Your brain is quieting down, and you’re slowly drifting to sleep when all of a sudden, you’re struck with an intrusive thought—an unpleasant image, memory, or scenario. Maybe it’s a reminder of the time in grade school when you embarrassed yourself, or maybe it’s something far more disturbing, like an image of jumping off a building.
Many people are able to simply take note of these thoughts and move on from them, recognizing that they’re unimportant and random. Others find them impossible to move on from, intensely anxious or worried that they mean something important. These intrusive thoughts can be unsettling, especially if they repeat frequently or feel particularly vivid and distressing. They might feel like they carry some deeper meaning, or like they’re revealing something about your character or future.
However, intrusive thoughts—whether they’re bizarre, distressing, or strange—are a common experience for many people, particularly when you’re trying to relax or wind down at night. In this article, we’ll explore what intrusive thoughts are, why they happen at night, and most importantly, how to handle them without letting them affect your sleep.
What are intrusive thoughts?
Intrusive thoughts are unwanted, unpleasant, and often distressing thoughts, urges, or images. These kinds of thoughts may come out of the blue, or they may happen as a result of an external trigger.
Intrusive thoughts are a key part of obsessive-compulsive disorder (OCD). OCD is a chronic mental health condition characterized by obsessions, which are recurrent and unwanted thoughts, urges, feelings, sensations, or images that are upsetting and distressing. People with OCD perform compulsions in response to these obsessions, which are repetitive behaviors that ease their anxiety, neutralize intrusive thoughts, or prevent a feared thing from happening.
Some examples of intrusive thoughts include:
- Violent thoughts: These can include feelings of harm towards yourself or others. You might imagine yourself jumping off a building or pushing someone in front of a car.
- Sexual thoughts: These can include thoughts about sexual acts or situations that are unwanted.
- Memories: These can look like random flashbacks or recollections of embarrassing moments, conversations, or replaying your day.
It’s important to note that everyone experiences occasional intrusive thoughts. What sets OCD apart is the need to perform compulsions in response to having intrusive thoughts.
Why do my intrusive thoughts often come at night?
If you experience intrusive thoughts at night, you might be wondering what you can do when these thoughts impact your ability to sleep. You might feel like once you’re in bed, your mind starts racing with worrying or random thoughts that grab your attention as you try to relax.
Your intrusive thoughts may look like:
- Repeating or replaying your day or conversations in your head: What did I do this morning?
- Making sure everything was done on your to-do list for the day: Did I remember to buy that thing at the supermarket?
- Thinking that you said something wrong and now you can’t remember what you said: Did something I say at work come across as rude?
- Checking safety measures: Did I lock the door? Is the stove turned off?
- Fear of forgetting important tasks: Did I forget to call that person?
Intrusive thoughts can happen at any point during your day. But you may find that they happen more frequently at night right before bed because you have less distractions during that time. “Work, school, friends, and more,” says Tracie Ibrahim, LMFT, CST, Chief Compliance Officer at NOCD. “Often we have other things going on that help us be distracted. As a result, when things get quiet we tend to pay more attention to our thoughts.”
Does it mean something if my intrusive thoughts always come at night?
“As hard as it may be to believe, there is no significance to the content of intrusive thoughts or the times they occur, but rather how a person responds to those intrusions,” says licensed NOCD therapist Melanie Dideriksen, LPC, CAADC. Nearly everyone experiences intrusive thoughts, and most people are able to brush them off as insignificant, proceeding with their day despite intrusive mental events.
The only thing that makes intrusive thoughts seem significant is the way we respond to them. When we feel unable to let go of intrusive thoughts, or they create a strong urge to engage with them, these responses can actually have a major impact.
Instead of trying to figure out why intrusive thoughts are happening at night, it’s more important to think about how you respond to intrusive thoughts, images, or urges.
Could nighttime intrusive thoughts be a sign of OCD?
It’s not uncommon for people with OCD to report that it is more difficult to deal with their intrusive thoughts at night, or that intrusive thoughts grab more of their attention when they are trying to go to bed.
Obsessions are intrusive, unwanted thoughts, images, or urges that cause significant anxiety or distress. These thoughts often feel out of your control and can be disturbing, frightening, or irrational.
Obsessions can look like:
- Sexually explicit thoughts or images/disturbing or taboo content
- Thoughts of harming yourself or someone else
- Fear that something may be contaminated
- Doubts about your memories
- Moral scrupulosity/fear of making a moral mistake
- Fear and doubts about your “true sexuality”
- An extreme need for perfection, symmetry, or for things to be “just right”
- Fixation on bodily sensations such as breathing, swallowing, or blinking
Compulsions are the rituals and repetitive behaviors or mental acts that are done in response to obsessions. “People without OCD just dismiss their intrusive thoughts,” Ibrahim says. “Whereas, people with OCD obsess about them and perform compulsions, trying to figure them out.”
Compulsions can look like:
- Excessive and repetitive hand washing or cleaning to rid yourself of contamination after touching anything that you think is “dirty”
- Repeating words in your head in order to drive out an unwanted thought or feel reassured about your doubts
- Checking or revisiting places or objects to ensure that nothing is wrong
- Hiding all the knives in a house, so there is no opportunity to hurt a loved one
- Excessive praying until you feel a “perfect” sense of satisfaction or ease
- Ruminating about the same moments or situations over and over again, even for hours in a day
- Avoiding certain situations, places or stimuli that may trigger your intrusive thoughts
- Asking others for reassurance
In OCD, the cycle of obsessions and compulsions can cause an impairment to your day-to-day functioning.
How to reduce intrusive thoughts at night
Exposure and response prevention (ERP) therapy is a specialized form of therapy created specifically to treat OCD. This evidence-based treatment is done in partnership with a therapist, where you will carefully confront your triggers and resist the urge to perform compulsions in response.
For example, if you struggle with intrusive thoughts at night, you might worry that you may have said something inappropriate during the day at work and spend hours mentally reviewing your conversations. As a result, your therapist may help you design exposure exercises to target this specific fear. You’ll create a hierarchy of exposures that starts at the least distressing level, and works its way up from there.
Here’s an example of a small hierarchy of exposures based on the fear of saying something inappropriate at work:
- Exposure: Before bed make a list of all the bad things you could have said to coworkers and then read it over and over.
- Response prevention: Do not ask your partner if you might have said these things.
- Exposure: Lay in bed and say the things on the list to yourself.
- Response prevention: Do not repeat “I’m sorry” after stating these things.
- Exposure: Think about the list of bad statements while at work
- Response prevention: Do not ask people at work if you said anything inappropriate.
Over time, you will begin to get used to the anxiety you feel when intrusive thoughts occur at night, gain tolerance for the uncertainty you feel, and this anxiety will reduce over time.
Bottom line
If nighttime intrusive thoughts are causing a lot of distress or taking up lots of time, you should reach for help from a therapist with experience in OCD . There is hope and support in treatment, and these thoughts don’t have to hold power over your sleep forever.