When your head hits the pillow at bedtime, does it race anxiously about unfinished business or tomorrow’s to-dos? You’re not alone—anxiety and sleep have a complicated relationship. That’s because an anxious brain makes it hard to fall and stay asleep, and a lack of sleep heightens anxiety.
So how can you break the cycle? Anne-Marie Osibajo, MD, a psychiatrist at Atlantic Health, shares some tips for calming an overstimulated mind at bedtime.
The anxiety–sleep connection
Worry and ruminating thoughts can prevent your nervous system from powering down. Over time, a lack of rest can make you irritable and stressed, which fuel anxiety.
“This cycle affects your mood and concentration. It can cause fatigue, weight gain, high blood pressure and even long-term health issues,” says Dr. Osibajo. “With a few practical strategies, most people can calm their thoughts and achieve deep, restorative sleep.”
1. Create a calming bedtime environment
Dim the lights and create a cool, dark, comfortable sleeping environment. Use calming sounds like white, pink or brown noise or soothing music. Avoid blue light from phones tablets and TVs about an hour before bedtime.
2. Support sleep with daytime habits
To help keep your internal clock (circadian rhythm) on track, get regular daylight exposure and gentle activities such as walking, stretching or yoga. Avoid strenuous exercise in the evening and limit caffeine or heavy meals five hours before bedtime.
3. Allow your body to calm your mind
Slow down your breathing by inhaling through your nose, counting to four and exhaling slowly through your mouth. Practice visualization techniques in your mind’s eye by imagining a peaceful place with your worries resolved, all while practicing deep breathing.
4. Try a proven mindfulness technique
A form of acupressure known as tapping or the Emotional Freedom Technique can be done in bed to interrupt anxious thought patterns. It’s a self-guided method of gently tapping or massaging specific points on the face, head or hands while thinking calming, positive thoughts.
5. Get thoughts out of your head—and onto paper
A journaling practice known as “scheduled worry” sets time to process your thoughts and write them down throughout the day. When worries are acknowledged during the day, they’re less likely to follow you to bed at night. A gratitude journal can also shift worries away.
6. Change your relationship with wakefulness
If you’re lying awake and anxious, and can’t seem to fall asleep after about 20 minutes, get out of bed and do something calming. Make sure the lights are dim and the body stays relaxed. Return to bed once you feel sleepy again.
When should you see a doctor?
If you’re consistently experiencing any of these classic symptoms when falling asleep at night, it could be time to seek professional help:
- Daytime fatigue, irritability and trouble concentrating
- Constant anxiety or worry that’s hard to control
- Reliance on alcohol, cannabis or over-the-counter sleep aids to sleep
- Fear of going to bed with worsening anxiety at night
“Our goal is to treat the root cause—not just the symptoms,” says Dr. Osibajo. “We often use cognitive behavioral therapy to calm anxious thoughts and sleep patterns. We investigate underlying causes and associated conditions, and in some cases, prescribe medications or provide referrals to a sleep doctor.”
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