What to do when you can't fall asleep
The advice from CBT for insomnia that surprises most people: if sleep won't come, get out of bed.
It’s 1:40 a.m. You’ve been lying there long enough to know the ceiling well. You’ve tried a new position, counted something, checked the time twice. The longer it goes on, the more awake you feel.
Most of us respond by staying put and trying harder. The approach with the strongest evidence for long-term insomnia says the opposite: get up.
What the evidence says
In 2021, the American Academy of Sleep Medicine reviewed the research on non-drug treatments for long-term insomnia. CBT-I was the only one to get its strongest recommendation.1
One of its core parts is called stimulus control, and the same guideline also recommends it on its own. The idea is simple: your brain learns what the bed is for. If you spend hours there awake, worrying and checking the clock, the bed starts to cue wakefulness. Stimulus control teaches it again that bed means sleep. Sleep hygiene tips on their own, like cutting caffeine or keeping the room cool, weren’t recommended as a treatment.
Your brain learns what the bed is for.
Why trying harder backfires
Sleep is one of the few things that gets harder the more effort you put in. Trying to fall asleep raises arousal, which is the opposite of what sleep needs. Lying in bed frustrated also gives your brain one more night of practice at being awake there.
Getting up breaks the loop. You stop fighting, your body settles, and when you go back to bed it’s because you’re sleepy, so you’re more likely to fall asleep fast.
How to try it
When sleep won't come
- Go to bed only when you feel sleepy, not just tired.
- If you've been awake for what feels like 20 minutes, get up. Don't check the clock to measure it.
- Go somewhere dim and do something quiet: read something dull, fold laundry, listen to something calm. Keep screens off if you can.
- Go back to bed when your eyes feel heavy. If you're still awake, repeat.
- Get up at the same time every morning, however the night went.
The first few nights can feel worse. You may end up with less sleep for a while. That’s expected, and it usually improves as your body relearns the pattern.
When to get help
If poor sleep has lasted three months or more, or it’s affecting your days, talk to your healthcare provider. CBT-I works best with guidance, and they can check for other causes like sleep apnea.
A wind-down routine can help on the nights in between. Brevé’s sleep sessions are built to be the quiet thing you do once you’re up, or the last thing you do before the lights go out.
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