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9 Anxious Thoughts Keeping You Up at Night—And How to Manage Them

Experts provide insights on the common concerns impacting people's sleep.

close up of woman anxious and unable sleep in the bed at night
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You've brushed your teeth, turned off all the lights, and climbed into bed only to find yourself staring hopelessly at the ceiling. The struggle of trying to sleep only to spend the entire night tossing and turning instead is something many of us know all too well. In fact, a Nov. 2023 survey from the Sleep Foundation found that 44 percent of adults in the U.S. say they regularly have problems sleeping due to anxiety.


"Constant worry can make us less present, less happy, and certainly sleep more poorly at night," Alex Dimitriu, MD, a physician board-certified in psychiatry and sleep medicine, explained in a statement accompanying the survey. "Thoughts, and especially worries, can continue to spiral as part of a vicious cycle."

But you don't have to stay in that spiral. We talked to several experts to find out the common concerns preventing people from getting good rest, and what can be done to help alleviate these stressors. Read on for nine anxious thoughts keeping you up at night, and how to manage them.

RELATED: 5 Common Habits That Are Making You Anxious, Experts Say.

1 | "There's so much I need to do."

Organization and To Do List concept, workplace with notepad, ballpoint pen, some sticky notes, a laptop and smartphone, on wooden desk. Checklist for work and life.iStock

Many people immediately start fixating on everything they need to get done the next day right when they lie down. If you find yourself in this situation often, don't run from it and lean into it instead, licensed psychotherapistFaith Reyes, LMFT, advises.

"Turn on the light, get out of bed, and write it all down. Having a plan reduces anxiety," she shares. "If you’re feeling overwhelmed, making a to-do list increases your sense of control and motivation. Get tomorrow’s tasks out of your head and onto paper, so you can rest."

2 | "I'm worried about going to work tomorrow."

Shot of a young business man frowning while using a laptop in a modern officeeiStock

Work anxiety can also keep people up at night, according to private practice psychotherapistGayle Weill, LCSW.

"This common worry impacts sleep, as it creates a cycle of rumination and anticipation, making it difficult to relax and unwind," she says.

If you often feel that your stress about going to work in the morning is stalling your sleep, Weill recommends speaking to a therapist.

"Through therapy, individuals can reframe their thoughts and learn strategies for managing performance anxiety on the job, or learn how to navigate having a difficult boss or coworkers, creating a more positive and manageable outlook for the next day," she explains.

RELATED: 6 Reasons You Feel Tired But Can't Fall Asleep, According to Doctors.

3 | "Am I doing the right things in my life?"

Mature woman feeling bad sitting on the floor in the bedroom at homeiStock

When you often keep busy with work or other commitments during the day, you might find that your mind turns to larger existential worries at night, says Alex Oliver-Gans, LMFT, a San Francisco-based therapist who specializes in anxiety.

"Often these thoughts can center around the theme of life direction," he notes.

In order to stop yourself from worrying whether your life's headed in the right direction when you're trying to sleep, Oliver-Gans suggests devoting more time during the day to address "these thoughts in a deliberate, purposeful way, possibly with a therapist."

4 | "Do I have enough money?"

Senior man holding piggy bank with glasses depressed and worry for distress, crying angry and afraid. sad expression.iStock

Perhaps the most common source of anxiety keeping people up at night is their finances. According to the Sleep Foundation survey, 77 percent of U.S. adults admitted to losing sleep over money worries, at least sometimes.

Preston Cherry, PhD, financial therapist and accredited financial counselor, tells Best Life this is something he often encounters in his work.

"The uncertainty of money keeps people anxious during the day and awake at night," he says. "People want to understand the notion of 'enough' better: Do we have enough? What is our enough, and how do we get to our enough?"

That uncertainty is what you'll want to tackle in order to manage this anxiety and get back to sleeping well, according to Cherry.

"Preventing money avoidance by addressing your aspirations and finances with financial planning helps you find more peace with clarity and confidence, turning unknowns into better knowns and shaping the life you envision," he explains.

5 | "Why did I say that?"

Shot of a group of businesspeople having a meeting in an officeiStock

Some people spend their time in bed at night replaying the day back in their head. When doing this, "they may begin to ruminate on something that happened earlier in the day," and how they responded to it, according to Oliver-Gans.

This may include an argument with a spouse, a meeting at work that could have gone better, or even an email with a typo in it. Whatever the case may be, Oliver-Gans says it's important to redirect your train of thought toward determining what you can do going forward instead of staying awake anxious over a moment that has already passed.

"Allow yourself to take on whatever lesson you feel you need for the future and note down anything you want to do to repair the situation the next day, and then recognize when you have done all you can for today," he advises.

RELATED: 10 Genius Tricks for Falling Back Asleep in the Middle of the Night.

6 | "Why didn't I say that?"

Worried male candidate waiting for human resource's decision on a job interview in the office.iStock

At the same time, other people may fixate on what they didn't say during the day's events.

"Maybe you froze up in a recent interview, social situation, or business meeting—and the words you couldn’t find in the moment are flooding into your mind now," Reyes says.

But beating yourself up over what you should have said won't help you move on and get to sleep. Instead, try saying what you wanted to out loud while in bed, Reyes suggests.

"Hearing yourself say the words can be a cathartic practice, and improve the likelihood you’ll be able to find your voice next time," she says.

7 | "Am I going to be OK?"

mature woman sits on the examination table and holds her mobile phone as she waits for her doctor to enter the room.iStock

It's all too easy for people to stay awake concerned about what problems they might end up facing with their health or safety.

"We don't have much control over the future, especially at the end of the day, and it's hard to turn down for sleep when you're feeling powerless," Oliver-Gans explains.

But what can you do to stop ruminating over the unknown so you can get some rest? The San Francisco-based therapist recommends redirecting your thoughts toward what you do know.

"Think about your strengths," he says. "What's gotten you this far in your life? You've dealt with uncertainty before—what in your history shows that you're someone who can figure out problems as they come?"

RELATED: 7 Effective Ways to Control Your Anxiety, According to Therapists.

8 | "Why can't I shut off my mind?"

Couple With Man Lying In Bed Awake At Night Suffering With InsomniaiStock

Some of us don't just battle one worry at night. Ashley Fields, LCSW, a mental health therapist based in Indianapolis, says thought flooding keeps people from falling asleep, too.

"You may lay down and find yourself thinking about so many things that you don’t even know what you're thinking about," she shares. "Sometimes these are called racing thoughts."

Racing thoughts may come out of nowhere and tend to "feel endless, unhelpful, and random," according to Fields. One way she suggests managing this is through a technique used in acceptance and commitment therapy (ACT) called "Leaves on a Stream."

"Imagine a stream of water flowing through a forest," Fields says. "As you have a thought, you should imagine yourself putting that thought on onto a leaf and let it float by when it's ready. This exercise helps you to notice all of your thoughts (positive, negative, and neutral) and separate from them."

9 | "I'm going to have an awful day tomorrow if I can't fall asleep."

Woman lying in bed suffering from insomniaiStock

Sometimes simply stressing over not being able to sleep is what is keeping us up, Katelyn McMahon, MSW, registered psychotherapist and content strategist at TherapieSEO, notes. You may start to worry about how you're going to feel tomorrow if you don't get enough sleep.

There are several things you can do to try and reverse this thinking, according to McMahon.

"People may find it helpful to listen to guided meditations, sleep stories, or relaxing white noise like waves crashing," she says. "This can give your brain something else to focus on instead of giving in to anxious thoughts."

Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.

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