What to Do When You Can't Sleep: Steps for Tonight
Not sure what to do when you can't sleep? See what studies found on writing a to-do list, watching the clock and leaving the bed, plus a wind-down for tonight.
OCT26
Ayse Tara, BSc in Nursing
8/26/20266 min read
Five minutes of writing, and no clock-watching. That is what two small sleep-lab studies point to for a night when you can't sleep. In a 2018 study, 57 young adults who wrote a to-do list before bed fell asleep faster than those who listed finished tasks. In a 2007 study, 60 people told to watch a clock worried more and took longer to fall asleep than those who were not. Neither study shows a fix that works for everyone.
Key takeaways
For chronic insomnia, a 2021 American Academy of Sleep Medicine guideline suggests stimulus control, which includes leaving the bed when sleep is not coming. It was written for ongoing insomnia, not a single bad night.
In a 2007 study of 30 good and 30 poor sleepers, people told to watch a clock reported more worry before sleep and took longer to fall asleep.
In a 2018 lab study of 57 young adults, a 5-minute to-do list at bedtime was followed by faster sleep onset than a list of finished tasks.
A 2010 review describes raised arousal, by night and by day, as a key feature of insomnia, which may be one reason a tired person can still lie awake.
In a 2002 study of 41 people with insomnia, an engaging imagery task was followed by shorter sleep onset than no instructions, and general distraction showed no such support.
What to do when you can't sleep: stay in bed or get up?
The 2021 American Academy of Sleep Medicine guideline suggests stimulus control as a single-component therapy for chronic insomnia disorder in adults, as a conditional recommendation. Programs of this kind typically ask people to go to bed only when sleepy, and to leave the bed and do something quiet when sleep is not coming, then return when sleepy. The aim is to keep the bed linked with sleeping, not with lying awake.
Two limits matter. The guideline covers chronic insomnia, meaning trouble that keeps happening, and not one bad night. And the full programs are taught by clinicians, so this short summary is not the same as the treatment. If what keeps you up is a conversation replaying in your head, our post on sleeping after an argument looks at that case. Whichever you choose, one habit tends to follow: checking the time.
Does watching the clock make it harder?
Clock watching has been tested directly. In a 2007 study by Tang and colleagues, 30 good sleepers and 30 poor sleepers were told either to monitor a clock or not as they tried to get to sleep. Clock monitors reported more worry before sleep and took longer to fall asleep, in both groups. In a second experiment, 38 people diagnosed with primary insomnia watched either a clock or a digit display. The clock task was rated more worry-provoking and sleep-interfering, and clock monitors overestimated how long it took them to fall asleep.
If the clocks have just changed and you keep checking them, our guide to sleep when daylight savings time ends covers that case. These were instructed lab nights, and the authors say clock monitoring may trigger worry, not that it does.
Can writing a to-do list help you fall asleep?
With the clock out of the picture, what often remains is the worry itself. The 2018 polysomnography study by Scullin and colleagues describes bedtime worry, including worry about unfinished future tasks, as a significant contributor to difficulty falling asleep. In it, 57 healthy adults aged 18 to 30 wrote for five minutes in a sleep laboratory before bed. Some listed tasks they needed to do in the next few days, and others listed tasks they had finished in the previous few. The to-do list group fell asleep significantly faster, and the more specific their list, the faster they fell asleep.
The limits are clear. The volunteers were young and healthy, the nights were in a lab, and the study compared two kinds of writing. For the thoughts that arrive after the list is done, our post on how to stop overthinking before sleep goes through what studies suggest.
Why a tired mind can stay awake, and what researchers tried
A list covers tasks, but some nights the mind is busy with more than that. Feeling tired and being able to fall asleep can come apart. A 2010 review by Riemann and colleagues in Sleep Medicine Reviews concluded that hyperarousal plays a key role in primary insomnia, during both night and daytime. A separate 2020 review links worry and mental activity before bed with trouble falling asleep. Both describe links in people with insomnia or poor sleep, not a single cause.
