How to Stop Nighttime Worrying With Scheduled "Worry Time"

Quick Answer: Worry time is a method from cognitive behavioral therapy for insomnia (CBT-I). You set aside about 15 minutes in the early evening, at least two hours before bed, to write down your worries and a next step for each. Research shows this can lower stress at bedtime and help people fall asleep more easily.

Most people have had nights where they lie awake thinking about problems. For some, this only happens during stressful weeks. For others, it becomes a regular pattern, and going to bed starts to feel like the time when worrying begins.

Experts use a technique called worry time to help with this pattern. It moves worrying out of the bedroom and into a set time earlier in the evening. 

In this article, you'll learn how to spot when worry is affecting your sleep, how to set up worry time, and when it might be time to seek more help.

Is it normal stress, or is it a sleep problem?

Occasional sleepless nights during stressful periods are normal. A big deadline, a health scare in the family, or money pressure can keep anyone up for a night or two. Once the stressful situation passes, sleep usually returns to normal.

A sleep problem is different. Chronic insomnia means having trouble falling or staying asleep at least three nights a week for three months or more, along with daytime issues like fatigue, irritability, or trouble concentrating. It is more common in women and tends to increase with age. 

Chronic insomnia often continues even after the original stress has passed, because worry and poor sleep can reinforce each other.

Also Read: Anxiety and Insomnia: What's the Connection?

How does worry show up at night?

Worry can affect sleep in several ways. Some common patterns are:

• Lying in bed for a long time thinking about problems before falling asleep

• Waking in the middle of the night and immediately starting to think about the next day

• Checking the clock repeatedly and calculating how much sleep is left

• Feeling tense or alert at bedtime even after a tiring day

• Starting to dread bedtime because of how the last several nights went

• Worrying about sleep itself, such as thinking about how bad tomorrow will be without rest

Research shows why these patterns make it harder to fall asleep. Thinking about unfinished tasks and upcoming responsibilities keeps your brain alert, and studies show this kind of thinking makes it take longer to fall asleep [1]. Worrying about sleep itself also matters. When people start to worry about their sleep problems, that worry becomes another reason they stay awake.

Also Read: Waking Up at 3 AM: Is It Bad, and Why It Keeps Happening

What is worry time?

Worry time is a writing exercise that gives your worries a set time during the day, so they don't take over at night. The most researched version is called constructive worry. Dr. Colleen Carney, a sleep psychologist at Toronto Metropolitan University, developed this approach [2].

This exercise is based on a simple idea from sleep research: bed is not a good place to solve problems, but worries show up there because they have nowhere else to go. By giving them a set time earlier in the evening and writing them down, you handle them before you go to sleep.

How do I set up worry time?

The version tested in research follows the same steps each evening:

1. Pick a regular time: Set aside about 15 minutes at least two hours before bed. Doing it at the same time each day helps make it a habit.

2. Write down all your current worries: Include the small, background worries as well as the big ones. List each worry in its own column on the page.

3. Write a next step next to each worry: The step doesn't have to solve the problem. It just needs to be the next reasonable action, like making a phone call in the morning or asking a question at your next appointment. For worries you can't control, write down that there's nothing you can do about it tonight.

4. Close your notebook or paper when the time is up: Limiting the session to about 15 minutes is important. The goal is to give worry a set space, not let it grow. Some people fold the paper and keep it near the bed as a reminder that everything is written down.

5. Spend the time before bed winding down: The two-hour gap lets you do relaxing things like reading or taking a warm bath, which are good for sleep.

Also Read: 13 Tips to Fall Asleep Faster

What do I do when worries show up at bedtime anyway?

Worries may still come up at night, especially in the first few weeks. The technique has a simple response for this. If a worry pops up in bed, remind yourself it's already on your list with a next step, and that anything new can be added to tomorrow's list.

This approach works better than trying to force the thought away. Writing things down is a key part of why it helps. In a Baylor University study, people who spent five minutes writing a to-do list before bed fell asleep faster than those who wrote about tasks they had already finished, as measured by brain-wave monitoring in a sleep lab [1]. The researchers found that writing tasks down helps clear them from your mind, so they stop repeating as you try to fall asleep. 

