4 Tips for What To Do When You Can't Fall Asleep

Try these expert-approved tips the next time you're tossing and turning.

Even if you diligently avoid caffeine late in the day and you quit scrolling through social media apps an hour before bed, there may come the occasional night when it's just impossible to fall asleep. So what can you do to help solve the issue?

"To answer this, we first need to reconsider what 'can't fall asleep' means," said Rubin Naiman, PhD, sleep and dream psychologist and clinical assistant professor of medicine at Arizona Center for Integrative Medicine. "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."

Furthermore, having trouble falling asleep can be a result of poor sleep hygiene. Sleep hygiene, according to a June 2016 Journal of Caring Sciences study, is comprised of behaviors that allow individuals to have good-quality sleep—such as avoiding regular naps during the day or going to sleep and waking up at the same time each day.

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

Use Different Relaxation Techniques

There are a number of relaxation techniques that can assist you in the process of falling asleep, like breathing techniques and, according to the National Library of Medicine (NLM), imagery (or visualization), autogenic training (AT), biofeedback, or progressive muscle relaxation (PMR).

Breathing Techniques

Using your breathing to help you relax is not that uncommon as a concept—those who are anxious or in the process of labor are often given breathing instructions to help them through their situations. The same can be said for breathing and sleep.

"[I practice] meditation, relaxation, and deep-breathing exercises, like 4-7-8 breathing," said Michael J. Breus, PhD, sleep specialist and clinical psychologist. 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," said Mark Muehlbach, PhD, staff clinician and director at the Clayton Sleep Institute Clinics and Insomnia Center and co-director of the CSI Research Center.

"Diaphragmatic breathing can be used when the brain is going a mile a minute and you feel distracted from falling asleep. I typically do this lying down. I breathe in slowly and deeply counting 1, 2, 3, 4, and then exhale slowly counting 5, 6, 7, 8. With practice, this can help you relax and prevent the pesky racing thoughts from interfering with your sleep," Muehlbach explained.


"I rarely have trouble falling asleep. However, 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," said Ilene M. Rosen, MD, former president of the American Academy of Sleep Medicine and associate professor of medicine at the Hospital of the University of Pennsylvania.

This is where imagery comes in: It allows you to focus on mental depictions of putting yourself in a place that you personally find relaxing. "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!" Dr. Rosen added.

Shalini Paruthi, MD, co-director of the Sleep Medicine and Research Center at St. Luke's Hospital noted that she has used this technique as well. "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. 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!"

Physical Relaxation

If being tense is your issue, you may want to try focusing on relaxing different areas of your body with AT and PMR. AT involves a course training that helps you become more aware of different places across your body to relax them. With enough training and practice, you can even use AT to control a more automatic function such as your heart rate.

Per the NLM, you pick a set of body muscles—in your legs, your arms, or your shoulders, for example—and take turns tensing and relaxing those muscles during PMR. That way, you can recognize when you're tense in certain areas and learn how to relax them if you're trying to fall asleep.

Biofeedback deals with using a device with electrodes to see how your body reacts in response to tension and relaxation. On the screen connected to the device, you can see measurements such as your body temperature, pulse, or breathing rate, according to the NLM, and use them to monitor how relaxation affects them.

Determine If There Is an Underlying Issue

If you've been stressed out or are excited about something, it may be hard to fall asleep. "When I have trouble falling asleep, it's usually because I have something on my mind about work or my kids," said Jennifer L. Martin, PhD, adjunct professor of medicine at UCLA.

However, that doesn't mean you can't calm your mind. Other than using imagery, you can take some time to put your thoughts down on paper or some other note-taking device. "If I have a lot on my mind, I may write down some thoughts to help me know I will revisit them in the morning so I can clear my mind," Dr. Rosen added.

Problems falling asleep could be related to the environment of the room per the NLM. If the room is too noisy, too bright, too hot, or too cold, you may have a hard time going to sleep. In those situations, reducing the noise (if it's in your control), turning the lights down or off, and adjusting the temperature may be all it takes to help you go to sleep a little better.

It may also be due to sleep's connection to other health issues you may have. "If I can't fall asleep and it's been more than 30 minutes or so, then I get up and figure out what is the problem. Is it my restless legs syndrome acting up? If so, I will put a blanket and pair of fluffy, loose, fleecy socks in the clothes dryer for five to 10 minutes to help me warm up so I can calm my legs and feet down," Dr. Paruthi said.

Get Out of Bed

The Sleep Foundation stated that you want to 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," Dr. Rosen said; Martin agreed with doing this method as well. Dr. Paruthi added that she might do something unrelated to looking at a screen, such as laundry or reading a book until she is sleepy.

It's "perfectly normal" to lie in bed for 10 or 20 minutes before you drift off, Naiman said. However, going to sleep right away isn't necessarily good—and neither is staying in bed for long periods of time 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," Naiman explained. "Spending stretches of time in bed while struggling to sleep negatively conditions the bed for sleeplessness, which can cause future conditioned insomnia," Naiman added.

Try Not To Stress About Not Being Able To Sleep

Being worried about not being able to fall asleep might be the reason you're having sleep troubles—but try to focus on something else to help calm yourself 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," Martin said. "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?" said W. Chris Winter, MD, president of Charlottesville Neurology and Sleep Medicine and author of The Sleep Solution. "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, sometimes coming to terms with your sleeplessness in the moment may be beneficial until you can fall asleep.

But if you still find that you're having difficulty falling asleep, you'll want to talk to a healthcare professional to determine what the issue causing sleep difficulties might be.

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  1. Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical SciencesJ Caring Sci. 2016;5(2):153-160.

  2. Insomnia: Relaxation Techniques and Sleeping Habits. Institute for Quality and Efficiency in Health Care (IQWiG); 2017.

  3. Relaxation exercises to help fall asleep. Sleep Foundation.

  4. Biofeedback - informedhealth. Org - NCBI Bookshelf.

  5. What is sleep hygiene? Sleep Foundation.

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