From TIME International
It’s 2 a.m., and you’ve been awake for an hour—staring at the same patch of ceiling, counting the same sheep, and doing increasingly alarming math about how wrecked you’re going to feel tomorrow. Your instinct is to stay right where you are and try harder. Surely sleep will come eventually. And even if it doesn’t, at least you’re resting, right? Not exactly. The better move, sleep specialists say, is the one that feels most counterintuitive: get up, leave the room, and do something else. The technique is called stimulus control, and it isn’t new—psychologist Richard Bootzin introduced it in 1972, and it remains a cornerstone of cognitive behavioural therapy for insomnia.
Why lying in bed when you can’t sleep makes it worse
The problem begins when you treat sleep like a task. “Effort is the enemy of sleep,” says Shelby Harris, a behavioural sleep medicine specialist in New York. The harder you work at it, the more frustrated and alert you become.
How long should you stay in bed before getting up?
People are often told to get out of bed after about 20 minutes awake. But timing yourself requires looking at a clock—which can make you even more stressed about not sleeping.
Instead, notice your mood. If you’re calm, give yourself a few minutes to see what happens. But if your mind is racing, you’re becoming annoyed, or you catch yourself trying to force sleep, get up. Do something else until you feel sleepy again.
Why getting out of bed helps
Michael Perlis, director of the behavioural sleep medicine program at the University of Pennsylvania’s Perelman School of Medicine, sums up his advice in a slogan: “Give up. Get up. Get out.”
Getting up allows sleep pressure, the biological drive that makes you sleepy, to build. Even if it doesn’t rescue that night, Perlis says, it can improve your odds of sleeping better the next one.
It also preserves the positive association between your bed and sleep—and helps “give sleep a chance” later.
What to do when you can’t sleep
The goal isn’t to tire yourself out, Harris says. Choose something enjoyable to pass the time until sleepiness returns.
Harris collects old cookbooks and flips through them, earmarking family recipes. She has seen patients take up art projects and knit what she affectionately calls “insomnia scarves.” Whatever you choose shouldn’t feel like a punishment—or particularly productive. “Don’t do your work. Don’t do taxes. Don’t do bills,” Harris says. “The more you wake up and do work, the more you’re teaching your body to have those awakenings.”
A few other rules help
Avoid screens when possible. Phones and laptops can pull you into messages and work— and make it difficult to put the device down.
If a screen is your only realistic alternative to lying in bed with a racing mind, watch something you enjoy, but treat it as a backup plan.
Turn on a lamp. You don’t need to sit in the dark. Use enough light to do your chosen activity comfortably.
Don’t fall asleep on the couch. When sleepiness hits, return to your bedroom so you don’t train yourself to sleep elsewhere.
Prepare during the day. Decide in advance where you’ll go and what you’ll do, and leave a book, magazine, or art supplies ready.
Practice makes perfect
Once you feel sleepy again, return to bed. “See what happens,” Harris says. If your mind starts racing or you become frustrated again, “get back out, rinse, and repeat.”
If you’ve been practicing stimulus control for two or three weeks, while maintaining a consistent bedtime and wake time, and your sleep hasn’t improved, Harris recommends seeing a sleep specialist. They can screen for conditions like sleep apnoea and determine whether you might benefit from a fuller course of cognitive behavioural therapy for insomnia.
And the next time you’re lying awake at 2 a.m., remember: “Change the narrative,” Harris says. “Trying to force it is only going to make it worse.”
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