Discover Why Anxiety Feels Worse at Night- How Therapy Can Help

Discover why anxiety often worsens at night, its common symptoms, and how therapy can help you regain control and sleep better.

Why Anxiety Often Feels Worse at Night

Many people notice that anxiety feels more intense at night, making it difficult to fall asleep or relax. Understanding why this happens can help you manage it effectively.

• Fewer distractions & more space for worry. During the day, we’re busy with tasks, socializing, and errands. At night, it’s quieter—our thoughts start creeping in.

• Fatigue and lowered emotional resilience. When you’re tired, your mind has less energy to regulate emotions and filters.

• Hormonal/circadian shifts and sleep disruption. Biological rhythms influence how we feel — and poor sleep or insomnia can amplify anxiety.

• Unfinished business and tomorrow’s “to‑do” list. The brain often revisits what’s unresolved or anticipates what’s coming next—especially when there’s no external occupation.

• Environmental triggers of the night. Darkness, isolation, quietness, and the feeling of vulnerability can heighten anxious thoughts.

Understanding that the night sets up a “perfect storm” for anxiety is the first step to managing it.

Common Symptoms of Anxiety at Night

• racing thoughts

• feelings of nervousness, restlessness, or worry

• trouble falling asleep or staying asleep

• frequent need to pee

• abdominal pain

• sweating

• tense muscles

• jaw pain

Some people may also experience a nocturnal panic attack. Nocturnal (nighttime) panic attacks have the same signs and symptoms as regular panic attacks, but they occur while you’re asleep.

Research shows that about 20% to 45% of people living with panic disorder experience frequent nighttime panic attacks. If you experience a nocturnal panic attack, it may be hard to calm down and fall back asleep.

How Therapy Can Help You Manage Nighttime Anxiety

At Jabali Behavioral Health Nursing, our integrative approach is designed for high‑functioning adults who are ready to reclaim their lives. Here’s how therapy can make a difference when worries are loudest at night:

1. Cognitive Behavioural Therapy (CBT) for Anxiety

Through CBT, you’ll learn to identify patterns of thought that magnify anxiety (especially at night), challenge distortions (“What if…”), and replace them with more balanced, calm thoughts.

2. Mindfulness, Relaxation & Sleep Hygiene

Therapy isn’t just talk‑based. We incorporate tools such as guided imagery, breathing techniques, and establishing a healthy sleep routine. These strategies can calm the mind before bedtime.

3. Medication Management & Integrative Psychiatry

For some clients, medication may be part of the solution. At Jabali, we offer medication management and integrative care, combining therapy, medications, and nutrition for optimal mental health.

4. Personalized, Compassionate Care

Every individual’s nighttime anxiety triggers—and their lives—are different. At Jabali, we create individualized treatment plans, taking into account your sleep issues, anxiety patterns, lifestyle, and goals.

Practical Tips to Reduce Anxiety at Night

Even before or alongside therapy, you can implement these habits:

• Establish a consistent bedtime routine — go to bed and wake up around the same times.

• Reduce screen time and stimulation 1 hour before bed.

• Keep a worry journal — write down what’s on your mind so the brain “stores” the thought instead of looping it.

• Progressive muscle relaxation: Learning to tense and relax individual muscle groups in the body is another technique that promotes relaxation. This technique is commonly used to treat panic attacks, excessive worry, and insomnia. Breathing exercises and progressive muscle relaxation can also be used together.

• Practice light activity or movement earlier in the day — it helps regulate the nervous system.

• Create a calming bedroom environment — dark, cool, minimal noise, comfortable.

• Therapy for anxiety: When anxiety begins to interfere with a person’s sleep or waking life, seeking professional treatment may help. Mental health professionals can offer support and a variety of tools for coping with anxiety.

Talking to Your Doctor About Nighttime Anxiety

If your anxiety at night is more than occasional worry, it’s important to reach out to your doctor. Mental health experts, the National Institute of Mental Health (NIMH), encourage discussing concerns with a primary care provider. Your doctor can evaluate your symptoms, rule out underlying health conditions, and refer you to a mental health specialist if needed. They can also discuss treatment options such as therapy or medication.

Be open and specific about your symptoms. Describe how long your anxiety has been occurring, its severity, and how it affects your sleep and daytime functioning. Even if your nighttime anxiety feels mild, it’s worth mentioning if it disrupts your sleep or daily activities.

A helpful tool is a sleep diary, which you can keep for one to two weeks before your appointment. Track:

• Bedtime and wake-up time

• Naps during the day

• Moments when you feel tired

• Exercise, caffeine, or alcohol intake

Sharing this information with your doctor provides them with a clearer picture of your sleep patterns and anxiety triggers, enabling more personalized and effective care.

Take the first step toward reclaiming calm evenings and restful nights. At Jabali Behavioral Health Nursing, you’re seen, supported and stronger than your anxiety. Book an appointment today.