Image: Shutterstock / Tero Vesalainen
You're exhausted. All you need is sweet, precious, lovely sleep. But the very thing you need right now just won't happen. You toss, you turn, you tear your hair out, but you don't drift off.
So, what do you do when you can't fall asleep? It's a question I've asked myself many a time when slumber has escaped me. Sleeping doesn't always come easily or as quickly as we'd like it to.
Perhaps you're in an unfamiliar bed, or with a new partner. Maybe you've slipped out of your usual routine, or you simply have a lot on your mind. Nodding off can be a real challenge sometimes, but it's not a lost cause. There are things you can do to coax yourself into drifting off.
Understand your deep-rooted sleep habits
Like many people, I have developed particular sleep habits. I can only fall asleep if I'm sleeping on the right-hand side of my body, on the left side of my bed, facing the wall. I only ever fall asleep in a kind of Superman-esque pose — awkwardly on my side, with one arm outstretched as if I'm steering myself through the sky.
Try as I might, I can't fall asleep any other way. Turns out, I'm not alone. Dr. Matteo Ria, a consultant psychologist at Pall Mall Medical, who specialises in sleeping issues, said that the reason this happens is because we have trained ourselves to sleep a certain way. "As with anything we physically and mentally do, our body gets used to certain habits, and this is no different when we sleep," Ria said. "If you are used to sleeping on a certain side, your brain tells you this is the comfiest position for you to sleep and this will become a natural process."
"Similarly, some people may sleep on their back or curl up with their pillow, and it’s the same process. Once your body becomes used to sleeping in a certain position, your brain will tell you this is the correct way for you to get to sleep, and your body will react," he added. "This is why if you are sharing a bed with your partner you may struggle to get to sleep, as your brain is telling you which position to lie in, but that position may not be available whilst sharing the space with someone else."
Take positive, proactive steps to optimise your sleep
Former Royal Marine Commando Louis Nethercott, peer development lead at Help For Heroes, was involved in intense combat during his tour of Afghanistan with 42 Commando. His experience there led to him developing PTSD and he was medically discharged in 2016, and found transition to civilian life difficult. "During your nine months training in the Royal Marines you are exposed to long periods of sleep deprivation to get you used to getting no sleep," said Nethercott. On a ten-day tactical exercise, he would get between two and four hours sleep a night — sometimes none at all.
"You would also be sleeping in miserable conditions on the ground, under a bush or in a ditch — in a sleeping bag inside a bivvy bag (a waterproof outer to the sleeping bag) in wet clothes, curled up next to a general purpose machine which is a huge cold, sharp lump of metal. None of this is conducive to a good night’s sleep and it’s stressful." Nethercott got used to it, though. He said the training taught him how to cope on very little sleep — a vital skill for those in the armed forces. "One of the biggest lessons I learned in the military about sleeping was to proactively take all the positive actions you could to optimise the potential for sleep," he said. "Find the best spot available to bed down, rather than just sleeping where you end up; take care how you set up your sleeping bag and bivvy bag to minimise wet."
For people like you and me, optimizing your sleep could mean making your bed in the morning, changing your sheets regularly, making sure your bed is as comfortable as possible, and that your room is the right temperature. "If I knew that I’d made every positive action then I felt more able to live with the conditions and this mindset actually helps you sleep," he said.
Try this simple mindfulness exercise
If you really, really can't sleep, or you wake up in the middle of the night and can't go back to sleep, try this exercise recommended by Sarah Romotsky, director of healthcare partnerships at Headspace, the mindfulness app.
"Eyes closed, take a couple of deep breaths, and, starting at the number 1,000, just slowly and gently count backwards to zero (you won’t get there)," said Romotsky. "Focus on the counting, rather than trying to will yourself to sleep. Failing that, and because mindfulness helps us to be more aware of how we’re feeling, it’s worth checking in with the body to see if we’re genuinely feeling sleepy."
Improve your sleep hygiene
No no, we're not talking about taking a shower before bed. Sleep hygiene is defined by the Sleep Foundation as "a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness."
Dr. Matteo Ria said in order to have good sleep hygiene, it's important to maintain a good sleep routine, like going to bed at the same time every night, buying a good mattress, and limiting alcohol consumption after 6pm. That afternoon nap habit? Ditch it. "Avoid sleeping during the day. A nap should strictly last no longer than 30 minutes, as this may affect your sleeping routine and conflict with your quality of sleep at night," said Ria.
"Ensuring you have a non-cluttered, clean and spacious bedroom space is essential for a good night’s sleep," he added.
Limit your caffeine intake
If you love your coffee and you've been having trouble getting to sleep, it might be worth taking a look at your caffeine consumption.
