Can't sleep because your mind won't stop thinking?

If you are still awake about 20 minutes after going to bed, the UK's NHS suggests getting up, sitting somewhere comfortable and doing something relaxing, then going back to bed when you feel sleepy, rather than lying there trying for an hour. For thoughts that keep circling, write down tomorrow's tasks or whatever is worrying you before bed, wind down for at least 1 hour beforehand, and get up at the same time every day.

This article focuses on lying awake because your mind won't switch off. For sleep habits in general, see Want to sleep better? Which habits can you change?, and for shallow sleep or waking in the night, see Lighter sleep with age: how can you adjust your sleep?

Why does my mind keep racing when I try to sleep?

Many people feel tired all day, yet the moment their head hits the pillow, work, money or a conversation from earlier comes flooding back. A few common reasons sit behind this.

Stress and unfinished business

The US National Heart, Lung, and Blood Institute (NHLBI) says that stress or worrying about school or work, relationships, money, or the death of a loved one raises the risk of trouble sleeping. The NHS likewise says worry, stress and anxiety can make it harder to sleep. During the day, work and other people hold your attention; once the lights go off, the quiet makes it easy for unresolved things to surface.

Worrying about not sleeping makes it harder

The NHLBI says that worrying about whether you will get enough sleep, and watching the clock, can make sleep problems more likely or make them worse. A familiar loop: you can't stop thinking about work, you check the clock and work out how many hours are left, the more you calculate the more awake you feel, and now not sleeping has become one more thing to worry about.

Lying in bed trying hard to sleep

Lying there for an hour trying to force sleep tends to keep you in bed awake and going over your thoughts. That is why the NHS suggests getting up to do something quiet first, then going back to bed when you feel sleepy.

Evening habits that keep you alert

Caffeine in tea, coffee and some soft drinks can make you feel more awake. Using a phone or tablet right up to bedtime, or exercising close to bedtime, can also leave your body not ready to sleep. The details are in the section on preparing for bed below.

I've been lying awake for an hour. What should I do?

The most direct advice is not to wait in bed for too long. The NHS suggests that if you are still awake after around 20 minutes, you get up.

Steps when you can't sleep after about 20 minutes

1. Get out of bed and sit somewhere comfortable.
2. Do something relaxing, such as reading a book, listening to quiet music or gentle stretching.
3. Avoid your phone; the NHS already advises putting screens away for the hour before bed.
4. Go back to bed when you feel sleepy.
5. If you still can't sleep after going back, repeat the same steps.

You don't need to time it exactly. "About 20 minutes" is a rough feel, which is better than getting up to check the clock.

Stop checking the clock

The NHS suggests keeping clocks out of view and placing your phone face down to reduce light. Seeing 1 or 2 a.m. on the screen tends to start you calculating how much sleep is left, which only adds to the worry.

How do I deal with thoughts going round in my head before bed?

The aim is not to force yourself to stop thinking, but to move the thoughts out of your head and onto something else before bed, and to let your body relax.

Write tomorrow's tasks down before bed

The NHS suggests that if you often worry in bed, you try making a list of things you need to do the next day before going to sleep. Writing things down can help clear your mind. A simple way to do it:

• Keep a notebook or piece of paper nearby in the evening.
• List what you need to do tomorrow, in the order you will do it.
• If something is worrying you, write down what it is and the next step you could take.
• Close the notebook and leave it outside the bed, as a signal that these things can wait until tomorrow.

Talk to someone you trust

The NHS says talking to someone you trust or writing down your worries can help you manage them. If something heavy has been circling for several nights, telling someone about it during the day may stop it following you to bed.

Slow breathing in bed

The NHS describes a calming breathing exercise you can do sitting up or lying on a bed.

1. Let your breath flow as deep down into your belly as is comfortable, without forcing it.
2. Breathe in through your nose and out through your mouth.
3. Breathe in gently and regularly. Some people find it helps to count steadily from 1 to 5; you may not reach 5 at first.
4. Let the breath flow out gently, counting from 1 to 5 again if it helps.
5. Keep going for at least 5 minutes.

Counting your breaths helps pull your attention away from the circling thoughts. Other things the NHS suggests trying include reading something you enjoy, meditation, and listening to calming music or a podcast.

How should I prepare before bed to fall asleep more easily?

The time before bed is when your body and mind slow down. If you are working or looking at a screen until the last minute, falling asleep the moment the lights go off is hard.

The hour before bed

• The NHS suggests relaxing for at least 1 hour before bed, for example by taking a bath or reading a book.
• Put phones, tablets and computers away for the hour before bed.
• The NHLBI suggests a hot bath or relaxation techniques before bed.

Drinks, meals and exercise

A quiet, dark, cool bedroom

The NHS suggests keeping your bedroom quiet, dark and cool: earplugs if there is noise, curtains closed, an eye mask if needed, and adjusting the temperature or opening a window so the room feels cool.

After a night of poor sleep, when should I go to bed and get up?

Even after a late night, what helps your sleep settle back is your wake-up time, not catching up on sleep.

• Go to bed when you are sleepy: The NHS suggests going to bed only when you feel sleepy. Getting into bed early "to allow extra time" often means lying awake thinking for longer.
• Get up at the same time every day: The NHS advises waking up and getting out of bed at the same time every day, and the NHLBI suggests going to bed and waking up around the same time each day, including weekends.
• Avoid daytime naps: The NHS advises not napping during the day when you have trouble sleeping at night, so that you feel sleepy at bedtime.

The NHS explains that going to bed and getting up at similar times each day helps your body know when it is time to sleep, which makes it easier to fall asleep.

When should I see a doctor about not being able to sleep?

If you have tried the steps above and still find it hard to fall asleep, talk to a doctor. The NHS advises seeing a doctor if:

• changing your sleeping habits has not helped
• you have had trouble sleeping for months
• not sleeping is affecting your daily life in a way that makes it hard to cope

If stress or worry is so heavy that daily life feels hard to cope with, that is also a reason to talk to a doctor.

If falling asleep stays difficult, talk to a doctor.