What To Do if You Can’t Sleep

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It is well established that restful, restorative sleep is important for physical and mental health. Insomnia, the inability to fall asleep and remain asleep, is one of the most common sleep issues. As many as two-thirds of adults report occasional bouts of insomnia. Others report chronic or ongoing insomnia, which can affect as many as 10 to 15% of adults.

If you’re one of the millions of people who can’t sleep at night, you may benefit from our tips and suggestions for how to fall asleep faster or get back to sleep if you awake at night.

It can be frustrating to lie in bed unable to drift off or to have trouble staying asleep. There are various strategies that you can try when you can’t fall asleep.

• Get Up if You Can’t Fall Asleep: Don’t lie in bed awake for more than 20 minutes. Feeling anxious if you can’t fall asleep makes it harder to sleep. Get up and move to a different room or do something relaxing before returning to bed to sleep.
• Adjust Your Sleep Environment: Bedroom lighting and temperature can affect your ability to fall asleep. Quiet, dark bedrooms with a cool temperature are best for sleep.
• Avoid Technology: Cell phones and other technology are stimulating and emit blue light that can keep you awake. Set devices to silent or remove them from the bedroom to avoid disruptive notifications or scrolling through news and social media while lying in bed.
• Engage in a Relaxing Activity: Listening to soothing music, reading a book, or practicing a deep breathing exercise can make you drowsy and promote sleep.
• Clear Your Mind of Stress: If the stress of your day is making it difficult to fall asleep, consider writing down any worries in a journal. This practice can free the mind to focus on sleep.
• Adjust the Clock Face: Avoid looking at the clock by covering it up or turning it away from you. If you focus on the time and sleeplessness you may have more trouble falling asleep.

Stress is a common cause of insomnia. Finding ways to relieve stress is key for many people to getting a better night’s rest. Relaxation techniques are one approach to reducing stress and improving the ability to fall asleep.

It takes practice to learn relaxation techniques for stress relief and better sleep. Over time, it may become easier to fall asleep and stay asleep using one or a combination of techniques.

Deep Breathing

Deep breathing exercises are a simple and established way to relieve stress and may help with sleeplessness. This exercise requires a few simple steps.

1. Lie down on the bed, find a comfortable position, and close your eyes.
2. Gently rest one hand on your chest over the heart and the other hand on your stomach.
3. Slowly inhale, noticing your stomach rise.
4. Hold your breath for a few seconds.
5. Slowly exhale, noticing your stomach fall.

Continue this pattern of breathing to help release stress and tension in the body.

Progressive Muscle Relaxation

Progressive muscle relaxation (PMR) is a stress-reduction technique that can help people relax and fall asleep. Practicing PMR several times before using the technique to improve sleep can be helpful. The technique involves a few simple steps repeated to address a number of muscle groups in the body.

1. Find a comfortable position laying down and close your eyes.
2. Gently tense the muscles in your face while breathing in for five seconds. Notice how the tension feels.
3. Release the muscle tension in your face while breathing out, noticing the sensation as your muscles relax.
4. Move down to the next muscle group, such as the shoulders. Gently tense the muscles while breathing in for five seconds. Exhale and release muscle tension.

Continue moving through the muscle groups in your body from head to toe. Focus on breathing in as you tense your muscles and exhale as you release tension. Notice the sensations of tension and relaxation as you tense and release your muscles. If you feel pain in a muscle group as you work through the exercise, soften or release tension.

Body Scan

Some people find the practice of body scans helpful in promoting sleep. The goal of this technique is to shift attention to your body and breathing for relaxation, noticing any feelings or sensations in your body without aiming to change them.

1. Lay in a comfortable position, preferably on your back. Center your attention on your body and breath. Throughout the exercise, recenter your attention if you get distracted.
2. Start at the top of your head. Feel where your head makes contact with your bed or pillow and recognize any pressure or sensations.
3. Work your way down through your face. Take notice of any tingling or tightness before continuing to your throat.
4. Notice any sensations and feelings in your throat and down through your neck, shoulders, and back. Acknowledge any pressure or tension that may be present.
5. Continue downward through your torso to your legs and feet, noticing the weight of your body and limbs against your sleeping surface. Recognize how your body feels, including pain, tension, or other sensations.

If you experience any worrying or anxious thoughts throughout the exercise, recognize them and turn your focus back to the body scan exercise.

Aside from exploring relaxation techniques, people can make changes to their sleep hygiene as a way to improve and maximize their sleep health. Sleep hygiene refers to healthy sleep habits that involve the sleep routine, the sleep environment, and lifestyle choices.

