What to do when you can't sleep

Last reviewed: 14 September 2026

You are lying in the dark doing sleep arithmetic. The most useful thing you can do right now is get out of bed — and there is good evidence behind that, however wrong it sounds.

Get up. Don't lie there.

If you have been awake for roughly 20 minutes, get out of bed, go somewhere else, do something undemanding in dim light, and return when you feel sleepy.

This is the opposite of what most people do, and it is the advice with the strongest evidence behind it. Lying in bed willing yourself to sleep is the single most reliable way to turn one bad night into a pattern.

Why getting up is the right answer

Your brain is constantly learning what places are for. Spend enough hours awake and frustrated in bed and it learns that bed is a place for being awake and frustrated — so lying down starts producing alertness rather than sleepiness. That is a real, learned response, and it is what turns a few bad nights into chronic insomnia.

Stimulus control breaks the association by refusing to let bed be the place where you fail to sleep. It is a core component of cognitive behavioural therapy for insomnia, the treatment the NHS recommends for persistent insomnia, and the NHS's own advice says the same thing: if you are still awake after about 20 minutes, get up.

Do not watch the clock

Twenty minutes means "about twenty minutes, by feel". Checking the time does two unhelpful things at once: it gives you a screen, and it hands you an arithmetic problem — if I fall asleep now I'll get five hours and ten minutes — which is precisely the kind of thinking that keeps people awake. Turn the clock away from the bed.

What to do when you get up

The aim is dull, dim and absorbing enough to stop you thinking about sleep.

What to avoid

Waking at 3am and not getting back to sleep

Waking in the night is normal — brief awakenings happen at the end of most sleep cycles and are usually forgotten. What makes 3:00 AM different is that by then you have had most of your deep sleep, so you are surfacing from lighter stages and wake more completely.

The response is identical: if you are not back asleep in about twenty minutes, get up. Two things make this particular waking worse and are worth knowing about — alcohol, which reliably produces a 3:00 AM waking as it clears, and worry, which finds an undefended mind at that hour. If it is consistently the same time every night, look at what you drank rather than at what you were thinking about.

Getting through the next day

One bad night is genuinely survivable, and how you handle the following day determines whether it becomes two.

When to stop self-helping and see a GP or doctor

The NHS advises seeing a GP or doctor if changing your sleep habits has not helped, if you have had trouble sleeping for months, or if it is affecting your daily life. Also see a GP or doctor if anyone has noticed you gasping, snorting or choking in your sleep — that points at sleep apnoea, which no amount of sleep hygiene will fix.

Sources. Self-help advice follows NHS guidance on insomnia, sleep and tiredness, alongside the American Academy of Sleep Medicine's recommendations. Cognitive behavioural therapy for insomnia (CBT-I) is the treatment the NHS recommends for persistent insomnia. This page is general wellbeing information, not medical advice — see a GP or doctor if sleep problems have lasted months or are affecting your daily life.

Common questions

What should I do if I can't sleep?

If you have been awake for about 20 minutes, get up, go to another room if you can, and do something undemanding in dim light until you feel sleepy. Do not watch the clock, and do not reach for your phone.

Is it better to lie in bed or get up when you can't sleep?

Get up. Lying awake in bed trains your brain to associate bed with wakefulness, which is what turns a few bad nights into chronic insomnia. Getting up is a core part of cognitive behavioural therapy for insomnia and is the NHS's own advice.

Why do I keep waking up at 3am?

By 3am you have had most of your deep sleep, so you surface from lighter stages and wake more fully. Alcohol is the most common aggravating factor — it reliably produces a waking as it clears. Worry is the other.

How long should I lie awake before getting up?

About 20 minutes, judged by feel rather than by looking at the clock. Clock-watching makes it worse.

Should I nap the day after a bad night?

A 20-minute nap before 3pm is fine and helps. Avoid anything longer or later, and get up at your normal time that morning — sleeping in to compensate shifts your body clock and makes the next night harder.

When should I see a doctor about not sleeping?

The NHS advises seeing a GP or doctor if changing your sleep habits has not helped, if the problem has lasted months, or if it is affecting your daily life. Also see a GP or doctor if anyone has noticed you gasping, snorting or choking in your sleep.