Can't Fall Asleep? 12 Tips for What To Do

Even if you diligently avoid caffeine late in the day and quit scrolling through social media two hours before bed, there may come a time when you lay awake at night and wonder, "why can't I sleep?"

"To answer this, we first need to reconsider what 'can't fall asleep' means," Rubin Naiman, PhD, a clinical assistant professor of medicine at the Andrew Weil Center for Integrative Medicine at the University of Arizona, told Health. "In our high-velocity world, many people believe that good sleepers fall asleep in a flash. This attitude can trigger anxiety when sleep onset isn't rapid, further delaying falling asleep."

Also, having trouble falling asleep can result from poor sleep hygiene. Sleep hygiene includes behaviors like going to sleep and waking up at the same time daily, which allows people to have good-quality sleep.

Here's what we learned about what to do when falling asleep is hard, based on a few sleep hygiene tips.

Why Can’t I Sleep?

Getting a good night's rest is key to maintaining your overall health. Sleep is key in helping your brain function and supporting your nerve cells. However, you may have trouble sleeping from time to time. Or you might regularly find yourself tossing and turning in the middle of the night. 

Some of the most common reasons why you can't sleep include:

• Change in your sleep schedule
• Poor sleep environment
• Blue-light screens
• Stress
• Mental health conditions
• Sleep disorders
• Alcohol and caffeine intake
• Diet
• Daytime inactivity

What To Do About It

Poor sleep quality increases your risk of chronic diseases, like cardiovascular disease and type 2 diabetes. Some sleep disorders, like insomnia, can lead to anxiety and depression. Therefore, getting a good night's rest is key. Try some of the following methods to fall asleep easier at night.

Avoid Alcohol and Caffeine

Experts advise avoiding caffeine and alcohol before bedtime. Drinking alcohol may make you feel sleepy. Still, alcohol might wake you up multiple times during the night to go to the bathroom. Also, alcohol reduces rapid eye movement (REM) sleep, which helps with brain function. 

Likewise, caffeine may also keep you up at night if you drink coffee or energy drinks in the late afternoon or evening. Some evidence suggests that caffeine may stay in your body for up to six hours before bedtime.

Avoid Blue-Light Screens

Electronics, like phones, computers, and TV screens, emit blue light. Blue light has one of the most potent effects on your sleep-wake cycle. Scrolling through social media or watching a TV show in bed to relax may adversely affect your sleep. 

In fact, a poll from the National Sleep Foundation’s Sleep in America found that people with high screen times right before bed had poorer sleep quality than others.

Instead, turning off your phone and leaving it in another room at least two hours before bed may help you fall asleep. 

Create an Optimal Sleep Environment

Your environment may make sleep difficult. If the room is too noisy, too bright, too hot, or too cold, you may toss and turn at night. In those situations, reducing the noise (if it's in your control), turning the lights down or off, and adjusting the temperature may help you get a good night's rest.

Don’t Stress About Not Falling Asleep

Being worried about not being able to fall asleep might be the reason you're having sleep troubles. If that's the case, focus on something else to calm down.

"One advantage of being a 'sleep expert' is that I know I will eventually get sleepy enough to fall asleep. So, I don't get too worked up about being awake at night on occasion," Jennifer L. Martin, PhD, adjunct professor of medicine at UCLA, told Health. "Most importantly, I avoid getting upset about being awake. Usually, what's on my mind is important."

"It is rare for me to struggle to fall asleep, but when I do, I've grown to love it. What's not to love?" W. Chris Winter, MD, president of Charlottesville Neurology and Sleep Medicine and author of "The Sleep Solution: Why Your Sleep is Broken and How to Fix It," told Health. "I'm in a really comfortable place. It's quiet. Nobody is texting or calling me, no arguing children, no list of home repairs to deal with, just relaxing in the dark with my thoughts." 

In other words, coming to terms with your sleeplessness may be beneficial until you can fall asleep.

Exercise During the Day

Staying physically active during the daytime can help. Try adding 20-30 minutes of daily exercise to help you fall asleep. Just be sure to stop exercising at least three hours before bed. 

The National Sleep Foundation's Sleep in America poll found that physical activity affects overall health, including sleep quality. The poll found that people who sat less during the day reported excellent or good health compared to those who sat for eight hours or more daily.

Get Out of Bed

You should refrain from tossing and turning in bed awake. If you've been doing so for more than 20 minutes, it's time to get out of bed and do something else.

"If I notice that I have been in bed for 20 minutes or so and nothing is working, I will get out of bed and go to another room," Ilene Rosen, MD, former president of the American Academy of Sleep Medicine, told Health.

Try doing something, such as laundry or reading a book you're sleepy, added Dr. Paruthi. However, avoid looking at any blue-light screens.