Sleep Routine

Developing a routine that prioritizes sleep and a consistent sleep schedule is an important part of improving sleep. Healthy sleep routines support the body’s sleep-wake cycle which helps control feelings of sleepiness and wakefulness. The sleep-wake cycle is a circadian rhythm that follows cues from the body’s internal clock.

• Set Consistent Sleep and Wake Times: Wake up and go to bed at the same time every night, including weekend nights. Altering sleep and wake times on weekends by more than an hour can disrupt your sleep-wake cycle.
• Make Sleep a Priority: Establish a schedule that makes time for adequate relaxation and sleep. This may sometimes mean rescheduling activities that don’t require immediate attention to another day.
• Prepare Your Body for Sleep: Preparing for sleep can include activities such as taking a shower and brushing your teeth. Reading a book, listening to music, or practicing a relaxation technique can also get your body and mind ready for sleep.

Lifestyle

A successful sleep hygiene regime often includes specific lifestyle choices that promote healthy sleep. Certain lifestyle choices can help support the sleep-wake cycle and better sleep.

• Avoid Meals Before Bed: A small snack may not cause sleep issues, but eating large meals before bed can lead to indigestion and make it difficult to sleep.
• Make Time to Exercise: Exercise during the day can help tire your body making it easier for you to fall asleep. Try to get 30 minutes of physical activity most days.
• Avoid Nicotine and Caffeine: Consuming stimulants such as caffeinated beverages and nicotine products before bed can make it hard to fall and stay asleep.
• Get Enough Sunlight: Sunlight exposure supports our body’s sleep-wake cycle and sleep patterns. Making time for 30 minutes of natural sunlight a day can help you sleep.
• Avoid Alcohol: Drinking alcohol before bed reduces your time in deep sleep, can compromise breathing, and can cause you to wake when the effects of alcohol fade.

Sleep Environment

Creating a sleep environment that promotes healthy sleep is important for a good night’s rest. You can improve your sleep environment with simple adjustments.

• Set the Room to a Comfortable Temperature: Many people find a cool bedroom best for sleeping.
• Minimize Light: A dark room can signal your body it is time to sleep. Eliminating light in the bedroom, with the exception of a dim night light, may help encourage drowsiness. This includes limiting light from electronic devices.
• Minimize Noise: Noise can disrupt our ability to fall asleep and stay asleep. Remove anything from the sleeping area that may be a noise distraction.
• Use the Right Bedding: A comfortable pillow and mattress can help you get a good night’s sleep. It can be helpful to identify your ideal firmness or softness preferences if you are considering a new pillow or mattress.

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One of the most common reasons people struggle with sleep is insomnia. Insomnia is a sleep disorder that can cause difficulty falling asleep, staying asleep, or awakening too early.

Insomnia may reduce the number of hours people sleep each night or affect their sleep quality. As a result, work, home, and social life can suffer.

Many people deal with acute or short-term insomnia. Episodes of short-term insomnia typically last less than three months. There are a variety of factors that can trigger the condition including stress, relationship changes, diagnosis of a new medical condition, and changes to a person’s usual sleep environment. In many cases, symptoms resolve on their own as people adjust to the event, life changes, or stressors that cause insomnia.

People with chronic insomnia experience long-term difficulty falling asleep and staying asleep. The symptoms of insomnia must be present for more than three months and happen more than three times a week to be considered chronic. Life changes, stress, coexisting physical and mental health conditions, substance abuse, sleep environment, and living conditions can increase the likelihood that a person may have chronic insomnia.

Chronic insomnia is unlikely to resolve on its own and often requires medical attention. A variety of treatments are available ranging from therapy to medications. Treatment for chronic insomnia can help improve sleep as well as quality of life by reducing daytime effects of insomnia.

People who have trouble falling asleep or staying asleep at night can start by working on their sleep hygiene. If sleep problems persist, it is important to speak with a doctor or other medical professional.

About The Author

Dr. Michael Breus

Clinical Psychologist, Sleep Medicine Expert

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Michael Breus, Ph.D is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. He holds a BA in Psychology from Skidmore College, and PhD in Clinical Psychology from The University of Georgia. Dr. Breus has been in private practice as a sleep doctor for nearly 25 years. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is also the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan, Good Night!, and Energize!

• POSITION: Combination Sleeper
• TEMPERATURE: Hot Sleeper
• CHRONOTYPE: Wolf

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