What Can I Do If I Wake Up in the Middle of the Night Feeling Anxious?

Dear Anonymous,

If you’re feeling anxious in the middle of the night and you’re not able to calm yourself down with deep breathing or relaxation exercises, I recommend getting out of bed and moving to another space — like a couch or a comfy chair. This can help you break the association of being in bed with feeling anxious, which can make it harder to fall asleep in the future (aka conditioned insomnia). 

However, some of my patients tell me they won’t get out of bed because it’s too cozy. Either way, what’s important is to learn how to relax the brain and body. Try: 

• Focusing on the sensations of lying in bed...Think: How comfortable it is or how soft your pillows are. 

• Reframing intrusive thoughts…For example, if you find yourself thinking, ‘I’m going to be so exhausted tomorrow. How will I get through the day?’ try shifting that narrative to something like, ‘Even if I’m tired tomorrow, it will be OK. I’ve gotten through this before.’ 

• Writing things down…Have a pen and paper next to your bedside. It can help you “brain dump” — when you write down all that’s swirling around in your brain — and let things go.  

A couple things you’ll want to avoid when trying to fall back asleep: 

• Looking at a clock…Watching the time go by will only exacerbate anxiety. 

• Scrolling through your phone…Screens aren’t an absolute no-no — it’s what you’re doing on your phone that matters. It should be soothing rather than anxiety-inducing. So avoid TikTok or email. Instead, you could try queuing up a meditation, pressing play, and turning your phone face down.  

Remember that there’s no right or wrong way to approach your sleep. You have to figure out what works for you. So if watching reruns of “Friends” helps you fall back asleep, then that’s OK. Removing some of the rigidity around sleep may actually lessen your anxiety about it.