If you can’t fall asleep, the single most helpful thing is to stop trying to force it — lying in bed straining to sleep raises alertness and makes sleep less likely. The most effective response is to get out of bed when you are wide awake, do something calm and quiet in low light, and return only when you feel sleepy. When trouble falling asleep happens night after night, CBT-I — recommended by NICE and the NHS as the first-line treatment for chronic insomnia — teaches a lasting way out of the cycle.
Most of us have lain awake unable to switch off, watching the minutes pass and growing more frustrated. The occasional bad night is normal. But when you regularly can’t fall asleep, or wake and can’t get back to sleep, it may be a sign of insomnia. This page explains why it happens and what to do in the moment — and over the longer term.
Why can’t I fall asleep?
There are several common reasons sleep won’t come. Often more than one is involved.
Stress and anxiety
When the body is alert and tense, sleep becomes lighter and harder to enter. The nervous system stays “switched on” when it needs to wind down.
A racing mind at night
The moment your head hits the pillow, the mind can start working through worries — the day behind you, the day ahead — and that mental activity keeps you awake.
Unhelpful sleep habits
Going to bed before you are genuinely sleepy, or spending long periods awake in bed, can weaken your natural sleep pressure and teach the brain to associate the bed with wakefulness rather than sleep.
Screens before bed
Screen use late in the evening can affect how quickly you fall asleep and how deeply you sleep.
Why does trying harder make it worse?
When you can’t sleep, it is natural to start thinking:
- How long is left until morning
- How you will cope or function tomorrow
- Why you are still awake
These thoughts increase the body’s alertness, and that alertness is precisely what blocks sleep. Effort and sleep pull in opposite directions: the harder you try to force it, the more awake you become. Sleep arrives when the body feels safe to let go — not when it is being pushed.
What should you do when you can’t fall asleep?
A few simple principles can break the cycle on a difficult night:
- Don’t check the clock — it only feeds worry about lost time
- Don’t stay in bed for long when you are clearly awake
- Get up and do something calm and undemanding in low light (reading, gentle stretching), then return to bed when you feel sleepy
- Avoid bright screens, work and anything stimulating
These principles are core tools within CBT-I, where they are tailored to your own pattern rather than applied as rigid rules.
What does the evidence say?
Extensive research shows that cognitive behavioural therapy for insomnia (CBT-I) is the most effective treatment for chronic insomnia, and it is recommended by NICE, the NHS and the American Academy of Sleep Medicine (AASM) as the first-line approach, ahead of sleeping tablets. CBT-I shortens the time it takes to fall asleep and reduces night-time waking, with benefits that last because people learn how to work with their own sleep system.
Frequently asked questions
What should I do if I can’t fall asleep after 20 minutes?
Rather than watching the clock, use how you feel as a guide: if you are clearly wide awake and frustrated, get up, do something calm and quiet in low light, and return to bed only when sleepiness returns. This protects the link between your bed and sleep.
Is it bad to lie in bed awake?
Lying awake for long stretches can train the brain to associate the bed with wakefulness and worry rather than sleep, which makes future nights harder. It is usually better to get up briefly than to lie there straining to sleep.
When should I seek treatment for trouble falling asleep?
When difficulty falling asleep happens frequently, persists for weeks or months, or starts to affect your mood and daytime functioning, a focused treatment such as CBT-I can help break the cycle.