"We’re not recommending you completely cut caffeine out of your diet but controlling your intake of caffeine is key for a good night’s sleep. I would recommend you limit your daily intake of caffeine and refrain from drinking caffeine after 6pm at night. Instead try sipping a natural caffeine free infusion — white and green tea or Matcha can be ideal substitutes to regular coffee.
Try to reduce your stress levels
Stress can be a big obstacle standing in the way of getting to sleep. Nethercott is, of course, no stranger to high stress levels. "At times, especially when on tour in Afghanistan, it would be difficult to sleep because of fear and stress about what was going to happen the next day," he said.
To ease those stress levels, he and his fellow operatives would debrief about how they were feeling and get things off their chest. "To counteract this we would chat amongst ourselves about what had happened today, what was going to happen tomorrow and how we were feeling," he explained. "By getting the emotions off your chest in this safe and informal way, you could clear your head and this made all the difference in enabling you to sleep rather than having thoughts going round and round all night."
Not everyone can chat to someone before bed, but there's another option. "The same is true in real life – even if you can’t talk to anyone before you go to sleep, some people find that jotting down thoughts and worries before you put your head down – or when you wake up in the middle of the night – can have the same effect," said Nethercott.
Romotsky from Headspace said that sometimes if your mind and body feel too energetic, then sometimes the best thing to do is simply get out of bed. "It might sound a bit counterintuitive, but that way, we’re not creating a negative association with our bed and losing sleep over it," she said. "If you do get up, take yourself to another room and engage in some kind of relaxing activity that isn’t too stimulating. Reading is great or even doing some tidying." Once you feel sleepy again, have another go at trying to go back to sleep.
Limit your screentime before bed
When you can't sleep, it can be so tempting to reach for your phone. And scrolling before bed can often feel second-nature to us. But don't do it. "It’s really important to avoid stimulating your mind late at night," said Romotsky. "Try to cut down screen-time by not answering emails and scrolling on social media late into the evening or right before bedtime."
Dr. Ria echoed this advice. "From a sleep clinic point of view, it’s recommended you limit access to smart devices at least 60 minutes before going to sleep, as these devices have backlights which keep our brain alert instead of supporting our neuro system to follow a natural curve towards sleep."
You don't need to sit there twiddling your thumbs, though. You could try reading a book or writing in a journal. "A warm bath or shower 30 minutes or so before bed has been shown to relax body and mind, and it’s worth cultivating an environment conducive for sleep, such as an uncluttered room with dimmed, warm lighting," said Romotsky. "Sleep by Headspace is also a great tool to help you disengage from a stressful day. This range of content is designed to create the ideal conditions for a healthy restful sleep at night, helping you drift off and stay asleep."
If you do decide to keep your phone in reach at bedtime, you might want to try one of the many popular sleep apps out there, rather than just scrolling endlessly through your timeline.
Ditch your rigid sleep routines
While it's perfectly normal to have a preference for sleeping certain positions, these habits and routines can also be a hindrance when it comes to nodding off.
James Wilson, AKA the Sleep Geek, said in his experience "it generally takes about seven to 10 days for new behaviours to be embedded." Sometimes these habits can be really useful in getting us off to sleep. "We need to be dropping our heart rate and core temperature before bed and there is no magic supplement, app or smell that works for everyone," said Wilson. "If it is something like watching TV in bed, move the tv viewing to the living room, and get ready for bed while you are watching TV and only go to bed when you are sleepy."
It's useful to acknowledge what is helpful in getting you to sleep, and what's hindering you. "If you have rigid routine that you feel you need to do and it is not helping you sleep then the first point is to accept that it is not working," said Wilson.
You can unlearn the habits you've developed, according to Dr. Ria. "It is possible to work around conditioning and deconditioning of the brain, if there is a clear indication that certain behaviours might be counterproductive over time," he said. Sleeping in a preferred position isn't inadvisable, but if you're getting any aches or discomfort, then you might need to reconsider.
"The aim is firstly to identify possible triggers which are causing sleep difficulty and work towards more functional strategies, in order to facilitate waking up feeling refreshed," said Ria. "It is not just about the number of hours a person spends resting horizontally in bed, it’s important we consider the quality of sleep, as this is when we will reach deeper phases of sleep."
Go to your safe place
It's important to feel safe before bed. Nethercott said that a lot of servicepeople bring with them something to sleep that remind them of home or a safe place.
"It could be a photo of your wife or an old teddy or mascot," he said. "For me it was a little pillow from my childhood. These small things help ground you and place you somewhere good. The comfort of this calms you down and really helps you get to sleep."
Next time you're struggling to get some shut-eye, don't despair. There's always something that can be done. Sweet dreams.