What to Do When You Can’t Sleep

Can’t sleep? Scientists say you should stop trying.

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When you wake up hours before your alarm, it might seem like a good idea to stay in bed. You should try to get as much shut-eye as you can before your day begins—even if that means lying awake (in agony) for a couple of hours until sleep comes, right? Wrong. Sleep scientists say this might just increase your chance for developing chronic insomnia. And according to a new study (abstract 0508) from the University of Pennsylvania School of Medicine, getting out of bed when you can’t sleep can prevent 70 to 80 percent of acute insomnia cases from turning into chronic insomnia. The findings were presented at the SLEEP 2016 Conference (because they have yet to be published in a peer reviewed journal, they should be considered preliminary). 

For the study, researchers tracked the time spent in bed and the sleeping habits for 416 people over a year. All participants began as “good sleepers.” During the study, 20 percent of participants experienced a phase of acute insomnia (having trouble falling asleep or staying asleep three or more nights a week, for between two weeks and three months). Of this group, 45 percent eventually returned to good sleep. But for 7 percent, the insomnia turned chronic (lasting longer than three months). The difference? Those who restricted their time in bed were more likely to return to good sleep, while those who stayed in bed when they couldn’t sleep were more likely to have their insomnia turn chronic.

“Those with insomnia typically extend their sleep opportunity,” Michael Perlis, PhD, study author and director of the Penn Behavioral Sleep Medicine Program, said in a statement. “They go to bed early, get out of bed late, and they nap. While this seems a reasonable thing to do, and may well be in the short term, the problem in the longer term is it creates a mismatch between the individual’s current sleep ability and their current sleep opportunity; this fuels insomnia.”

Choosing to stay awake—instead of trying to force yourself to sleep—is a formal strategy for insomnia treatment in Cognitive Behavioral Therapy, which the American College of Physicians announced as their preferred first treatment last month. 

If you aren’t able to fall asleep during the night, try getting out of bed and making use of that time instead, Perlis wrote in an email to RealSimple.com. You might find yourself falling asleep after an hour or so, but you will do so faster and ultimately sleep better than if you had just stayed in bed. And don’t adjust your sleep schedule the next day, Perlis says: don’t sleep in, take naps, or go to bed earlier. Keeping a regular sleep/wake schedule will help you to regulate your sleep within three to five days.

It’s important, too, to try to reserve your bed for sex and sleep (not reading, working, or scrolling through your Instagram feed)—so your brain doesn’t start to associate it as a place for wakefulness. Limit time awake in bed to up to half an hour a week, suggests Michael Grander, another study author and director of the Sleep and Health Research Program at the University of Arizona College of Medicine. Here, six other cures for insomnia (that don’t involve medication).