Why Do Things Feel More Stressful in the Middle of the Night?

Lying in bed at night, even the slightest concerns can feel amplified, increasing your anxiety and making it hard to find sleep. Here’s why things can feel more stressful at night.

A person holding a pillow over their head at night, seemingly frustrated.
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It’s 3 a.m., and all is quiet — except for your racing mind.

Did you forget to sign your kid’s field trip permission slip? What did your boss mean in that email? Will your 401(k) ever bounce back?

Problems, even small ones, seem to get magnified when you’re lying awake in the middle of the night unable to sleep. And as that worry builds, sleep becomes more and more elusive.

In a 2021 survey commissioned by the American Psychological Association (APA), 32% of respondents said that stress caused changes in their sleeping habits. Even more alarming, another APA survey found that stress kept 43% of adults awake at least one night in the previous month.

So why does stress — and the body’s natural reaction to it (anxiety) — seem to ramp itself up at night, making it so hard to sleep? We asked the experts and learned a few surprising answers as well as sleep solutions.

Why stress can hit as you try to fall asleep

There can be a lot of reasons why stress seems to be worse at night, whether it hits you as you’re trying to fall asleep or it keeps you from falling back asleep in the middle of the night.

For those who struggle to calm their minds in the middle of the night, it’s because your unwinding time is a chance to focus on things that you’ve otherwise overlooked during a busy day. “For the first time in the day, you’re not busy or distracted, so anxiety that was tamped down gets to resurface,” explains Jade Wu, Ph.D., a sleep medicine specialist, a Sleep.com advisor and the author of “Hello Sleep.” “Some people also report that they’re anxious because they didn’t accomplish all the things they wanted to get done for that day or [because] they dread the upcoming battle with insomnia or other sleep problems.”

Why stress can keep you up in the middle of the night

If you find yourself catastrophizing in the middle of the night, you’re not alone, and it’s not unjustified. “The prefrontal cortex is sometimes called the ‘CEO of the brain’ because it’s the part that is most involved in rational thinking, organizing information, and checking our impulses,” explains Wu. That prefrontal cortex is more dormant when we sleep. “Even when we’re not fully sleeping at night, the prefrontal cortex is less active because of our brain’s circadian rhythms.”

Because the emotional control center is not fully functioning, things that would seem trivial by day seem dire at 3 a.m. “That’s definitely part of why emotions can feel more ‘raw’ during the night and [why] it can be harder to rationally talk ourselves down from catastrophizing thoughts,” Wu says. “Also, even if we’re having insomnia and feel like we’re awake for a long time, it’s likely that we’re dozing off sometimes during that bout without realizing it, making our prefrontal cortex even less likely to perform at its best. The perception of time can also slow down during the night because there’s not much stimulation other than our own thoughts, and if those are running at 60 miles per hour, it can make time feel very slow and make us even more anxious about how long we’re tossing and turning with insomnia.”

How stress can energize you at night

Stress affects more than just your mind.

When you’re under stress, your body amps up production of the hormones cortisol and adrenaline, which help elicit the body’s fight-or-flight response. Your breathing becomes quicker, your heartbeat increases, and your blood pressure rises. Not exactly the makings of a sweet slumber.

“Think about the fight-or-flight response,” says Carleara Weiss, Ph.D., a specialist in behavioral sleep medicine and circadian rhythms. “We must be wide awake to respond to a stressful situation, and that is why it is so hard to sleep when we’re anxious.”

And as anyone who has spent a few (or more) nights staring at the ceiling knows, sleeplessness can make anxiety worse, leading to a seemingly never-ending cycle.

According to a University of California, Berkeley study, a sleepless night can ratchet up anxiety levels by a whopping 30%. “Lack of sleep increases the release of stress hormones, contributing to even more anxiety,” notes Weiss.

Adequate sleep, on the other hand, gives your body and brain a chance to rest, recharge, process information, and heal. Deep sleep in particular, according to the Berkeley study’s authors, seems to help the brain regulate emotions and physiologic reactivity, thereby taking anxiety down a notch or two.

