Increased anxiety at night
March 31, 2013 1:10 PM   Subscribe

I tend to get increased anxiety in the evening, hoping for advice or explanations for what might be causing it.

I'm a bit on the anxious side of things at the best of times, I've been in CBT for a while and it has helped immensely (so please no standard "try therapy". I have brought this up a few times, but it's not my main focus currently), but I've noticed that my anxiety tends to increase at night. It's like I'm sundowning.

I've been waking up and going to bed at regular times, I practice good sleep hygiene (no screens after a certain time, only sleep in bed, etc). It certainly gets worse if I stay up late past when I usually go to sleep, so sticking with that has been helpful, but I still notice a general rising of anxieties at night and I'd rather not move my bedtime to 8pm to avoid it.

My general anxiety overall has decreased with various practices I've learned in therapy, and I keep it up at night, I'm just interested in why it tends to ramp up as the sun goes down. (And hopefully how to prevent it.)
posted by Dynex to Health & Fitness (17 answers total) 18 users marked this as a favorite
Could be a sunlight/darkness issue. I have Seasonal Affective Disorder, it means that the less sunlight I get the more anxious and depressed I get. I take an anti-anxiety drug, and it works fine.

You can get a special light, that might help. I used it when I lived in a different time zone.
posted by Ruthless Bunny at 1:38 PM on March 31, 2013

Does this happen equally whether you are busy/preoccupied in the evening or sitting quietly? I'm going to assume not, that in the evening as you start to slow down and prepare for bed your anxiety comes to the forefront because there's nothing else filling that space.

I tend to get more anxious at bedtime because I have nothing to distract me and random things pop into my head while I am trying to fall asleep. Humiliating 3rd grade incident, relationship from 2 years ago, what I should do with my cassette tape collection, why my boss was weird yesterday.

I've tried meditation, that seemed to help somewhat. I currently listen to something - a sitcom, an audiobook, a Fresh Air podcast - while falling asleep, and I find it very helpful.
posted by bunderful at 1:39 PM on March 31, 2013 [6 favorites]

It's really, really common for this to happen. As you wind down for the night there are fewer distractions, you start to think about your day tomorrow, you are more tired, and your mind is more prone to wander to anxious thoughts. Add to this worries that you won't be able to sleep, and worries that it's going to happen again the next night and you can wind up with a cycle of worry that seems to get worse. There are absolutely CBT strategies to deal with this, and asking your therapist for some coaching wouldn't be off base. Something like scheduling a time to worry at some other point in the day can work for some folks. Coping strategies like mindfulness meditation, progressive muscle relaxation, relaxation breathing, etc. can help reduce anxiety in the moment.
posted by goggie at 1:41 PM on March 31, 2013 [8 favorites]

What's your caffeine intake like during the day?
posted by empath at 1:52 PM on March 31, 2013

I've had acute anxiety disorder for the better part of ten years. I've gone through periods where the time of day when I experience anxiety most varies. I can't say I know why this happens. It could very well be as bunderful said, that you're winding down and the things you worry about start coming to the fore.

I listen to anything with a white noise layer in the background - rain, the waves, etc. while falling asleep. Have you heard of binaural beat therapy? I've found this extremely helpful, especially when my head won't slow down when it's time to go to bed.

Seconding empath on caffeine - I changed to decaf on coffee and it made a big difference.
posted by New England Cultist at 1:55 PM on March 31, 2013 [3 favorites]

I second what bundeful said, but instead of listening to a podcast I usually read until I get sleepy enough to fall asleep. It helps a lot because I'm focusing on what I'm reading instead of my thoughts. I have trouble falling asleep if I don't read a bit(even if it's only a couple of minutes) before going to sleep.
posted by fromageball at 2:11 PM on March 31, 2013 [5 favorites]

I have the same problem and really, meds helped me immensely. (I understand if that's not a solution for you.)
posted by sperose at 2:52 PM on March 31, 2013 [1 favorite]

I have mild anxiety and I used to not be able to sleep at night. I would be up for hours. I would have racing thoughts, worry about all the things I needed to do for work the next day since I work from home. Sometimes they would turn into horrible "What if.." thoughts.

I finally figured out what it was! I would watch TV shows before bed, while in my bedroom.

NO more TV in the bedroom!!

That really allowed me to fall asleep so much faster. It's the same for phone games. I still sometimes pick up my iphone when I can't sleep and I need to stop as it tends to keep me up longer. "Just one more game of solitaire!" Uhg.

I have also heard that the same tricks for insomnia work for anxiety. For example if you can't sleep you are supposed to leave the room, read a calming book for 20 ish minutes, then try again. You could also try walking around to get out some anxiety. Physical activity can help you relax. That should help keep you mind on the sleep track of things. It also keeps your bed and bedroom as a place for sleeping, not a place for games, books, and other media.

Could a white noise machine or fan help also? That noise can distract your mind too.
posted by Crystalinne at 2:57 PM on March 31, 2013

I'm just interested in why it tends to ramp up as the sun goes down. (And hopefully how to prevent it.)

Because at night the usual structures (work/school, relationships, usual leisure activities) come to a close, and now it's just you and the Nothingness that is nighttime and the expectation/necessity to go to sleep, which is sort of, kind of, like dying (losing consciousness).

How to prevent it -- well a lot of good ideas are posted above. To work on remembering that night isn't really any different from day, and day will come again. Personally I usually have to replicate day, in the sense of listening to TV shows through earbuds as I fall asleep.