It's easier to set aside a worry that's on paper than one that's only in your head.

Does worry time work for everyone?

Research supports this technique, but with some limits. In one study, adding constructive worry to standard insomnia treatment reduced worried thinking, but the group did not get much more total sleep than those who only had behavioral treatment [3]. A later analysis found that less worry explained some of the improvement in insomnia severity and sleep quality [4].

In practice, worry time works best when overthinking is the main thing keeping you from sleeping. It's one tool for treating insomnia, not a complete treatment by itself. How you use it matters too. If you spend the 15 minutes just thinking about problems without writing next steps, it can turn into rumination, which the technique is meant to stop.

When should I get help for nighttime worry?

Some signs point to a problem that needs professional attention rather than a self-help technique:

• Sleep problems have lasted 3 months or more, at 3 or more nights per week

• Poor sleep is affecting your work, mood, or relationships

• Worry fills your days as well as your nights

• You feel anxious most of the time, or worry feels impossible to control

• You rely on alcohol or repeated doses of sleep aids to fall asleep

A healthcare provider is a good place to start. Many people don't think to talk to their doctor about sleep problems, but insomnia and anxiety are common reasons for visits. Providers can check for medical causes and help you find the right treatment.

Also Read: Why Am I Not Getting Enough Deep Sleep?

What kind of help exists for insomnia?

The first recommended treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I), which is given by a trained provider in person or through digital programs. CBT-I helps with worry and the habits and physical factors that keep insomnia going. 

Worry time is a standard part of this therapy. Guidelines suggest trying CBT-I before or along with medication.

Treatment can also address physical factors. Some research links inflammation and an overactive stress response to poor sleep, so care often targets several things at once. Some people ask their doctor about supplements as part of their plan. Sip2Sleep®, a liquid supplement with Montmorency tart cherry extract and rafuma leaf extract, is one option a doctor can help you consider along with behavioral treatment.

The bottom line

Worry is a common reason people stay awake at night, and it can turn short-term stress into a long-term sleep problem. Worry time gives you a set 15-minute slot in the early evening to write down each concern and a next step. Research shows this technique can lower stress at bedtime and help people fall asleep faster, especially when overthinking is the main issue. If sleep problems last for months or worry fills your days too, it's a good idea to talk to a doctor about treatment.

About the author

Dr. Ruchir P. Patel, MD, FACP, is the Medical Director of the Insomnia and Sleep Institute of Arizona and the founder of Sip2Sleep. He is triple board-certified in sleep medicine, obesity medicine, and internal medicine. Dr. Patel is a multi-year Phoenix Magazine Top Doctor and holds the Inspire Excellence designation.

References

1. Scullin MK, Krueger ML, Ballard HK, Pruett N, Bliwise DL. The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to-do lists and completed activity lists. J Exp Psychol Gen. 2018 Jan;147(1):139-146. doi: 10.1037/xge0000374. Epub 2017 Oct 23. PMID: 29058942; PMCID: PMC5758411. 

2. Carney, C. E., & Waters, W. F. (2006). Constructive Worry protocol. https://drcolleencarney.com/wp-content/uploads/2013/05/Constructive-Worry-Worksheet.pdf

3. Jansson-Fröjmark, M., Lind, M. and Sunnhed, R. (2012), Don't worry, be constructive: A randomized controlled feasibility study comparing behaviour therapy singly and combined with constructive worry for insomnia. British Journal of Clinical Psychology, 51: 142-157. https://doi.org/10.1111/j.2044-8260.2011.02018.x 

4. Sunnhed, R., & Jansson-Fröjmark, M. (2013). Behavior therapy singly and combined with constructive worry for insomnia: Cognitive and behavioral processes as mediators. Sleep Medicine, 14(Suppl 1), e159. https://doi.org/10.1016/j.sleep.2013.11.366