Can’t Sleep? What to Do Tonight and in the Long Run

01Tonight

What to do if you can’t sleep tonight

• Don’t watch the clock: turn it away. Checking the time and calculating how many hours are left increases stress.
• If still awake after about 20 minutes, get up: go to another room with low light.
• Do something calm: read a paper book, listen to quiet music or a podcast, stretch gently, or do a relaxation exercise.
• Avoid screens, news, work and problem-solving.
• Return to bed only when sleepy, and repeat if needed.
• Keep the room cool and dark; a warm shower earlier can help.
• Try slow breathing: in for 4, out for 6. See deep breathing for anxiety.
• Accept a bad night: one poor night does not harm you, and worrying about it makes it worse.

02Why

Why you can’t sleep

• Stress and worry keep the brain in alert mode.
• Irregular schedule, late naps, shift work or jet lag.
• Caffeine, nicotine, alcohol, heavy late meals.
• Screens and bright light in the evening.
• A bedroom that is too hot, bright or noisy.
• Physical conditions: pain, reflux, asthma, thyroid problems, restless legs, sleep apnoea, menopause symptoms.
• Mental health: anxiety, depression and trauma.
• Medicines: some antidepressants, steroids, stimulants, decongestants.
• Learned insomnia: the bed becomes associated with frustration.

03Worry

When your mind races

Earlier in the evening, write down what is on your mind and one next step for each item, so the brain does not feel it must remember them at night. Keep a notepad by the bed. Use a mindfulness or body-scan recording, progressive muscle relaxation or a gentle “cognitive shuffle” (thinking of random unrelated words). Avoid arguing with your thoughts in bed. See how to stop overthinking.

04Habits

Habits that fix sleep over time

• Same wake-up time every day, including weekends.
• Morning daylight for 15–30 minutes.
• Daily physical activity, finishing intense exercise 2–3 hours before bed.
• Limit caffeine to the morning and avoid alcohol close to bedtime.
• Eat dinner earlier and avoid large or spicy meals before bed.
• Limit naps to 20–30 minutes before mid-afternoon.
• Wind down for 30–60 minutes before bed with dim light and no screens.
• Use the bed only for sleep and intimacy.

05CBT-I

CBT for insomnia

If poor sleep persists for weeks, CBT for insomnia is more effective in the long term than sleeping pills. It usually includes stimulus control (the get-up rule), sleep restriction (temporarily limiting time in bed to your actual sleep time to build sleep drive), cognitive strategies to loosen unhelpful beliefs about sleep, relaxation and sleep education. It works for about 70–80% of people over 4–8 sessions and can be done with a psychologist or through digital programmes. See insomnia.

06Medicines

What about sleeping pills and supplements?

Short courses of prescription sleep medicine may help in specific situations but carry risks of dependence, next-day impairment and falls. Over-the-counter antihistamines lose effect quickly and are not advised for older adults. Melatonin helps with jet lag and shifted body clocks but has a small effect in typical insomnia. See over-the-counter sleep aids and valerian root for sleep.

07Waking

Waking in the night or too early

• Avoid looking at the clock or your phone.
• Use the same get-up rule if awake for more than 20 minutes.
• Limit evening alcohol, which fragments sleep in the second half of the night.
• Keep the bedroom cool and consider blackout curtains and earplugs.
• Early waking with low mood and loss of interest may signal depression: speak to a doctor.
• Needing the toilet frequently at night may point to prostate, bladder, diabetes or heart problems, or too much evening fluid.
• Hot flushes or night sweats may be due to menopause.

08Kids

Children, teenagers and older adults

Children need consistent routines, a regular bedtime, no screens before bed and a calm environment; talk to your paediatrician about persistent sleep problems. Teenagers naturally shift to later bedtimes and need 8–10 hours; limit evening screens and caffeine. Older adults tend to sleep lighter and wake more, but should not accept constant poor sleep as normal: review medicines, pain, mood and sleep apnoea.

10Cases

Three common situations

Can’t fall asleep before a big day: use relaxation, avoid the clock and remind yourself that one poor night will not ruin performance.

Waking at 3 a.m. and can’t get back to sleep: use the 20-minute rule, review alcohol and stress.

Sleep problems for months with daytime fatigue: seek assessment and consider CBT-I.

11Summary

Key points to remember

Get up if you are not sleeping, keep calm and light low, then return when sleepy. Build regular habits and seek CBT-I if the problem persists. Check for medical and mental health causes. Our psychology team can help.

This guide is for general information and does not replace an assessment by a qualified health professional.