What to Do When You Can’t Sleep

By Lisa L. Lewis

You’re in bed, you’ve turned out the lights, and now you’re staring at the ceiling or tossing back and forth. Or maybe you fall asleep fine, but you wake in the middle of the night, your brain starts thinking about all the things, and you can’t fall back asleep. 

Occasional insomnia, or trouble sleeping, is common. Most of us have times when it’s hard to sleep well, and then we worry we’re not getting enough sleep, which, ironically, makes it even harder. 

Here are six things you can do when you find yourself awake when it’s time to sleep.

Adjust Your Environment

If it’s too loud to sleep, try wearing inexpensive foam earplugs or playing some soothing background noise. Too light? Turn off and block what you can, wear eyeshades, or see if your caregivers can get blackout curtains. Too hot or too cold? Adjust the thermostat if you have control over it, open or close a window, or add or remove a blanket. If it seems appealing to you, try a weighted blanket, which a lot of people find really calming.

Shift Your Focus

Our brains sometimes like to get active as soon as we slow down. They replay stressful events or run through all our to-dos, which, of course, is super unhelpful. It keeps you from falling asleep, and it doesn’t really help with the stuff you’re worried about. “Two a.m. is not the time to solve problems,” says psychologist Terri Bacow, Ph.D. She recommends keeping your mind occupied with something else, like the alphabet game. 

Choose a category you like, such as flowers, songs, bands, movies, or cars, and then come up with an item in that category that starts with each letter of the alphabet, Bacow says. If a letter stumps you, just skip it and go to the next. The alphabet game is challenging enough that it will engage you, but not so hard that it will keep you awake, says Bacow, the author of a workbook for teens called “Goodbye Anxiety: A Guided Journal for Overcoming Worry.” “The idea is to shift to a neutral place,” she says.

Get Out of Bed

If it’s been about 20 minutes and you can’t fall asleep, it’s time to get up and do something quiet and relaxing (in dim light) until you feel sleepy enough to return to bed, says psychologist and sleep specialist Shelby Harris, Psy.D. But avoid watching the clock, which can make you feel more stressed. 

Instead of tracking the time, Harris recommends paying attention to when you start to get frustrated or it feels like your brain is too busy to be able to fall asleep, which is usually around 20 minutes. “The more you stay in bed tossing and turning, the more you teach your body that the bed is a place for remaining awake,” Harris says.

Keep It In Perspective

One night of poor sleep won’t doom you. The next morning, bright light will help cue you to feel alert. Go outside into the sunshine or open the curtains or blinds and turn on the indoor lights. Splashing some cold water on your face or getting out in the brisk air can also help you feel more awake. Don’t let your brain add the fact that you’re not sleeping to the list of things it’s worrying about. The next night is not that far away. 

Plan Ahead

If you routinely wake up because of something specific, such as feeling too cold, take a few minutes before bedtime to address it or have a quick fix close by, such as an extra blanket at the foot of the bed. You may not completely eliminate nighttime wake-ups, but you can minimize how long it takes to address anything that wakes you in the middle of the night.

Get Help If None of This Works

If you regularly have trouble falling or staying asleep, there may be contributing factors, such as drinking caffeine, long or frequent naps, or using tech devices too close to bedtime. If you’ve already ruled out things like that and you still have consistent trouble falling or staying asleep, let your health care provider know. They may refer you to a sleep specialist who can determine if a sleep disorder is the problem. Insomnia is considered chronic if it occurs three or more nights a week for at least three months.