Here's What to Do When You Can't Sleep—and It's Kind of Counterintuitive

Can't sleep? Scientists explain why trying to force it might just make sleeplessness worse.

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When you wake up hours before your alarm, you might think making yourself stay in bed sounds like the best plan—however agonizing it may be. In other words: Trying to sleep seems like exactly what to do if you can’t sleep—however, sleep scientists say trying to make yourself sleep when you really can’t might actually make things worse. It could increase your chance for developing chronic insomnia.

What to Do If You Can’t Sleep

According to findings from a 2016 study from the University of Pennsylvania School of Medicine (presented at the SLEEP Conference in 2016), getting out of bed when you can’t sleep—instead of staying in bed and trying to sleep—can prevent 70 to 80 percent of acute insomnia cases from turning into chronic insomnia.

For the study, researchers tracked the time spent in bed and the sleeping habits of 416 people over the course of a year. All participants began as “good sleepers.” During the study, 20 percent of participants experienced a phase of acute insomnia (defined as 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 become chronic.

If you can’t fall asleep during the night, Perlis suggests getting out of bed to make use of that time to (maybe read, fold some laundry, or write those thank-you notes you’ve been putting off). You might find yourself falling asleep after an hour or so, but you’ll fall asleep faster and into a better sleep than if you'd stayed in bed wondering, “Why can’t I sleep?”.

What Not to Do When You Can’t Sleep

Michael Perlis, PhD, the study’s author and director of the Penn Behavioral Sleep Medicine Program, describes the pitfalls of prolonging what’s called “sleep opportunity,” which can lead to misalignment with your actual sleep ability.

“Those with insomnia typically extend their sleep opportunity,” Perlis says. “They go to bed early, get out of bed late, and they nap. While this seems like 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.”

Put another way, people often try to overcompensate sleep loss by extending their sleep opportunity (or adjusting their sleep schedule). But, though it may appear completely counterintuitive, 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. And Perlis says keeping a regular sleep/wake schedule should help regulate your sleep within three to five days.

It’s also important 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. (Read up on six medication-free cures for insomnia.)

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