Can't Fall Asleep? Why Trying Harder Makes It Worse

Where sleepiness comes from: sleep pressure and the body clock

A classic framework in sleep science, in use for more than forty years, is the two-process model proposed by Swiss researcher Alexander Borbély. It describes sleepiness as two processes working together:

• Process S (sleep pressure): the longer you are awake, the higher it rises. During sleep, it gradually drains away.
• Process C (circadian rhythm): set by the brain's internal clock and tuned by time cues such as light, it makes you more alert or more sleepy at different times of day.

When the two line up, meaning you have been awake long enough and your clock has moved into night mode, falling asleep is usually easier. If you napped for a long time in the afternoon, went to bed much earlier than usual, or your schedule has been disrupted by jet lag or catching up on sleep, you can end up in bed before sleepiness arrives. That isn't a failure to sleep properly. The timing just hasn't lined up yet.

Why trying harder to sleep makes it worse

Beyond sleep pressure and timing, a third factor is arousal. In a 2010 review, German sleep researcher Dieter Riemann and colleagues summarized evidence for "hyperarousal". In people with chronic insomnia, studies have found signs of higher arousal at several levels, including the autonomic nervous system, hormones and brain activity. That research is about people with insomnia disorder, but it offers a useful picture: when your body and brain are still "online", sleep can be hard to reach even when sleep pressure is high.

Another factor is common but easy to miss: sleep effort. In 2006, UK sleep researcher Colin Espie and colleagues described an "attention–intention–effort" pathway. Sleep is normally automatic, like digestion, and doesn't need directing. When someone starts paying close attention to sleep, forms a strong intention to fall asleep, and puts in effort to control it, that effort can interfere with the automatic process. Researchers also developed the Glasgow Sleep Effort Scale to measure this urge to control sleep.

In everyday life it looks like this: working out "if I fall asleep now I'll get five hours", checking the time again and again, trying position after position, and getting more and more anxious. The harder you grab at sleep, the more it slips through your fingers.

Should you stay in bed if you can't sleep?

Sleep medicine uses a method called stimulus control. The American Academy of Sleep Medicine's 2021 clinical practice guideline on behavioral and psychological treatments for chronic insomnia gives it a conditional recommendation as a standalone treatment. The core instructions described in the guideline are:

• go to bed only when sleepy;
• get out of bed when unable to sleep;
• use the bed and bedroom for sleep and sex only;
• wake up at the same time every morning;
• avoid daytime napping.

The idea is that after many nights of tossing, turning, worrying and scrolling in bed, the brain may start linking the bed with being awake and anxious. Leaving the bed for a while helps the bed become linked with sleepiness, calm and sleep again.

To be clear, the guideline covers chronic insomnia treatment that clinicians assess and guide, and it does not set a fixed number of minutes. A gentle everyday version: don't time yourself by the clock. If you notice you are getting more awake and more frustrated, get up, go somewhere dim, do something quiet and low-key, and go back when sleepiness returns. If you have mobility issues or are at risk of falling at night, take care getting up.

The guideline also describes "sleep restriction therapy", which adjusts time in bed based on sleep diaries. It isn't suitable for everyone and is best done with professional guidance rather than on your own.

Small things to try tonight

• Change the goal from "fall asleep now" to "rest well". Lying quietly with your eyes closed is still rest.
• Move the clock. Not seeing the time removes one source of pressure.
• Slow your body down a little. Try a few minutes of slower breathing with a longer exhale, or relax your body from feet to head.
• If you're getting more awake, leave the bed for a while. Sit in dim light, listen to something gentle, and go back when you feel sleepy.
• Get up at your usual time tomorrow. Even after a rough night, a steady wake time helps sleep pressure and your body clock line up again.

When to see a doctor

The UK's NHS suggests seeing a GP if changing your sleep habits hasn't helped, if you've had trouble sleeping for months, or if insomnia is affecting your daily life in a way that makes it hard to cope. It's also worth getting checked if you have loud snoring with pauses in breathing, extreme daytime sleepiness, uncomfortable legs that won't settle, or persistent low mood or anxiety. For chronic insomnia, the AASM guideline strongly recommends cognitive behavioral therapy for insomnia (CBT-I) delivered by trained clinicians. If you ever feel unable to keep yourself safe, contact local emergency services or a crisis line right away.

FAQ

How long does it take to count as "can't fall asleep"?

People take different amounts of time to fall asleep, and one slow night is nothing to worry about. More important than counting minutes is whether you feel more awake and more frustrated the longer you lie there, and whether this has gone on for weeks.

Is it okay to use my phone when I can't sleep?

Phone content tends to pull you in and wake you up, and the NHS self-help advice also suggests not using devices like smartphones right before bed. If you get up, choose something quiet in dim light, like gentle sounds or a few minutes of breathing.

After a bad night, should I go to bed early to catch up?

If you go to bed much earlier than usual, your body clock may not be in night mode yet, which can mean more time lying awake. The NHS also advises against sleeping in after a bad night; sticking to your regular hours is usually the gentler path.

Does a drink before bed help me sleep?

Alcohol may make you drowsy for a while, but drowsy is not the same as sleeping well. NHS self-help advice is to avoid alcohol, tea and coffee for at least six hours before bed. If you regularly rely on alcohol or sleep medication to fall asleep, talk it over with a doctor.