Why Anxiety Gets Worse at Night—for Children and Adults

Why does anxiety get worse at night?

I hear versions of this question often—from parents whose children suddenly become worried at bedtime and from adults who are perfectly capable of getting through their day, only to find their minds racing the moment their head hits the pillow.

Your child may suddenly worry about getting sick, school, friendships, something happening to you, or the mysterious noise down the hall.

Adults do it too.

We replay conversations. We rethink decisions. We worry about tomorrow. We imagine what someone might say, what we might say back, and every possible outcome.

Why does everything suddenly feel bigger at night?

One reason is surprisingly simple: our brains finally have time to think.

Why Anxiety and Worry Often Show Up at Bedtime

During the day, our brains are busy.

Children have school, friends, activities, screens, homework, play and conversations. Adults have work, errands, family responsibilities, appointments, emails and an endless list of things requiring our attention.

Then nighttime comes.

The house gets quiet. The stimulation decreases. There are fewer distractions competing for our attention.

And suddenly there is plenty of room for thoughts.

For someone prone to anxiety or overthinking, that quiet can quickly become filled with “What if?”

What if I get sick?

What if I can’t fall asleep?

What if something happens tomorrow?

What if my friend is mad at me?

What if I made the wrong decision?

What if…?

Children have their nighttime monsters. Adults have our own version of them.

Your Brain Thinks Worrying Is Protecting You

Our brains are designed, in part, to look for danger.

That was extremely useful when human beings needed to remain alert to immediate threats in the environment. You can think of it as the part of the brain that helped our ancestors survive.

Most of us are fortunate to have our immediate basic needs—food, water and shelter—met much of the time. But our protective brains haven’t simply stopped looking for threats.

Instead, many of our threats have become much more complicated.

Will my child be okay?

Will I succeed?

Does someone dislike me?

What happens if I make the wrong choice?

What if I embarrass myself?

What if something goes wrong?

Our brains can treat these imagined possibilities as problems that need to be solved right now.

That’s where anxiety and rumination can take over.

The Problem With “What If” Stories

We often convince ourselves that if we think about something long enough, we will somehow be more prepared for it.

Usually, we’re just rehearsing situations that haven’t happened.

You can spend an hour imagining how a conversation will go and still have the actual conversation unfold completely differently.

You can predict ten possible outcomes and encounter an eleventh.

Thinking about every possible outcome doesn’t give us control over the future.

Yet an anxious brain can interpret all of this thinking as preparation and protection.

That is why one of the questions I often encourage people to ask is:

Is this happening right now?

Then:

Is what I’m thinking factual?

And sometimes:

Has this already happened and I’m replaying something I can no longer change?

Those questions help bring us out of an imagined future—or a replayed past—and back into the present.

“I Can Think About This Tomorrow”

Nighttime is rarely the best time to solve life’s biggest problems.

When a worry appears, try acknowledging it without following it:

“I don’t have to solve this tonight. If this still needs my attention, I can think about it tomorrow.”

That’s different from telling yourself not to think about something.

Trying desperately to push a thought away can give it even more importance.

Instead, we can notice the thought and decide whether it deserves our attention.

Not Every Thought Needs Your Attention

One metaphor I use is to imagine thoughts as clouds moving across the sky.

You can notice a cloud without chasing it.

For children, I also like the image of leaves floating down a stream.

A thought appears.

We notice it.

We put it on a leaf.

And we watch it continue downstream.

Another thought might arrive right behind it. That one can keep floating too.

The goal isn’t to have an empty mind. The goal is learning that having a thought doesn’t mean we have to engage with it.

This is something I frequently build into art therapy because children tend to understand abstract emotional concepts more easily when we make them concrete and visual.

We can actually draw the clouds. Create the stream. Make the leaves. Externalize the worry.

That’s one of the things I truly love about my job.

The “What If” Shredder

I also have something in my office that children tend to understand immediately: a “What If” Shredder.

A child can write down:

What if I get sick?

What if everyone laughs at me?

What if I can’t do it?

What if Mom doesn’t come back?

Or whatever repetitive worry keeps demanding their attention.

Then they physically shred it.

The shredder isn’t pretending the thought never existed. It’s a concrete way of practicing:

“I had this thought. I don’t have to keep carrying it.”

For children, physically doing something with a worry can be much more meaningful than simply being told, “Don’t worry about it.”

Why Art Therapy and Play Can Help Anxious Children

Children are concrete.

We ask them to talk about incredibly abstract concepts—anxiety, uncertainty, control, fear, anticipation—and then sometimes wonder why they struggle to explain exactly what is happening.

Art and play give us another language.

A worry can become an image.

An overwhelming feeling can become a color, shape or character.

A frightening thought can be placed outside of the child instead of remaining something enormous inside of them.

This is one reason some families specifically seek out board-certified art therapists (ATR-BCs), creative arts therapists and play-based therapists when their child struggles with anxiety, emotional regulation or persistent worries.

When Your Child’s Nighttime Anxiety Keeps Growing

Occasional nighttime worries are a normal part of childhood. But if anxiety at bedtime becomes persistent, interferes with sleep, creates repeated reassurance-seeking, causes significant distress, or begins affecting school, friendships or family life, it may be worth looking more closely at what is happening.

And sometimes the work isn’t simply about making the worry disappear.

It’s helping children learn:

I can have an uncomfortable thought without believing it.

I can feel anxious without having to solve every possibility.

I can let a thought pass without giving it all of my attention.

Those are skills that don’t just help at bedtime.

They can last a lifetime.

I provide art therapy and psychotherapy for children and families in Mount Kisco, NY, serving Westchester County, with a focus on anxiety, emotional regulation and helping children find concrete, creative ways to understand and manage difficult feelings.

Beth Patane, MS, LCAT, ATR-BC, NCC
Licensed Creative Arts Therapist
Mount Kisco, New York