The night has a particular cruelty for people with anxiety. The distractions of the day are gone. The to-do list is done (or as done as it's going to be). You should be resting. But your brain, apparently, has other plans. It has decided that right now — at 11:30 p.m., in the dark, when you are at your most vulnerable — is the ideal time to process every unresolved worry, rehearse every difficult conversation, and preview every possible disaster that could unfold tomorrow.

The relationship between anxiety and sleep is bidirectional and genuinely vicious: anxiety disrupts sleep, and sleep deprivation worsens anxiety. Each night of poor sleep makes the anxious brain more reactive, more prone to threat-detection, more capable of catastrophizing — which makes the next night's sleep worse. Understanding this cycle — and how to interrupt it — is the foundation of actually getting better sleep when anxiety is involved.