Anxiety at Night

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Do You Have Anxiety At Night?

Anxiety at night can take many forms and can happen for many reasons. One form is a general ruminating that keeps you up, wide awake, and feeling tortured about your mistakes in the past and your fears about the future. You lay in bed thinking about all the things that happened and how you've screwed up your life, ruined relationships and sealed your fate. You also may worry about the future and all the terrible and catastrophic things that can indeed go wrong tomorrow or five years from today.

At nighttime, you are more vulnerable. You are tired, have less control over your thoughts and mind, and cannot distinguish irrational or unrealistic ideas. The pattern can become increasingly anxious in the evenings because you fear what your mind may subject you to. That can soon develop into a sleeping disorder, which might lead you down the path of sleeping pills or heavy caffeine use. 


If you have powerful avoidance mechanisms in place and cannot distract yourself at night, you cannot avoid your anxious thoughts when it becomes time to rest. It is for this reason that avoidance and distraction are not reliable avoidance techniques. Learning mindfulness, or being with your anxiety and befriending it, is an excellent technique to investigate if you suffer from nighttime anxiety. 


Check on this page on ruminating if this is the flavor of your anxiety at night—also, this page on mindfulness.


Additionally, being very careful of your alcohol and caffeine intake and the kinds of exposure you are having to electronics and media before bedtime can impact your ability to rest without anxiety. It may help you to have a nighttime ritual that entails winding down that you stick to. 

Take your devices out of the bedroom and see if it doesn't help. 

People who struggle with this kind of anxiety can most benefit from cognitive behavior therapy or mindfulness-based interventions throughout their day. 

These are Better than Counting Sheep!

Strategy: Containment

Set aside time during the day to worry. During that allotted time, allow yourself to list your worries and keep a running log. Next to each concern, you will write there is something you can do about this. Can you take action, or is this a problem you cannot solve out of your control? You can refer back to this list or add to it if you find yourself excessively worrying during the evening or any other time during the day. You can jot down a new worry or look at the list to remind yourself you have a plan. The idea is you tell yourself, " I have time set aside to worry about that tomorrow". Generally, this is a great strategy to help " contain" your worries or rumination. 

Strategy: Distraction techniques

Although distraction isn't the primary method you should use with worry, it may be okay if it keeps you up at night. Try some of these strategies and see if they help. 

  • Count backward from 1000 by 7. Start over each time you mess up
  • Choose a category with a lot of options ( names, cities, etc.). Pick one name, for example, Anabelle, and the next name must start with the last letter of the first name. In this case, it would be E- Edgar. Continue doing this until you get tired and have stopped worrying. 
  • Choose a fruit or another interesting object and imagine it entirely ( for example, a strawberry). Then change all aspects of the fruit's color. The strawberry would change to blue; for example, its seeds would change to green, its leaves would change to orange. Continue doing this. 
  • Get in bed, and instead of closing your eyes to go to sleep, force yourself to stay awake and do "nothing" longer than you would want to. This usually will have the effect of relaxing you and causing you to want to sleep. 

Anxiety at Night Special Situations :Panic, PTSD or Night Terrors

'Other forms of anxiety at night include panic attacks, stress-related to imagery and memories of trauma for PTSD, or anxiety associated with night terrors. 

  • Panic attacks: People can awaken in a panic state similar to what occurs during a daytime panic attack and remember the episode later. This fear causes them to avoid sleeping, have increased anxiety around the evening time. 
  • Night Terrors: Children and adults with bipolar disorder may have very vivid nightmares that they have difficulty separating from reality, and this cycle looks similar to the one in PTSD. Some adults with night terrors awaken but then quickly go back to sleep with little disruption or anxiety about their evening routine. 
  • Post-traumatic stress disorder: If you have PTSD, you may have your sleep disrupted by images or memories associated with the trauma that causes you anxiety and fear. You may be anxious and fearful ABOUT going to bed because of these images, leading to a general increase of anxiety at night and an avoidance of bedtime. 

Anxiety at night: children, the elderly and sick and sleep disordered

Nighttime anxiety is most common in children, especially if they have a fear of separation. Nighttime anxiety is also common in the elderly, those with dementia, and those with Parkinson's, psychosis or restless leg syndrome, or sleep disorders. 

Anxiety at Night: Bipolar Disorder

Many of my clients who have bipolar disorder have a sudden spike in anxiety or depression in the evening. It can be very uncomfortable for them and feel unmanageable. Mood swings can exacerbate anxiety.  Sometimes the anxiety can be eased by a medication change.

Anxiety at Night: Sunday Anxiety

Almost everyone feels some anxiety on Sunday night.   You've been avoiding thinking about or dealing with work stress for the weekend, and it now becomes unavoidable. The level of your anxiety may indicate that your work stress is more than you can handle. 

Anxiety at Night: Menopause

Women who are in perimenopause may also deal more with anxiety at night. The discomfort from hot flashes can cause sleep disruption, and hormonal changes wreak havoc on women's moods. Cooling the room can help. Talk with your doctor about supplementing hormones with an antidepressant. It can take years before you fully complete menopause. 

Check out another page on anxiety at night


Sources

Ellis, J. (2017, Feb 16). Forget counting sheep - imagine a RAINBOW instead. Daily Mail Retrieved from http://nclive.org/cgi-bin/nclsm?url=http://search.proquest.com/docview/1868555707?accountid=13217

Tippett, S., & as told to, S. F. (2011, May 03). G2: Health: Three-minute fix late-night worries. The Guardian Retrieved from http://nclive.org/cgi-bin/nclsm?url=http://search.proquest.com/docview/864536294?accountid=13217


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Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.