Giving the mind a specific job is one idea researchers have tried. In a 2002 study by Harvey and Payne, 41 people with insomnia were told to distract themselves with an engaging imagery task, to distract themselves in a general way, or given no instructions. The imagery group had shorter sleep onset latency and less pre-sleep cognitive activity than the no-instruction group, and general distraction showed no such support. The authors attribute this to the imagery task using up enough cognitive space to keep a person from returning to worries. For busy nights like that, how to stop racing thoughts at night and why the mind races at night look at the research. If the worry is about sleep itself, not only tonight, what surveys show about worry at night describes how common it is.
Something to try tonight
That imagery study is part of why we built something to try tonight. The guideline's usual advice is to leave the bed when sleep is not coming, and if you would rather not get up, here is a new kind of pass for you. Hypnagogia is the drifting, half-lit stretch between waking and sleep. Hypnagogia-Pass is our library of 30 videos, more than 2,400 minutes in total, curated by CantSwitchOff to walk you through the hypnagogic pass: a word, then a matching picture, one after another on a dark screen, with no talking and soft background sound. No ads. All sessions pair the on-screen shuffle with a slow breathing rhythm of about six breaths a minute. It was inspired by that study and others like it, and none of them examined our videos. Our reasoning, not a study result, is that effortful imagining can keep a mind busy, so we show the picture for you. It is something to try, not a treatment. You can read why we built Hypnagogia-Pass or read about cognitive shuffling for sleep before you decide.
Hypnagogia-Pass is watched on a screen, so it is fair to ask what studies say about screens at night. The authors of a 2015 study in PNAS cite a survey of 1,508 American adults in which 90% used electronics within an hour of bedtime at least a few nights a week. They found that people who read on a light-emitting eReader in the evening took longer to fall asleep than when they read a printed book. That study tested a bright eReader, not our videos, so we cannot say what it means for them.
Your can't sleep questions, answered
Should I stay up if I can't sleep?
A 2021 guideline from the American Academy of Sleep Medicine suggests stimulus control for chronic insomnia. Programs of this kind typically ask people to leave the bed when sleep is not coming and return when sleepy. That advice is for ongoing insomnia, not one night, and a clinician can tailor it to you.
How do I fall asleep fast right now?
Searches for how to fall asleep fast turn up many quick tricks, and we found no study of the 5-minute or military methods. In a sleep-lab study, young adults who wrote a specific to-do list fell asleep faster than those who wrote about finished tasks, and watching a clock went with longer sleep onset.
Why am I so tired but can't sleep?
Being tired and being able to fall asleep are not always the same. A 2010 review found that raised arousal, by night and by day, plays a key role in primary insomnia. A 2020 review also links worry and mental activity before bed with trouble falling asleep, though both describe links and not one cause.
Why am I having trouble sleeping at night all of a sudden?
Sleep can change for many reasons, and we cannot tell you yours from here. The 2010 review describes insomnia as arising from a mix of vulnerability, stressors and habits that keep it going. Why it started is hard to say from the outside.
Is it bad to look at a screen when you can't sleep?
A 2015 study found that reading on a light-emitting eReader in the evening delayed sleep onset, reduced evening sleepiness and suppressed melatonin, compared with a printed book. It tested a bright eReader at bedtime, not every kind of screen, and it did not test people who were already awake at night.
Know someone who's awake right now?
If you have a friend you have recently talked with about a night when sleep would not come, or someone you think needs this information, send them this article. It brings them what the science says, in plain words
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If trouble sleeping lasts for weeks, or if racing thoughts come with other symptoms that worry you, please talk with a doctor. This article is general information, not medical advice.
Sleep Video for Racing Thoughts (No Talking) Hypnagogia-Pass
A sleep video with no talking and soft background sound: one word, one picture, on a dark screen.
THIS IS A SAMPLE OF Hypnagogia-Pass.
