Sleep and Anxiety: How to Quiet Racing Thoughts at Night

Why your mind races at night

During the day, tasks and conversations occupy your attention. In a dark, quiet bedroom there is nothing to compete with worries, so they expand. Anxiety activates the body's stress response, raising heart rate and alertness, which is the opposite of the state needed for sleep. Over time, worrying about sleep itself can become the main thing keeping you awake.

Move worry to earlier in the day

Try a scheduled 'worry time': 15 minutes in the late afternoon or early evening, well before bed. Write down what is on your mind, and for each item note one next step or decide it cannot be solved tonight. When worries come up at bedtime, remind yourself they have a slot tomorrow.

Writing a short to-do list for the next day before bed can also help. A small 2018 study found that people who wrote to-do lists fell asleep faster than those who wrote about completed tasks.

Calm the body

• Slow breathing: gently breathe in for about 4 seconds and out for about 6, for several minutes.
• Progressive muscle relaxation: tense and release muscle groups from feet to face.
• Mindfulness or a body scan: notice sensations and thoughts without engaging with them.

Practice during the day so these skills come easily at night.

Change how you relate to sleep

Thoughts like 'If I do not sleep tonight I will fail tomorrow' raise the stakes and keep you alert. Remind yourself that most people function reasonably after a poor night, and that resting quietly in bed still has value. Some people find paradoxical intention helpful: instead of trying to sleep, you lie calmly with your eyes open and let sleep come when it will.

Get out of bed if you are wound up

If you have been lying awake and feel frustrated, get up and go to another dim room. Read something calm or listen to quiet audio until you feel sleepy. This is part of stimulus control, a core CBT-I technique, and it stops your bed from becoming a place of struggle.

Daytime habits that lower night-time anxiety

• Limit caffeine, which can intensify anxiety, especially after noon.
• Exercise regularly.
• Reduce news and social media in the evening.
• Avoid using alcohol to calm down; it worsens sleep later in the night and can increase anxiety the next day.

When to seek help

If anxiety or insomnia lasts more than a few weeks or affects your daily life, talk to a doctor or mental health professional. CBT for anxiety and CBT-I are both effective and can be combined. If you are in crisis or thinking about harming yourself, in the US call or text 988 to reach the Suicide and Crisis Lifeline, or contact your local emergency number.