For those who struggle with anxiety and insomnia, lying in bed at night can be dreadful. Before getting into bed for the night, many will describe allowing themselves to have a nice, relaxing evening. They may feel relatively low stress or little to no anxiety. But, as soon as the lights turn off for the night, the brain turns on with a vengeance. Now you’re in bed, wide awake, worrying about any and every possible negative outcome in the days, weeks, months and even years ahead. 

What’s more, anxiety at bedtime often becomes anxiety about sleep. The focus then shifts to trying to sleep, which puts us in a frustrating paradox because sleep is an automatic process that we cannot force. 
What's really keeping us awake at night

So, why does our anxiety have such a propensity to attack us when we try to sleep? Conditioning has a lot to do with it. The more time we spend awake in bed, the more our brain and body get conditioned to respond to our bed with wakefulness. This is why experts encourage people to minimize wakeful activity in bed. The more we use the bed only for sleep, the higher the likelihood our body will associate the bed with sleepiness. We call this process “stimulus control,” and it is a key factor in cognitive-behavioral treatment for insomnia, a first-line treatment. 

We also worry as a means of problem-solving. A small dose of anxiety can help us productively generate solutions in our day-to-day lives. When our anxiety gets the best of us, we end up creating more anxiety by “spinning our wheels.” We end up worrying to an unhelpful end, and we worry more in bed when we have a lot of experience worrying in bed via conditioning. 

Give time to your anxieties

In comes the idea of “worry time,” which is the idea of scheduling time during waking hours to effortfully worry. Instead of saving all those racing thoughts for the bed, perhaps schedule a half-hour period after dinner. It may not be the be-all-and-end-all solution to your sleep troubles, but self-talking is a powerful tool that can help you manage better. Write down those catastrophic thoughts that keep you up at night. Spend your “worry time” arguing back against your anxiety, poking holes in the reasons it believes everything could go wrong. Sure, you still spend time with anxious thoughts, but it's better to address them when you’re supposed to be awake than when you’re finally trying to sleep. Then, when your anxiety ramps up in bed, you’ve already addressed it earlier in the day, saving you the hassle of having to troubleshoot through your fears at bedtime.

Mindfulness meditation can also provide benefits when incorporated into the nighttime routine. Practicing mindfulness can help manage the dread of not sleeping and take our focus off something we can’t control (falling asleep). It can also put our brain and body in a relaxed enough state to help facilitate sleep when we are ready for bed. The practice of mindfulness has never been more accessible, with several apps at our fingertips that promote easy, regular practice. 

We may be conditioned to stay awake in bed when we suffer from anxiety and insomnia. Described above are some basic strategies for helping to manage and ultimately break this frustrating cycle. If you are truly suffering, it is always best to see a psychologist with expertise in cognitive-behavioral therapy for the treatment of anxiety and insomnia, who can elaborate on the strategies discussed above.