Panic Disorder Coping Effective Ways to Manage Evening Anxiety By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on October 17, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW Medically reviewed by Amy Morin, LCSW Facebook LinkedIn Twitter Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, the author of the bestselling book "13 Things Mentally Strong People Don't Do," and the host of The Verywell Mind Podcast. 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Nighttime anxiety is a problem for many people with anxiety disorders, who find that their evenings are filled with a sense of uneasiness, worry, and apprehension. Anxiety at night can keep you from sleeping, while lack of sleep can increase your anxiety. Luckily, there are ways to manage your anxiety so you can rest, function the next day, and live a fulfilling life. Why Anxiety Increases at Night There’s no one easy explanation as to why anxiety increases at night for some people. Instead, it can be the result of a variety of factors. One explanation is that when the lights go out and all is quiet, there is less distraction and more opportunity for worry and rumination about your career, finances, or relationships. Difficulty falling asleep may also unleash its own set of worries about how well you'll be able to function the following day. Other reasons why anxiety increases at night may include: Drinking too much caffeine during the day or close to bedtime, which can make some people jittery and more anxious Experiencing a recent trauma or having pre-existing post-traumatic stress disorder Health anxiety, or noticing aches and pains more while trying to fall asleep Having certain medical conditions; one study linked nighttime anxiety to menopause, for example Worry or fear over the next day Symptoms Everyone experiences anxiety differently, and symptoms may vary. Symptoms of nighttime anxiety may be similar to those you experience during the day. Or they may be specific to the evening hours. Aches and pains Difficulty breathing Heart palpitation Feeling nervous or restless Uncontrolled or racing thoughts Difficulty falling and/or staying asleep Nightmares Gastrointestinal problems Panic attacks and nocturnal panic attacks Impact Anxiety that strikes in the evening can be incredibly bothersome, as it may take away from your free time, zap your energy, and contribute to sleep issues. Sleep deprivation can have a major impact on your functioning, quality of life, and overall health. Loss of sleep can also trigger anxiety at night, creating a vicious cycle. Another result of nighttime anxiety is panic attacks or nocturnal panic attacks, which take place during non-REM sleep, primarily in stages 2 and 3. Nocturnal panic attacks can awaken you from sleep and leave you feeling tired throughout the following day or days. Overcoming Panic Disorder and Insomnia with Sleep Hygiene How to Manage Anxiety at Night Fortunately, there are steps you can take to help reduce your nighttime anxiety, allowing for a relaxing evening and restful night's sleep. Set an Intention Early Many of us go from one activity to the next throughout our day without really considering how we are feeling, let alone how we would like to feel. For example, do you ever come home after a long day of work and think to yourself, “I really want to relax and enjoy this evening?” Most likely you are far too busy or preoccupied to stop and ponder how you want your evening to be. However, by setting an intention early, you are more likely to get the results you want. If you remind yourself each day that you are determined to have a peaceful evening, you are more likely to actually experience it that way. Remembering to set an intention is easier when you mark a certain point in your day for it. For example, while driving home from work, you may be going over in your mind all the stress that you went through that day. At a certain point during your drive home, such as when you drive over a certain bridge or pass a particular landmark, you can set the intention to let go of work stress from that point forward and enjoy the rest of your evening. Another option can be to set an alarm that reminds you to set your intention for a nice evening. Regardless of what type of prompt works for you, get in the habit of setting your personal objective of how you want to feel each evening. Learn to Be Present Along the same lines of not being in touch with how we want to feel, many of us spend much of our time completely unaware or detached from the present moment. By making an effort to be more mindful, you may be better able to enjoy your evening. Mindfulness can prevent you from going over every worry in your head and allow you to recognize that you do not have to react to every thought that pops into your mind. Mindfulness is a skill that can be learned through activities such as mindfulness meditation. If mindfulness seems awkward or too time-consuming, simply make an effort to be more aware of life as it is, instead of searching your mind for nervousness and fear. Try to listen closely to your loved ones, enjoy the food you are eating, notice the beauty of the earth—these are all simple ways to push anxiety aside and become more mindful. How to Make Mindfulness Your Way of Life Leave Some Extra Transition Time Transition time