‘I almost become paranoid’: Why anxiety is so much worse in the middle of the night

You know the scenario: It’s nighttime. You’re cozy under the bed covers, drifting off to sleep. Then, your eyes fly open. 

Wow, that was a big credit card bill this month. It’s time to make a budget. Your boss made that weird comment yesterday. Are you on thin ice at work? Forget work—are we on the brink of a world war? And what the heck is going on with that weird mole?

Before you know it, the worries are flooding your brain. You’re wracked with anxiety—and sleep isn’t coming any time soon.

“I think we’ve all had that experience where we seem to spiral at night and, in the morning—in the light of day—whatever you were stressing about the night before sometimes seems almost ridiculous,” says neuropsychologist Sanam Hafeez.

And that’s a problem. Lack of sleep seriously affects our ability to function, says licensed clinical psychologist and Brown University assistant professor Kristen Stone, who specializes in behavioral sleep medicine. Without enough sleep, we may experience reduced ability to pay attention, delayed reaction times, and lack of impulse control. And “enough” sleep isn’t just stitching together interrupted sleep.

“If you get eight hours of very fragmented sleep, you’re not significantly better off than someone who gets four hours of consolidated sleep,” she says.

Monsters in the Dark

There are a few reasons why anxiety spikes in the middle of the night. 

First, there are fewer distractions. During the day, we can turn our thoughts to work, socializing, hobbies, and completing tasks. But brains are efficient workers—and when all those demands are fulfilled or put aside for the day, they go to work on the matters that remain. 

“When you think about it, it is quite adaptive for the brain to pull up the stressor once the competing material has gone away,” Stone says.

Plus, we’re tired, Hafeez adds, and that fatigue may make us less able to hold off worries. At night, Hafeez says that lately she has been worrying about the locks on the doors of her house.

“It’s happened several times, and I almost become paranoid,” she adds. Logically, she knows the locks are secure, but the worries are persistent.

Then, there’s the snowball effect: Stone says that if you tell yourself not to think about something, you’re likely to think about it more, Stone says.

Hafeez says there’s also a biological component to our night fears—that’s when we’re more attuned to danger. 

“That’s when the wolves and all the predators come out,” she says. We may be more likely to think, “Oh, if I fall asleep, something terrible is going to happen,” she adds. 

So, the amygdala, which is responsible for this restriction, your fear center, is more active, she says. Researchers like the authors of the “Mind After Midnight” paper find that our minds are more prone to negative, emotional, and less rational thoughts at night. The paper pointed to increases in behaviors ranging from violence and suicidal thinking to alcohol consumption and overeating at night.

If you find your sleep interrupted by worries—or even that awkward thing you said at a family gathering last year—experts have some tips to help you get back to sleep.

Process your stress

Sometimes, climbing into bed is the first quiet time of the day, which may leave you vulnerable to worry-driven sleep interruptions, says sleep expert Nancy H. Rothstein, known as The Sleep Ambassador. Rothstein, who began studying sleep to find solutions for a snoring spouse, has developed a virtual sleep improvement program and consults about optimizing sleep. 

“When you lie down, what are you carrying into bed with you?” she asks. Before you settle in for sleep, use mindfulness or other techniques that can be effective in processing stressful thoughts and worries: Meditation, exercise, journaling, deep breathing, or other tactics can help you “transition to sleep in peace,” she says.

Find gentle distractions

When worries emerge at night, you may need to call on your prefrontal cortex—the part of the brain that engages in critical thinking and emotional regulation—to help control your thoughts. Remind yourself that you’re likely tired and that fatigue or nighttime negativity bias are likely making the situation look worse than it is. Hafeez suggests looking for gentle distractions, like naming objects in the room, or thinking about a positive event that happened recently.

Find your ideal sleep conditions

Your sleep environment matters, too. While some people need silence to sleep, others prefer some noise in the background, like ocean waves or falling rain. From temperature to noise, Hafeez suggests experimenting with the environment that works best for you.

Write it out

If the worries linger or other thoughts intrude, write them down. Hafeez admits to using her phone to make notes about tasks that need to be done. But if you’re concerned about blue light’s effects on sleep (which are debated)—or getting drawn into doomscrolling—you might keep a notebook and pen next to your bed. Sometimes, just writing out what’s on your mind can help you let it go.

Accept that some worry is normal

Stone points to evidence that a scheduled worry time during the day, sometimes called “worry postponement,” can decrease daytime worry, but the evidence that it will help you sleep better is thin. The bigger issue is worrying about worrying, she says, which will steal sleep. 

“There have been good effects shown for mindfulness-based interventions for helping folks improve their relationship with their thoughts: learning to notice thoughts without struggling with them, which decreases overall stress and generally fosters better sleep,” she says.

Establish regular sleep times

Stone also says that sleep timing matters because of our circadian rhythms. When we keep different sleep schedules on different days, we essentially “jet lag ourselves,” she says. 

“Trying to get more sleep by sleeping in or napping throws off these other important aspects of healthy sleep.”

If sleep interruption is a chronic issue, discuss the issue with a mental health professional or your doctor to help determine if there may be underlying physical or mental health issues that need to be addressed. Sometimes, medical intervention can help keep the worries away, too.

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