Why Anxiety Gets Worse at Night

Many people find that anxiety intensifies at night. Even if the day has passed without significant stress, the moment your head hits the pillow, a flood of racing thoughts and tension may take over. This is not just anecdotal — there are psychological and physiological reasons why anxiety tends to feel worse in the evening and overnight.

Key Takeaways

• Night-time anxiety is often worsened by a lack of distractions and elevated cortisol levels.

• Poor sleep and disrupted circadian rhythms create a feedback loop with anxiety.

• There are proven strategies to manage night-time anxiety, including CBT, mindfulness, and reducing stimulants.

Why do you get more anxious at night?

Fewer Distractions, More Rumination

During the day, distractions are everywhere. Work, chores, errands, social interactions — they all help keep the mind occupied. At night, when external stimulation drops, the brain turns inward. For those with anxiety, this often leads to rumination: overthinking, catastrophising, and mentally replaying events or future worries.

With nothing else demanding your attention, anxious thoughts can feel louder and more pressing. In psychology, this is linked to something known as the default mode network — a brain system that becomes more active during rest and mind-wandering, which is often more negative in anxious individuals.

Cortisol and the Body’s Stress Response

Cortisol, the body’s main stress hormone, follows a daily rhythm. It typically begins rising in the early morning and peaks shortly after waking. However, for those with chronic stress or anxiety disorders, cortisol patterns can become dysregulated, leading to elevated levels in the evening — precisely when the body should be winding down.

Research published in the journal Biological Psychiatry has shown that people with anxiety disorders may have higher evening cortisol levels, which can lead to racing thoughts, shallow breathing, and increased heart rate — all of which make sleep harder.

The Link Between Anxiety and Insomnia

Anxiety and sleep disturbances are closely intertwined. The Sleep Foundation reports that individuals with anxiety are more likely to experience insomnia, fragmented sleep, and lower sleep quality overall. In turn, poor sleep contributes to increased emotional reactivity and reduced resilience to stress the next day, creating a vicious cycle.

A study in Behaviour Research and Therapy found that people with insomnia are significantly more likely to experience night-time anxiety due to their preoccupation with not sleeping — the harder they try to fall asleep, the more anxious they become.

Night Sweats and Physical Symptoms

Night-time anxiety often comes with physical symptoms, including:

• Sweating or hot flushes

• Restlessness or tossing and turning

• Racing heart or palpitations

• Muscle tension

• Shallow breathing

• Gastrointestinal discomfort

These are caused by the activation of the sympathetic nervous system, also known as the fight-or-flight response. When the brain senses a perceived threat — even if it's imagined or future-based — the body prepares to take action, even if you’re lying in bed.

Hormonal Shifts and Menopause

For women, especially those over 40, night-time anxiety may also be linked to hormonal changes. As oestrogen and progesterone levels fluctuate during perimenopause and menopause, many experience new or worsening anxiety, including anxiety night sweating and panic-like symptoms.

According to The British Menopause Society, hormonal changes can disrupt the body’s thermoregulation and emotional processing, contributing to feelings of anxiety, especially during the night.

Blue Light and Sleep Interference

Exposure to blue light in the evening — from phones, laptops, or LED lighting — suppresses melatonin production, the hormone that helps regulate your sleep cycle. This can delay sleep onset and increase alertness when the body should be winding down.

Reduced melatonin not only makes it harder to fall asleep but has also been shown to reduce the quality of REM sleep, which is vital for emotional regulation. A poor night’s sleep often results in elevated anxiety levels the next day.

Overthinking, Perfectionism and Hyperarousal

For some, night-time anxiety is rooted in high-functioning anxiety or perfectionist tendencies. The quiet of night allows space for harsh self-criticism or worries about performance, social interactions, or future events.

This state of hyperarousal — where the body is alert and overstimulated — can make it impossible to transition into a relaxed state suitable for sleep.

How to Reduce Night-Time Anxiety

Managing anxiety at night often requires a multi-pronged approach. While each person’s triggers and responses may vary, the following strategies are backed by research and clinical practice:

Cognitive Behavioural Therapy for Insomnia (CBT-i)

CBT-i is a gold-standard, evidence-based treatment that targets the thoughts and behaviours disrupting sleep. Studies published in The Lancet Psychiatry (Freeman et al., 2017) have shown that CBT-i can significantly reduce both insomnia and anxiety symptoms by helping retrain the brain’s associations with sleep.

Mindfulness and Meditation

Mindfulness practices, including body scans and breathing exercises, help anchor the mind in the present. They lower activity in the amygdala (the brain’s fear centre) and reduce physiological arousal.

Apps like Headspace, Calm, and Insight Timer offer free guided meditations tailored for night-time anxiety and sleep preparation.

Reduce Evening Stimulation

Avoid caffeine, alcohol, heavy meals, and intense exercise within three hours of bedtime. These can all spike alertness, affect cortisol levels, or disrupt digestion — all contributing to restlessness at night.

Establish a Wind-Down Routine

A structured evening routine — such as taking a warm bath, using calming scents like lavender, or journaling — signals to the brain that sleep is approaching. Avoid screens in the hour before bed or enable “night mode” to reduce blue light exposure.

Try a Natural Supplement (Cautiously)

Some individuals benefit from natural sleep supplements such as magnesium, valerian root, or L-theanine. However, always consult a GP if you’re considering supplements, especially if you're on medication or managing a mental health condition.

Create a Calm Sleep Environment

A cool, dark, and quiet bedroom promotes melatonin production and eases anxiety. White noise or nature sounds can help mask environmental disturbances, and weighted blankets have shown promise in reducing anxiety symptoms.

Seek Professional Support

If night-time anxiety is chronic, overwhelming, or affecting your quality of life, speak to your GP. Cognitive therapy, medication, or further assessment for conditions such as Generalised Anxiety Disorder (GAD), ADHD, or depression may be necessary.

Final Thoughts

Anxiety getting worse at night is a shared experience for many. While the silence and darkness should bring calm, they often allow anxious thoughts and sensations to come to the surface. From overthinking to hormonal imbalances and disrupted sleep cycles, the reasons are complex but manageable.

With the right combination of routine, environment, and support, it’s possible to reclaim your nights and get the rest your body and mind need.