Overthinking at night: a short CBT routine for bedtime

Why do worries get louder at night?

During the day, worries compete with work, people, noise and things to do. At night that competition stops. You lie still in the dark with nothing else to hold your attention, and whatever was sitting at the edge of your mind moves to the middle.

Tiredness plays a part too. When you're worn out, it's harder to put a thought in proportion. A late reply from a friend, a small mistake at work or a bill you haven't opened can start to feel like the beginning of something much bigger. That jump to the worst case has a name in CBT: catastrophising. So does its close relative, taking a bad outcome as certain before it has happened: fortune telling.

The result is a loop. You worry, you feel more awake, you worry that you're not sleeping, and the night gets longer.

Why doesn't "just stop thinking about it" work?

Telling yourself not to think about something usually keeps it close. Your mind checks whether the thought is still there, finds it, and you're back where you started. It's more useful to give the worry somewhere to go than to push it away.

That's the idea behind two simple CBT techniques you can use in the evening: worry time, and slow, paced breathing.

What is worry time, and how does it help at night?

Worry time is a set slot, usually around fifteen minutes in the early evening, when you sit down and look at your worries properly. During the rest of the day, and at night, you note each worry in a sentence and let it wait for that slot.

It sounds too simple to work, but it changes two things. First, it moves the thinking to a time when you're more awake and can do something about the worries that are real. Second, it teaches your mind that a worry doesn't need attention the moment it appears. It has a time, and it will get looked at.

In worry time, sort each worry into one of two piles:

• Something you can act on now. Write the next small step and when you'll take it. If the problem is big, problem solving helps you break it down.
• A "what if" you can't act on now. Notice it, and let it go until the next worry time. You don't have to win an argument with it.

You can read more in the worry time exercise.

What can I do if a worry wakes me up anyway?

It will happen, especially at first. When it does:

1. Write it down. Keep a notebook or your phone by the bed and note the worry in one line. Don't try to solve it.
2. Remind yourself it has a time. "This goes on tomorrow's list" is enough.
3. Turn your attention to your breathing. Breathe in gently for about four seconds and out for about six, a little slower than usual. A longer out-breath is a calm way to slow down. Keep it soft; big, deep breaths can make you feel more awake.
4. If you're still awake after a while, get up. Sit somewhere dim and do something quiet until you feel sleepy, then go back to bed. Lying awake and frustrated tends to keep the loop going.

The paced breathing exercise walks through the rhythm step by step.

What does an evening routine look like?

Here's one way to put it together. Adjust the times to your day.

• Early evening, about 15 minutes: worry time. Read the day's list, sort it, write next steps for anything you can act on.
• An hour before bed: put the list away. Lower the lights and keep screens and work out of the bedroom where you can.
• In bed: if a worry comes, note it in one line and go back to slow breathing.
• The next day: look at the night's notes in your worry time, not before.

None of this has to be perfect. Missing a night of worry time doesn't undo the habit. The point is to give your worries a regular place, so the night doesn't have to be that place.

What else helps with sleep?

Worry time and slow breathing work best alongside a few ordinary sleep habits. None of them are new, but they're easy to drop when you're stressed:

• Keep regular times. Going to bed and getting up at about the same time, even at weekends, helps your body know when to feel sleepy.
• Give yourself a wind-down. The last half hour before bed is for something calm: a bath, reading, quiet music. Work emails and news can wait until morning.
• Watch the late caffeine. Coffee, strong tea and energy drinks in the afternoon can still be keeping you awake at midnight.
• Get some daylight early in the day. A short walk outside in the morning helps set your body clock.
• Make the bedroom for sleeping. Dark, quiet and not too warm, with the phone out of reach if you can manage it.

How long until it helps?

Give the routine a couple of weeks before you judge it. The first few evenings of worry time can feel strange, and you may catch yourself worrying at night out of habit. That's expected. What usually changes first is not that the worries disappear, but that they feel less urgent, because they have a place to go. Writing them down and leaving them for later gets easier each time you do it.

When is it more than ordinary worry?

Most people have nights like this sometimes. If sleep has been poor for weeks, if worry is getting in the way of work or relationships, or if you're having thoughts of harming yourself, talk to your doctor or a mental health professional. If you're in danger right now, call your local emergency number.