When I was a little kid afraid of falling asleep I'd tell myself to think of all the people in all the other time zones across the planet who were still awake -- that nighttime was a relative concept.
posted by DMelanogaster at 3:35 PM on March 31, 2013 [3 favorites]

I sometimes get this sort of sad anxiety thing towards sundown, especially on Sundays, and even more so in the winter. It's not as simple as "weekend over, have to go back to school/work tomorrow". It's more like an awareness of mortality, that the light is dying and everything dies - no, can't really get it in words. It's not as literal as a fear of death, it's more of an archetypal kind of reaction. Anyway, what helps for me is turning on lots of lights - especially incandescent/yellowish lights, not those horrible clinical fluoro ones - and playing music, cheerful stuff (for me this is usually Celtic music). If that doesn't do the trick, ringing friends to either talk and/or invite them round for dinner, because company does seem to help drive it away, as does having something to do (like make dinner). Otherwise, watching a cheerful film or video.

I also have a bit of a bedtime routine, developed when I kept getting insomnia, of reading for a bit and then doing a logic problem like sudoku or pixel puzzles. For me, concentrating on the logic and the numbers makes the worried, anxious bit of my brain recede (or maybe it's just focused on problem-solving) so that I get tired despite myself and usually start nodding off. Mind you, it's not foolproof - last night I then lay awake and turned things over and over until finally I fell asleep. I think I've been doing it long enough now that it doesn't upset me the same way it used to.
posted by Athanassiel at 5:15 PM on March 31, 2013 [2 favorites]

What's your caffeine intake like during the day?

Yes. The "awake" effects of caffeine last a lot longer than the "happy" effects. If I have any caffeine after 3pm, it gets harder and harder for me to get to sleep. And coffee has a LOT more caffeine than you'd think...

As for mind issues, the end of the day is when you take stock of the day and plan the next day. Even if it is subconscious. So if you failed to get shit done and this is going to have negative effects the next day, you may well feel anxiety. (Anxiety that would have been helpful at noon when you could do something about it, but not at 11pm when you can't.) In other words, the more on top of my shit I am, the better I sleep. You may find the same thing about yourself.

Also, have a notebook or clipboard that you can write stuff down on for the next day. Knowing that that "thing" you are hoping you won't forget tomorrow is safely written down allows your brain to ease up on it.
posted by gjc at 6:54 PM on March 31, 2013

I don't drink caffeine, it gives me hives. Rarely have chocolate or other caffeinated foods either. I have a pretty careful diet of whole foods and lots of fresh vegetables, and I go to the gym 3-5 days a week, in the late morning. Both have helped immensely. And I do have a white noise machine! I practice mindfulness and breathing, it helps a lot, it's just that I tend to have to do it more at night. I have been considering medication, though I do have some anxiety about side affects (ha).

Thanks for all the advice and comments so far, a lot to think about. It's comforting to know other people have this issue.
posted by Dynex at 7:07 PM on March 31, 2013 [1 favorite]

One thing that helped me with this when it was an issue is having a nice nighttime routine to look forward to at night. I generally shower in the evening, and using nice smelling or scrubby soap or lotion or massaging my feet with the brush is good. I have "comfort books" that I've read over and over, that are good during anxious times (Dorothy L Sayers mysteries, or the Master and Commander books, or The Earthsea Trilogy are among them). If you have a pet this could be a time that you play with them or brush them. You can accumulate different kinds of decaf tea and have it as a nighttime treat- I was really not into tea for a long while, but I'm enjoying it more lately. You could sketch, or build things, or do jigsaws, or any of a number of indulgent hobbies that are hard to get to during the day, but easy to put down once it's bedtime. It's pretty soothing for me to feed my fish and sit there and watch them, so that combines a number of things (pets, indulgent hobby, routine) that make nighttime meaningful in a good way.

I was definitely very anxious at night when I was procrastinating at school, and when I was sleep deprived, which was horrible. When it got really bad I started taking valerian extract and melatonin, and trying to get stuff taken care of during the day because I didn't like doing work at night. The supplements really helped.
posted by oneirodynia at 7:21 PM on March 31, 2013 [2 favorites]

I have a similar problem sometimes. Everyone has made really good suggestions so far, but I found that my casual factor was something completely different-- I was trying not to eat before bedtime, so by the time I finally went to bed, my blood sugar was so low it was making me sad! (In my case, I'd wake up about an hr after nodding off and have miserable little mini-anxiety attacks.) I have SAD and I think somehow my blood sugar dropoff is more likely to make me depressed rather than "feel hungry" after dark or something. Anyway.... You don't mention your night eating habits, but you might want to try a simple, healthy snack (for me it's usually a piece of fruit and a few almonds) a bit before you go to bed and see if that helps.
posted by WidgetAlley at 7:40 PM on March 31, 2013 [3 favorites]

I should have mentioned - I take 30mg of Citalopram a day. I used to take Fluoxetine, but it didn't work that well for me. Along with this I do constant CBT and apply mindfulness techniques.
posted by New England Cultist at 11:59 PM on March 31, 2013

WidgetAlley - I've noticed as well that, when my anxiety levels are excessive and I go to sleep, I wake up an hour later getting a mini panic attack. I have low blood sugar, bit I have never associated these instances with that in any way. Will keep it in mind. I still think it's pretty weird how it always ends up being almost exactly an hour after nodding off.
posted by New England Cultist at 2:05 AM on April 1, 2013

You are moving around a doing things all day. Laundray, cooking, errands, friends, work...All these things distract you such that your anxiety is not as noticable, or is being 'burned off'. When you slow down in the eveining, you notice it again. You're not as active and not working it off. It's awful and I can definitely relate. Me, I take klonopin.
posted by kitcat at 8:32 AM on April 1, 2013

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