Should You Stay in Bed If You Can't Sleep?

When you can’t sleep, staying in bed and waiting can feel like the obvious thing to do. Clinical sleep guidance recommends something different. This page explains what the guidance recommends instead, why, and how to follow it.

Quick Answer (TL;DR)

No. Sleep guidelines say that if you can’t fall asleep after about 20 minutes, you should get out of bed, do something relaxing until you feel sleepy, and then go back to bed. Repeat this as often as needed. This is called stimulus control, and it is one of the techniques used in cognitive behavioral therapy for insomnia (CBT-I), the treatment the American Academy of Sleep Medicine strongly recommends for chronic insomnia.

Key Takeaways

• About 20 minutes is the usual rule. The AASM’s insomnia guideline describes leaving the bed if you can’t fall asleep within 20 minutes, doing a relaxing activity until drowsy, then returning (Schutte-Rodin et al., 2008). Some reviews use 15 to 20 minutes (StatPearls).
• Estimate; don’t clock-watch. The same guideline advises judging how long you’ve been awake rather than watching the clock.
• The aim is to re-associate the bed with falling asleep quickly (review, NIH).
• CBT-I is the strongly recommended treatment for chronic insomnia in adults (AASM guideline, 2021).
• The NHS gives matching advice: go to bed only when you’re sleepy, and wake up and get out of bed at the same time every day (NHS).

Should I Just Lay in Bed If I Can’t Sleep?

No. Clinical guidance treats long stretches of lying awake as something to avoid. Stimulus control aims to train you to “re-associate the bed and bedroom with rapid sleep onset” (review, NIH). In other words, the bed should become a cue for falling asleep, not for lying awake.

How to Do It: The Stimulus Control Steps

These steps are the standard stimulus control instructions as described in the AASM’s insomnia guideline and a clinical review (Schutte-Rodin et al., 2008; review, NIH):

1. Go to bed only when you feel sleepy.
2. Use the bed only for sleep and sex, not for watching TV or other waking activities.
3. If you can’t fall asleep after about 20 minutes, get up. Estimate the time; don’t watch the clock.
4. Do something relaxing somewhere else until you feel drowsy, then go back to bed. Repeat as often as needed.
5. Get up at the same time every morning, however the night went.
6. Avoid daytime naps.

Exact timings vary between sources; some reviews give 15 to 20 minutes (StatPearls).

If getting up at night is risky for you, for example because you are at risk of falling, ask your doctor how to adapt this.

How Strong Is the Evidence?

It’s worth being precise about what is proven here:

• CBT-I as a whole gets the strongest rating. The 2021 AASM guideline states: “We recommend that clinicians use multicomponent cognitive behavioral therapy for insomnia (CBT-I) for the treatment of chronic insomnia disorder in adults (strong recommendation)” (Edinger et al., 2021).
• Stimulus control used on its own receives a weaker, conditional recommendation in that guideline. The AASM’s evidence review rated the quality of the evidence for it as low, mainly because of imprecision and risk of bias in the trials (AASM systematic review).

So getting out of bed is a standard, guideline-backed technique. Its strongest support comes as one part of a full CBT-I programme.

If It Keeps Happening

Trouble sleeping that keeps coming back may be chronic insomnia. The AASM defines it as difficulty falling asleep, staying asleep or waking too early at least three times a week for at least three months, together with daytime symptoms such as fatigue or poor concentration (AASM). The NHS advises seeing a GP if changing your sleeping habits has not helped, if you’ve had trouble sleeping for months, or if it is affecting your daily life in a way that makes it hard to cope. A GP may offer CBT, face to face or through an online self-help programme (NHS).

If your problem is the opposite pattern, sleepy all day and awake at night, see why you can be sleepy all day but can’t sleep at night.

Keeping Track of Your Nights

Stimulus control asks you to keep a fixed wake-up time and go to bed only when sleepy. A record of your nights shows whether you’re actually doing that.

With Snollo, you tap Start at bedtime and the app records the night on your iPhone. The free tier keeps your full sleep history, so you can see your bedtimes and wake-up times over weeks. Sleep stages are most accurate with an Apple Watch. Without one, Snollo estimates approximate stages from the iPhone’s microphone and motion sensors, with the iPhone on the mattress near you. Phone and watch stages are estimates; the most accurate way to measure sleep stages is an overnight sleep study (polysomnography), which records brain waves (EEG), eye movements (EOG) and muscle tone (EMG) (NHLBI). Snollo does not treat insomnia, is not a medical device and does not diagnose any condition.

Download Snollo free on the App Store

Frequently Asked Questions

How long should you lie in bed before getting up?

Clinical guidance usually says about 20 minutes. The AASM’s insomnia guideline describes leaving the bed if you can’t fall asleep within 20 minutes, and some reviews use 15 to 20 minutes. It is meant as an estimate: the guidance advises against watching the clock.

What should I do when I get out of bed?

Something quiet and relaxing, until you feel sleepy, and then go back to bed. Repeat this as often as needed. The point is for the bed to become linked with falling asleep quickly, not with lying awake.

What is CBT-I?

Cognitive behavioral therapy for insomnia. It combines techniques such as stimulus control with other behavioral and cognitive methods. The American Academy of Sleep Medicine strongly recommends it for chronic insomnia in adults, and the NHS says a GP may offer CBT, face to face or through an online programme.

Snollo does not diagnose or treat any medical condition. This article summarizes clinical sleep guidance for general information. If you have trouble sleeping for months, talk to a doctor. If you have any doubts about how you feel or how you sleep, talk to a doctor or sleep specialist.

Sources

• Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults (Schutte-Rodin et al., 2008) — AASM / PMC
• Behavioral and psychological treatments for chronic insomnia disorder in adults: AASM clinical practice guideline (Edinger et al., 2021) — JCSM
• AASM systematic review, meta-analysis, and GRADE assessment of behavioral treatments for insomnia — PMC, NIH
• Diagnosis and treatment of chronic insomnia — PMC, NIH
• Chronic Insomnia (StatPearls) — NCBI Bookshelf
• Insomnia — American Academy of Sleep Medicine (Sleep Education)
• Insomnia — NHS
• Sleep Studies — NHLBI