild]

OMGOSH, the last two nights in a row no sleep. I have watched a majority of your videos and they have helped me immensely. Thank you. I know you’re so busy. I appreciate you

[realdeal]

I love that you make me laugh while teaching me how to deal with anxiety. Laughter is the off button for anxiety. Thank you, thank you.

[WishfulThinkingArt]

I can attest to getting out of bed when I can’t sleep. I always have a hand-sewing project that I can sit in a comfy chair doing until I’m tired. Not only do I get to enjoy something creative, but sewing is also repetitive, and the motions help my mind to relax. Plus, the quiet of a late night helps soothe my mind. 😊

[i.ehrenfest]

According to Victor Frankl we should tell ourselves we really don’t want to sleep. Works for me, a bit - I listen to an audiobook I really like and just can’t stay awake, though I want to.
Mind, Emma’s suggestion to deal with your issues is much better in the long run…

[elijahthompsonsr.]

I always feel like I'm going to die of a heart attack

[DezzieYT]

I don't have an issue falling asleep. It's when I wake up for that inevitable call of nature in the middle of the night the anxiety hits. Going to follow your advice and try doing something enjoyable till my brain calms down because my current "strategy" of lying in bed letting anxiety run rampant isn't working. >.<

[gutmicrobiomequeen]

🤯 Holy macaroni, that first one is GOLD. My therapist suggested that a while ago and I never did it (LOL), but you've motivated me to finally incorporate it now 🥰 Thank you for all that you do!

[kateregier]

I got three hours of sleep last night due to anxiety. I hope this helps me ☺️

[aamnahere]

I think anxiety and depression need a multi pronged approach to deal with them. Seeking help is important but so is aiding yourself in unique ways that work for you. I've personally experienced the life changing effects of yoga for my mental health. It might sound like an exaggeration but the Zen like calm and clarity I enjoy after yoga is incredible. Even a 15 minute short yoga practice in the morning or before going to bed calms your mind and nervous system in a way that is truly amazing.

[deborahchristiansen]

I'm so happy that I ran across this YouTube channel. My husband just recently passed away and I have so much anxiety surrounding being alone. I am perfectly capable of taking care of myself, but I always feel like I'm overlooking something - and the fear comes up at night when I'm ready to go to bed. Thank you so much for this informationl

[BlinkPopShift]

You are so much more effective than a personal therapist. I'm not sure why but I'm autistic and your clear instructions work much better than me trying to tell a therapist about my struggles.

[chellyuh]

i haven’t sleep properly for like weeks this is so exhausting my heart can’t stop beating so fast for no reason🥲😭

[nordveien]

Big fan of Emma's work here. Not to discount solid advice, but to validate people for whom it doesn't work due to the complexity of their situation. The strategies described in this video have a good chance to be insufficient when the anxiety is brought on by something big, like years of childhood trauma. Not understanding the roots of anxiety well enough combined with the sheer amount of work one needs to do to process years or abuse/neglect and all their consequences often results in chronic sleep issues which cannot be solved quickly. Not knowing what we don't know means we can't plan for dealing with it. Scheduling the time for worries may not lead to any progress, unless there's parallel work being done on gaining insight and taking stock of all the issues that will need to be worked on and worried about that contribute to anxiety. Getting up until we are sleepy may mean simply staying up all night and not being functional the next day, as the anxiety is just too strong. Or going to bed only when completely exhausted and screwing up the circadian rhythms for years to come.

Again, solid advice for simpler situations, but may not work at all for more complex ones. Don't beat yourself up if these purely logistical strategies don't work for you at this time, you may need more.

[eggsberts]

Emma, i cannot thank you enough for everything you do, you are such an amazingly kind soul, i really appreciate you so very much. this is a great video, i have noticed my anxiety usually spikes at night more than any other time. you are an absolute blessing. ❤

[sunshineher]

I just started the scheduled worry three days ago and it has helped me so much!! I usually do my brain dump an hour before bed because that's when my brain runs the most. I've noticed that my anxiety symptoms have lessened and my thoughts aren't running as much during the day which equals less stress on my body and mind. It's working!