Lily Brown, director of the University of Pennsylvania’s Center for the Treatment and Study of Anxiety, has heard a common theme from her patients: the feeling of being overwhelmed and exhausted, only to find that their brains won’t turn off at night. Research has long suggested that anxiety symptoms spike and mental health suffers after dark, and a 2022 study dubbed this phenomenon the “mind after midnight hypothesis.” A 2024 study published in Psychiatry Research found that general anxiety peaks at various times throughout the day, but the racing thoughts that plague many anxiety sufferers are at their worst in the evening.
The human body’s biological clock plays a significant role in this phenomenon, with the sleep pressure building throughout the day and cognitive function often suffering as a result. This can make it harder for the brain to regulate emotions, making people more susceptible to self-harm and substance abuse late at night.
The lack of distractions during the night can also exacerbate anxiety, as people are often alone and without external resources to regulate their emotions. Additionally, the brain has fewer distractions at night, creating a “perfect setup for that runaway anxiety, that ruminative thinking about ‘what if’ and ‘what about,’ and then also replaying the prior day.”
But there is hope. Research suggests that getting a good night’s sleep can ease anxiety and reduce negative memories. This is because sleep is closely linked to anxiety, with anxious people often struggling to sleep and poor sleep predicting future anxiety.
To combat nighttime anxiety, Dr. Brown recommends setting aside 10 minutes during the day for “worry time” and using a timer to keep her patients on track. She also advises journaling by the bed, jotting down a quick note or reminder about whatever is troubling, and getting out of bed if spiraling into anxiety. It’s also important to establish good sleep habits, such as sleeping in a cool, dark, and quiet room, and establishing a consistent bedtime routine.
By addressing nighttime anxiety, people can find relief from the racing thoughts and rumination that plague them, and start to experience better sleep and improved mental health.