Why Is Anxiety Worse at Night?

Anxiety is something many people grapple with daily, but for some, it can peak during the quiet hours of the night. If you’ve experienced this, you’re not alone. Nighttime anxiety is common and can feel especially overwhelming when the rest of the world is sleeping. Understanding why this happens and what you can do to manage it can bring relief and help you take control of your evenings.

In this blog, we speak to Kelly Duren, PA-C, a board-certified physician assistant with INTEGRIS Health Medical Group Norman, to learn more. “Anxiety is one of the most common causes for insomnia,” Duren says. 

Anxiety at night

The basics: Many people experience anxiety throughout the day, but others see it intensify at night. Nighttime anxiety can disrupt sleep, lead to feelings of worry and make nights feel longer and more torturous.

Anxiety is the body’s natural response to stress or a perceived threat. 

• This heightened state of alertness is designed to protect you from danger.
• However, when anxiety becomes chronic or occurs without a clear cause, it can interfere with your daily life.

Nighttime anxiety refers to a heightened state of worry, unease or fear that manifests during the evening or bedtime hours. 

• While anxiety itself is a natural response to perceived stress or danger, nighttime anxiety can feel particularly intense because it occurs during a quiet part of the day when you are supposed to be winding down.
• Common symptoms include racing or intrusive thoughts, waking up with a pounding heart or tight muscles and an inability to relax.
• Some people also experience catastrophic thinking or replay the day’s events, which makes it more difficult to fall asleep or stay asleep.

A study published in the British Medical Journal from February 2025 discovered people tend to feel happiest in the mornings and experience increased sadness or anxiety at night. 

• The research, which involved more than 49,000 participants, revealed that happiness, life satisfaction and feelings of worthiness peak in the morning, while depression and anxiety symptoms are at their lowest during this time.
• This pattern is influenced by circadian rhythms, which regulate cortisol levels – peaking in the morning to promote alertness and decreasing by bedtime.
• At night, reduced distractions and overactive thoughts can amplify negative emotions, contributing to heightened anxiety or sadness.

What makes anxiety intensify at night?

What to know: Several physiological and psychological factors come into play when anxiety intensifies during the evening or overnight hours. These elements work together, creating a “perfect storm” for people prone to worry.

During the day, work, errands or social activities occupy your time, which can redirect anxious energy. 

• At night, when things quiet down, your mind has more space to wander.
• Without the hustle and bustle, worries can feel louder and more unmanageable.

Ruminating over past events or worrying about the future is common at night. 

• These thoughts can spiral quickly, especially if you’re lying in bed with nothing to do but think. The result is a heightened state of mental alertness, making it hard to relax or sleep.

Hormone levels fluctuate throughout the day. 

• Cortisol levels typically rise in the morning to help you wake up and decrease as the day ends. 
• However, for people with anxiety, cortisol levels may remain high even at night, making you restless and experience heightened worry.

The natural circadian rhythm controls your sleep-wake cycle. 

• Disruptions to this rhythm, such as when sleep patterns become disrupted, can lead to poor sleep quality. 
• A lack of sleep can fuel anxiety, creating a vicious cycle where one worsens the other.

How to manage nighttime anxiety

Why it matters: While nighttime anxiety is challenging, there are strategies you can implement to ease symptoms and reclaim control over your evenings to get a better night’s sleep.

Establish a bedtime routine to signal to your brain it’s time to wind down.

• Try activities like reading a calming book, taking a warm bath or practicing gentle yoga.
• Over time, these habits can teach your body to associate specific behaviors with relaxation.

Practice relaxation techniques to counteract feelings of anxiety.

• Focus on slow, deep breathing to lower your heart rate and reduce tension.
• Use mindfulness meditation to ground yourself in the present moment.
• Progressive muscle relaxation involves tensing and then releasing each muscle group, working your way from head to toe.

“I recommend two short breaths in through the nose and one long breath out through the mouth,” Duren adds. “This helps calm the vagal response often triggered through anxious, sleepless moments.”

Limit screen time before bed to reduce blue light exposure.

• The blue light emitted by screens interferes with melatonin production, a hormone that helps regulate sleep.
• Try to avoid any screen time – phones, tablets and TV – at least an hour before bedtime.
• Instead, try activities that promote relaxation.

Challenge negative thoughts by writing them down and approaching them with rational thinking.

• Ask yourself, “Is this thought based on facts or assumptions?” and “What would I tell a friend dealing with the same worry?”
• Reframing your perspective can help you regain control over intrusive thoughts.

Adopt healthy sleep habits by sticking to a schedule.

• Create an environment conducive to sleep by keeping your bedroom cool, dark and free of distractions.

Avoid alcohol, caffeine and heavy meals close to bedtime.

• While alcohol may initially make you feel drowsy, it interferes with your sleep cycle, particularly REM sleep, which is essential for restorative rest.
• Caffeine blocks adenosine, a chemical in your brain that promotes sleepiness.
• Eating large or rich meals close to bedtime can cause discomfort, indigestion or acid reflux, making it harder to fall asleep. 

Next steps: If you find your anxious thoughts are getting in the way of a good night’s sleep, contact INTEGRIS Health Mental Health to learn more about treatment options to put your mind at ease.

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