How to fall asleep and stay asleep

It's 10.50pm. The lamp goes off, and you lie on your back and wait. From here, the night goes wrong in one of two ways.

In the first, nothing happens. The day replays itself, you turn the pillow to the cool side, and at 12.40am you're still waiting. In the second you're gone in minutes, and then it's 3.20am, you're wide awake for no reason, and the boiler is clicking.

Neither one says anything about you, and neither is rare. The NHS lists stress, noise, a room that's too hot or cold and an evening drink among the everyday causes of broken sleep. The trouble is that both problems get the same advice, when each needs a different fix.

Either way, the morning is the same. You do the school run on autopilot, and the 2pm call happens with you nodding in the wrong places.

Sleep pressure and the body clock

Sleep is run by two systems, in a model sleep researchers have leaned on since the 1980s. The first is sleep pressure, which builds every hour you're awake and drains while you sleep. The second is your body clock, a roughly 24-hour timer that decides when the night is allowed to start.

When both say yes, you drop off. When the pressure is low, you lie there waiting for something that hasn't arrived. A nap, a lie-in or a bright evening will do that.

Staying asleep is mostly the clock's job, because by 3am most of the pressure has been spent. Anything that unsettles the clock, or that pokes you awake once it's in charge, shows up in the second half of the night. That's where the two kinds of bad night come from.

If you only ever get the second kind, fall asleep fine but can't stay asleep is written for you.

Why lying there makes it worse

Your brain learns places. If bed is where you lie awake and fret, bed starts to mean fretting, the way your desk means work. The Royal College of Psychiatrists calls this protecting your space: the bed is for sleep, and lying awake in it teaches the wrong lesson.

So getting up when you can't sleep isn't giving up. It's unlearning. It works slowly, over weeks rather than nights.

What to do, in order

1. Fix the wake time and hold it. For most people the weekday time is already fixed by work; the choice is what happens on Saturday. The NHS says the same time every day, and no sleeping in after a bad night, and this is why: the clock sets itself by when you get up and see light, so a lie-in starts the next night late. If a whole weekend at the weekday time is more than you can face, an hour's lie-in is the limit.
2. Spend the day building pressure. Daylight early and movement in the day. No nap after lunch. The NHS asks for regular exercise, kept out of the four hours before bed, and says not to nap. A nap is pressure spent in advance. If you sit at a screen all day, a walk at lunchtime counts, and so does walking to the shops.
3. Make the last hour go downhill. The NHS asks for at least an hour of relaxing before bed, because your body can't drop from full speed to sleep in a minute. Lower the lights and finish the work. Leave the argument for tomorrow. A warm bath helps, if it's early enough. In a 2019 review of 17 studies, a bath or shower at 40 to 42.5°C shortened the time to fall asleep. The timing was one to two hours before bed, and ten minutes was enough. It works by pulling heat out to your hands and feet so your core can cool, which is what falling asleep needs.
4. Get the screen out of the bedroom. Devices right before bed are on the NHS's don't list. In a laboratory study, 12 people read on a light-emitting device for four hours before bed, five evenings running. They took longer to fall asleep, felt less sleepy at bedtime, and their body clocks ran more than an hour later. They were also less alert the next morning. The content matters too: a work email at 11pm is a deadline in bed. Charge it in the hall.
5. Go to bed sleepy, and get up if you're not. Only go to bed when you're sleepy, the NHS says. If you're awake and fretting, get up. Keep the lights low, do something dull in another room, and come back when the sleepiness returns. This is stimulus control, from CBT for insomnia. Across 20 trials of 1,162 people with long-term insomnia, CBT cut the time to fall asleep by 19 minutes. Waking in the night fell by 26 minutes. It works slowly, over several weeks, and you may sleep a bit worse before you sleep better.
6. Keep the second half of the night quiet. Alcohol is the big one. It helps you drop off and then wakes you in the night, so the NHS puts it six hours from bed, with tea and coffee. Add a cooler room, the big meal eaten earlier, and no clock you can read from the pillow. If you still surface, how to get back to sleep covers the next twenty minutes.
7. Don't stretch the night to make up for it. If you're in bed for nine hours and sleeping six, the spare three are spent practising being awake. The Royal College of Psychiatrists suggests the reverse of an early night. Pick the earliest bedtime you're comfortable with, then move it 15 minutes later each week. Stop when you fall asleep within about 20 minutes and aren't awake for more than about 20 in the night. Only then bring it earlier again. How to sleep through the night goes further into this.

What this won't do

The bath evidence is thin. Of the 17 studies, only 13 had numbers that could be pooled, and the authors say the best timing and length are still unclear. We'd rather say so now than have you blame the bath.

The CBT figures come from people with long-term insomnia, so an ordinary sleeper on a bad run should expect a smaller gain. And nothing here fixes a night wrecked by pain, a snoring partner, a toddler or a cat; those have their own fixes, and some involve a GP. The NHS says to see one if the habits haven't helped, or if it's been months.

The full ranking of what helps, with the weak items flagged, is in how to sleep better.

Start with the wake time; everything else hangs off it. If you're not sure whether your night is more a falling-asleep problem or a staying-asleep one, a fortnight with the alarm will tell you.