Why does my anxiety get worse at night?
Answered by Dr. Nitnem Singh Sodhi · Consultant Psychologist & Psychotherapist · Updated 2026-05-05
Short answer
At night the brain has fewer external inputs, so internal threat-prediction gets louder. Combined with a tired prefrontal cortex (which normally dampens the alarm), worry feels amplified. Stimulus control plus paced breathing is the fastest fix.
There is a reason this is the most common complaint I hear from working professionals in their 20s and 30s: nighttime is when the prefrontal cortex (your in-house worry-dampener) is most fatigued, while the amygdala (your alarm system) is still wide awake. With the day's distractions gone, internal predictions get the microphone.
Three moves that actually work tonight
1. Decouple bed from worry. If you are not asleep within 20 minutes, leave the bed, sit somewhere dim, return only when sleepy. This is the active ingredient of CBT-I.
2. Paced breathing. Inhale 4, exhale 8, for ten cycles. The long exhale switches the body into the parasympathetic state required for sleep onset.
3. Worry window. Earlier in the evening, write the day's worries on paper for ten minutes. The mind stops rehearsing them at 1 a.m. when it knows they are recorded.
When to seek help
If insomnia plus nighttime anxiety has been present for more than three weeks, take the ISI and the GAD-7 and book a consultation. This pattern responds very well to combined CBT-I + Cognitive Regulation work, usually inside 4–6 sessions.
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