Even if you diligently avoid caffeine late in the day and you quit scrolling through Instagram an hour before bed, there may come the occasional night when it’s just impossible to fall asleep.
After you’ve tossed and turned, adjusted and readjusted your pillow, checked the clock again, and sufficiently groaned about your lack of sleep, what are you supposed to do that’s actually going to help solve the issue?
“To answer this, we first need to reconsider what ‘can’t fall asleep’ means,” says Rubin Naiman, PhD, sleep and dream psychologist and clinical assistant professor of medicine at Arizona Center for Integrative Medicine. “In our high-velocity world, many people believe that good sleepers fall asleep in a flash. This attitude can trigger anxiety when sleep onset isn’t rapid, further delaying falling asleep.”
It’s “perfectly normal” to lie in bed for 10 or 20 minutes before you drift off, Naiman continues. “Regularly falling asleep in a moment or two is not a sign of being a good sleeper. In fact, it may be a symptom of excessive sleepiness and an underlying sleep disorder."
With that perspective in mind, we asked sleep experts themselves: What do you do when you can’t sleep? Because if anyone holds the secret keys to dreamland, it’s these folks. Here’s what we learned.
“When I have trouble falling asleep, it’s usually because I have something on my mind about work or my kids. Most importantly, I avoid getting upset about being awake—usually what’s on my mind is important. One advantage of being a ‘sleep expert’ is that I know I will eventually get sleepy enough to fall asleep, so I don’t get too worked up about being awake at night on occasion.”
—Jennifer L. Martin, PhD, associate professor of medicine at UCLA
“It is rare for me to struggle to fall asleep, but when I do, I’ve grown to love it. What’s not to love? I’m in a really comfortable place, it’s quiet, nobody is texting or calling me, no arguing children, no list of home repairs to deal with, just relaxing in the dark with my thoughts. If sleep seems to be a little elusive, I use the time to figure out fun places to go on vacation or plan something to do for my wife's birthday. In short, when it comes to not being able to fall asleep, despite my profession, I honestly don't give a damn, and that is precisely why I never have an issue sleeping. People fear not sleeping, but it’s really an irrational fear, since everyone sleeps.”
—W. Chris Winter, MD, president of Charlottesville Neurology and Sleep Medicine and author of The Sleep Solution
“I rarely have trouble falling asleep. However, on occasion, particularly if I have something on my mind, I will get into bed and not fall asleep because my mind is in overdrive. Once I recognize this, I will start by trying to distract myself with relaxing thoughts and images—a favorite vacation with my family is a good one!”
—Ilene M. Rosen, MD, president of the American Academy of Sleep Medicine and program director of the University of Pennsylvania Sleep Fellowship
“I think of my favorite things to dream of. I like to imagine I am on the beach, in a hammock, with my kids playing close by in the sand. I can feel the sun’s warmth on my skin, I can hear the ocean waves. I can smell the saltiness of the sea. I frequently dream of being on the beach!”
—Shalini Paruthi, MD, co-director of the Sleep Medicine and Research Center at St. Luke’s Hospital and an adjunct associate professor in pediatrics at the Saint Louis University School of Medicine
“If there are nights where I have difficulty falling asleep, I will do a very simple relaxation technique called diaphragmatic breathing. Diaphragmatic breathing can be used when the brain is going a mile a minute and you feel distracted from falling asleep. I typically do this lying down. I breathe in slowly and deeply counting 1, 2, 3, 4, and then exhale slowly counting 5, 6, 7, 8. With practice, this can help you relax and prevent the pesky racing thoughts from interfering with your sleep."
—Mark Muehlbach, PhD, staff clinician and director at the Clayton Sleep Institute Clinics and Insomnia Center and co-director of the CSI Research Center
“[I practice] meditation, relaxation, and deep-breathing exercises, like 4-7-8 breathing. [Inhale through your nose for a mental count of four; hold for a count of seven; then exhale through your mouth for a count of eight.] Or I make a gratitude list. There is data to show that positive thinking before bed can not only help you fall asleep quicker, it makes for more positive dreams!”
—Michael J. Breus, PhD, sleep specialist and clinical psychologist
“If I can’t fall asleep and it’s been more than 30 minutes or so, then I get up and figure out what is the problem. Is it my restless legs syndrome acting up? If so, I will put a blanket and pair of fluffy, loose, fleecy socks in the clothes dryer for five to 10 minutes to help me warm up so I can calm my legs and feet down.”
—Shalini Paruthi, MD
“The best practice involves going to bed only when one is feeling sleepy and getting out of bed if sleep doesn’t arrive in more than 30 minutes. Spending stretches of time in bed while struggling to sleep negatively conditions the bed for sleeplessness, which can cause future conditioned insomnia.”
—Rubin Naiman, PhD
“If I notice that I have been in bed for 20 minutes or so and nothing is working, I will get out of bed and go to another room. I usually turn on a small lamp and read a magazine. I do not watch television and try very hard not to check my phone. If I have a lot on my mind, I may write down some thoughts to help me know I will revisit them in the morning so I can clear my mind. Once I feel tired again, I will go back to my bedroom and try to sleep.”
—Ilene M. Rosen, MD
“I may do something boring, non-screen, like fold a basket of laundry that is waiting to be folded. I have also picked up a paper book to read quietly in another room so as not to bother my husband until I am sleepy.”
—Shalini Paruthi, MD
“I go into the family room and read a book or a magazine on the sofa. I go back to bed when I get sleepy. I don’t like watching TV or moving around too much during the night because I don’t want to wake up my family. As time passes, I do get sleepy, and the reading distracts me from what was bothering me in bed. Once I go back to bed, I fall asleep pretty quickly.”
—Jennifer L. Martin, PhD
“I sometimes do pull out my phone (with the night shift function on to block out blue wavelength of light) to run the app Stop, Breathe & Think. This mindfulness meditation app includes short three- to nine-minute guided meditation, relaxation, and breathing programs.”
—Shalini Paruthi, MD
By Sarah Klein on March 19, 2018, "Exactly what 7 sleep experts do when they can't sleep", www.health.com.