It's "perfectly normal" to lay in bed for 10–20 minutes before you drift off, said Naiman. Falling asleep right away isn't necessarily good, nor is staying in bed for long periods until you go to sleep. 

"Regularly falling asleep in a moment or two is not a sign of being a good sleeper. In fact, it may be a symptom of excessive sleepiness and an underlying sleep disorder," explained Naiman. "Spending stretches of time in bed while struggling to sleep negatively conditions the bed for sleeplessness, which can cause future conditioned insomnia."

Have a Consistent Sleep-Wake Schedule

Research has found that going to bed and waking up at the same time every day can improve your sleep quality. For example, one study found that people with more variability in their sleep-wake schedules had poorer health outcomes than others.

Relax Your Body

If you're so tense that you can't sleep, try relaxing with autogenic training (AT) and progressive muscle relaxation (PMR). 

AT helps you become aware of different body parts to relax them. With enough training and practice, you can even use AT to control automatic functions like your heart rate.

PMR is more active. Pick a set of body muscles (e.g., your legs, arms, or shoulders), then take turns tensing and relaxing them. With practice, you will recognize if you're tense in certain areas and be able to relax them when you're trying to fall asleep.

There are also in-office biofeedback options. A provider uses a device with electrodes to see how your body reacts in tense and relaxing situations. They'll be able to see your body temperature, pulse, or breathing rate on a screen connected to the device, and see how your sleep affects them.

Think About Calming Scenarios

"On occasion, particularly if I have something on my mind, I will get into bed and not fall asleep because my mind is in overdrive," Dr. Rosen said. "Once I recognize this, I will start by trying to distract myself with relaxing thoughts and images. A favorite vacation with my family is a good one."

Imagery like this allows you to focus on mental depictions of putting yourself in a relaxing place, which can help your body physically relax.

"I think of my favorite things to dream of. I like to imagine I am on the beach, in a hammock, with my kids playing close by in the sand," Shalini Paruthi, MD, co-director of the Sleep Medicine and Research Center at St. Luke's Hospital, told Health. "I can feel the sun's warmth on my skin. I can hear the ocean waves. I can smell the saltiness of the sea. I frequently dream of being on the beach."

Treat Any Underlying Health Issues

In some cases, poor sleep links to an underlying health condition. Some of the most common sleep disorders include:

• Insomnia: This is the most widespread sleep disorder. Insomnia happens when you regularly have trouble sleeping and staying asleep.
• Sleep apnea: This happens when you stop breathing for 10 seconds or longer while sleeping.
• Restless leg syndrome: This causes tingly, prickly feelings in your legs. You may need to move your legs to alleviate those feelings. 
• Hypersomnia: With hypersomnia, staying awake during the day may be hard. One example of hypersomnia is narcolepsy. 
• Circadian rhythm disorders: This causes problems with your sleep-wake cycle.
• Parasomnia: This includes walking, talking, or eating while sleeping.

If you regularly find that you're having difficulty falling asleep, consult a healthcare provider to figure out what's causing your sleep difficulties. They can prescribe remedies to treat any underlying health issues, which may help your sleep.

Try Breathing Techniques

People with anxiety or who are in the process of labor often use breathing techniques to help them through their situations. You can also use breathing techniques to sleep.

"[I practice] meditation, relaxation, and deep-breathing exercises, like 4-7-8 breathing," Michael Breus, PhD, a clinical psychologist and sleep specialist, told Health. 

The 4-7-8 breathing pattern is when you inhale through your nose for a mental count of four, hold for a count of seven, then exhale through your mouth for a count of eight.

"If there are nights where I have difficulty falling asleep, I will do a very simple relaxation technique called diaphragmatic breathing," Mark Muehlbach, PhD, clinical director of the Clinics at Clayton Sleep Institute, told Health.

Diaphragmatic breathing is when you take slow, deep breaths, while keeping your chest still and contracting your diaphragm. Place your hand on your abdomen to feel your stomach move in and out.

"I breathe in slowly and deeply, counting 'one, two, three, four,' and then exhale slowly, counting 'five, six, seven, eight.' With practice, this can help you relax and prevent the pesky racing thoughts from interfering with your sleep."

Try Some Relaxing Activities

If you can't sleep, another way to relax your body is to try some calming activities. For example, take a warm shower or bath, read a book, or listen to soothing music. 

A Quick Review

Sleep helps your brain function and supports your nerve cells. Without quality sleep, your risk of chronic diseases, like cardiovascular disease and type 2 diabetes, rises. 

If you can't sleep at night, try breathing techniques, reading a book, and adjusting your bedroom temperature and noise level. However, if you regularly have trouble falling and staying asleep, consult a healthcare provider.