How to stop stress from ruining your nights

Whether stress is causing your sleeplessness or sleeplessness is causing your stress, the end result is the same: You’re awake when you want to be sleeping. So how can you change that?

In general, experts advise combining good sleep hygiene with stress-reduction techniques.

Sleep hygiene tips:

  • Go to bed and wake up at the same time each day — even on weekends. When you get up later than usual, for example, you change how much light exposure your body gets, and that can throw off your sleep-regulating circadian clock, thereby making it harder to get to sleep when night comes.
  • Have a relaxing evening routine. “It can help your brain switch from your ‘doing’ mode to your ‘being’ mode,” says Wu.
  • Keep your bedroom dark and cool. Experts from the Cleveland Clinic say the ideal temperature for adults is between 60 and 67 degrees Fahrenheit. This temperature range, they say, helps bring about REM sleep, the stage of sleep that the National Sleep Foundation says helps give you better mental concentration and mood regulation the next day.
  • Don’t use electronic devices like smartphones within a couple of hours of bedtime. One study looking at college students found that 98.1% of those who experienced poor sleep quality reported using an electronic device every day within two hours of bed.
  • Exercise. Study after study shows that exercise can improve not just your sleep quality but also how long it takes you to fall asleep. An added benefit: Physical activity can be a stress reducer. While most experts recommend 150 minutes of moderate-intensity exercise on average a week for health benefits. However, a study published in the British Journal of Health Psychology found that even low to moderate amounts of physical activity were associated with significantly lower stress levels. Check with your doctor before beginning any exercise program.

Stress-reduction tips:

  • “Have a couple of coping thoughts ready to go before going to bed,” suggests Wu. Rather than building up your anxiety with the consequences of a bad night’s sleep, Wu recommends comforting thoughts from your inner voice. “If you often find yourself anxiously thinking, If I don’t fall asleep soon, I’ll feel terrible tomorrow, remember during the day, when you’re thinking rationally, that this has not always been true. So you can have this coping thought ready to go: Even if I don’t fall asleep soon, I’ll probably function fine tomorrow. I’ve done it before.”
  • Get out of bed when you’re awake. “Instead of staying in bed trying hard to sleep, just get up — or at least sit up — and do something enjoyable,” suggests Wu. “That decreases your anxiety and relieves your prefrontal cortex of the stress of trying to function when it’s not supposed to be functioning.”
  • Concentrate on your senses rather than your thoughts, suggests Wu. “Do something that gets you focused on your body, whether it’s stretching or a body scan meditation or sexual activity, to help ground you in your physical senses instead of swirling away with your thoughts.”
  • Practice relaxation techniques like guided imagery or deep breathing. One study looking at nurses in China during the COVID-19 pandemic found that those who used diaphragmatic breathing relaxation (aka, belly breathing) had better sleep quality and lower anxiety after being trained in the technique than before. Wu suggests visualizing leaves on a stream and putting each worry on a leaf and watching it drift away down the stream.
  • Write down your worries, and schedule worry time well before you go to sleep. According to Weiss, this allows you to focus on anxiety-provoking thoughts before your head hits the pillow.
  • Cut yourself some slack. “Many people are hard on themselves as they take inventory of the day, and this is a surefire way to get stressed,” says Paul DePompo, a behavioral and cognitive therapist with the Cognitive Behavioral Therapy Institute of Southern California. “What was done (or not done) today is now a learning experience. Remember, things rarely get wrapped up nicely in a day.”

At the end of the day, if self-help techniques fail and you find that stress is consistently impacting your sleep, consider reaching out to your doctor for help — be it in the form of medication or therapy.

“For those struggling with nighttime anxiety and insomnia, cognitive behavioral therapy for insomnia [CBT-I] is an optimal choice,” Weiss says. CBT-I combines relaxation techniques with things like sleep hygiene and what practitioners call “cognitive restructuring,” or changing negative thinking patterns. While sleep medications are still an option, research shows that CBT-I can be as effective as medications, without any side effects.