is the time that is needed between tasks. Many of us underestimate how much transition time is needed. For instance, your evening may consist of numerous different tasks that you need to do before you go to bed. Whatever amount of time you have allotted for each task, consider adding a bit more time as a buffer in case the task takes longer than you think. That way you will avoid feeling overwhelmed, trying to cram too much in before bedtime. Prepare for the Next Day Many people find it anxiety-provoking to think about all that they need to do the next day. Being prepared is one of the best things to do to avoid this type of anxiety. Get as much ready as you can, like having your clothes picked out, lunches and bags packed, and your alarm clock set. Putting a small amount of effort into preparation can help keep evening anxiety under control. Create Some Space to Unwind When everything is done for the night and ready for the next day, you do need some time each evening to simply relax, let go, and re-energize. A few ideas: Practice a relaxation technique, such as deep breathing, journaling, or yoga. Read a book. Unwind with a warm bath or cup of tea. Regardless of what brings you serenity, set aside at least 10 minutes of downtime each evening. Doing so allows you to feel calmer and may be the prompt you need to get a good night’s rest. Establish a Bedtime Routine Establishing a bedtime routine lets you focus on taking proactive steps for yourself instead of ruminating in your anxiety. Your bedtime routine may include activities such as taking a shower, brushing your teeth, changing into pajamas, reading from an inspirational book, prayer, or listening to music. Your bedtime routine should be established to help set you up for better rest. Don’t include any activities that may be too overstimulating, such as scrolling through social media or watching TV. Instead, make your routine calming and quiet, leading up to you falling asleep. This will signal to your brain that it is time to rest and will allow you to go to sleep without an upset and anxious mind. Treatment While self-help strategies can go a long way, you may also find it useful to schedule an appointment with a healthcare professional. They can rule out any medical or sleep conditions contributing to your nighttime anxiety. In addition to maintaining good sleep habits, treatment options typically involve psychotherapy, medications, or a combination of both. Psychotherapy Research has shown that psychological treatments, including cognitive behavioral therapy and exposure therapy, can be helpful for treating anxiety. Cognitive behavioral therapy (CBT): One study found that CBT improved both sleep quality and sleep latency (how long it takes to fall asleep) in people with anxiety. Exposure therapy: This therapy may be used to help reduce your fear about having anxiety at night and/or trouble sleeping due to your anxiety. Medication A variety of medications can be used in the treatment of anxiety, including: Benzodiazepines (sometimes called "benzos") are the most widely used group of sedative drugs. They are usually prescribed for short-term management of severe or treatment-resistant anxiety. Selective serotonin reuptake inhibitors (SSRIs) are currently considered the first-line medication for most forms of anxiety. Serotonin-norepinephrine reuptake inhibitors (SNRIs) are an option for people who don't respond to SSRIs. Frequently Asked Questions How do you calm anxiety at night? Calming your anxiety at night can take some practice, but it is possible. Start by trying several relaxation techniques, including mindfulness, deep breathing, journaling, or yoga, and see which ones work best for you. How do you stop panic attacks at night? Unfortunately, you can't always stop panic attacks, especially if it's a nocturnal panic attack that can happen during sleep without warning. However, you can learn to stay relaxed and "talk yourself down" by controlling your breath, practicing positive self-talk, relaxing your muscles, and seeking support from a friend or family member. Why is anxiety worse at night? Unfortunately, there is not an easy explanation. Anxiety can become worse at night for a variety of reasons, including rumination, worry over not sleeping, pre-existing anxiety disorders, excessive caffeine during the day, underlying health conditions, or anxiety over the next day. A Word From Verywell If your anxiety is making it difficult to function, reach out for professional help. Schedule an appointment with your physician or reach out to a mental health professional. Anxiety is treatable and therapy, medication, or a combination of the two can help you manage your anxiety in a healthy way. If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Simple Steps to Help You Cope With Anxiety 11 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Koffel E, Khawaja IS, Germain A. Sleep disturbances in posttraumatic stress disorder: updated review and implications for treatment. Psychiatric Annals. 2016;46(3):173-176. doi:10.3928/00485713-20160125-01 Bremer E, Jallo N, Rodgers B, Kinser P, Dautovich N. Anxiety in menopause: a distinctly different syndrome? The Journal for Nurse Practitioners. 2019;15(5):374-378. Manber, R., & Carney, C. E. 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