How Do I Deal With Nighttime Anxiety?

This week in the Coping newsletter: What to do when worry keeps you awake, why New Year's Eve is so depressing, and a sanity checklist for 2019.
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Xavier Lalanne-Tauzia

Welcome to Coping, Episode Sixteen.

We can’t change most anxiety-inducing situations—like a work deadline coinciding with a hostile breakup coinciding with a politics-induced migraine—but there are factors completely within our control that set us up to be our most unshakeable selves. Here are the four most fundamental tent poles of mental stability. Take a look and see what you might want to try in time for the new year.

Ask the therapist

Q: How can I deal with anxiety that seems to surface at night? The kind that wakes me in my sleep and then keeps me up for hours with the "what ifs"?

A: Ah, such a common and extremely difficult problem with anxiety. You are not alone, and there is much you can do to shift this to get the better sleep you deserve.


  • Alter your sleep routine by experimenting with one change per week (so you can truly see what is making the difference). This includes limiting external stimuli before bed, like tv or phone use, implementing an eating cut off time, and maybe even changing where you are sleeping.

  • Try to reserve your bed for sleep time ONLY. When you wake up in the middle of the night, give yourself a few minutes to potentially fall back to sleep. If no luck, get out of bed, as your brain will begin to associate being awake with your bed—which may be part of the problem at play now.

  • Schedule 'worry time.' This is a tried and true technique that consists of literally scheduling a time in your day specifically for the purpose of worrying. Try with 20 minutes, let's say at 5pm (perhaps your commute home from work). Set an alarm on your phone. Whenever a worry or "what if" comes up in your day, tell yourself: "I'm too busy to think about this right now, I'll figure it out at 5." When worry time approaches, you'll flood yourself with all of the "what if" scenarios you can think of. You'll probably find it's hard to fill the full 20 minutes. Try to anyway. The goal is to fill your brain with the anxious thoughts on your time. That way you're not waking up in the middle of the night with the same worries.

  • Finally, if you do wake up, get out of bed and turn to a journal. Jot down what is on your mind and one potential solution. Note: Do not try to fix the scenario in the middle of the night, just plan ahead on what you could do. This strategy gives your brain a rest on these what if scenarios, even if just for the moment.


If you do these things with consistency and repetition for two weeks with no change, I would recommend picking up a manual I use with clients: Overcoming Insomnia, a CBT approach to tackling sleepless nights.

Wishing you many 💤💤💤!

Michelle Lozano is an Associate Marriage and Family Therapist and member of the Anxiety and Depression Association of America.

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Happy New Year!