Getting to sleep when your mind will not stop

Difficulty falling asleep because of racing thoughts is among the most common complaints, and the standard advice to relax fails because relaxation is not a thing that can be performed on demand.

Why the mind speeds up at bedtime

Because it is the first point in the day with no external demand on attention.

Everything deferred during the day surfaces when there is nothing else to attend to, which is a scheduling problem rather than a sleep problem.

Cognitive arousal — mental activity — is a better predictor of difficulty falling asleep than physiological arousal in several studies, which suggests the intervention should be cognitive.

And effort makes it worse: trying to fall asleep introduces performance monitoring, which is incompatible with the process.

The techniques with evidence

Cognitive shuffling, or serial diverse imagining.

The method involves picking a random word, then imagining an object for each letter, then moving to another word — deliberately unconnected images with no narrative.

The rationale is that this occupies the verbal and visual systems with material that cannot form a coherent train of thought, which is what the mind does spontaneously at sleep onset.

It has small-scale supporting research and is widely reported as effective.

The constructive worry technique. Earlier in the evening, write down the concerns and the next concrete step for each.

Trials of writing before bed have found reduced sleep onset latency, and one study found that writing a to-do list for the following day worked better than writing about completed tasks — the more specific the list, the greater the effect.

Paradoxical intention. Lying in bed and gently attempting to stay awake, which removes the performance pressure and has trial evidence in insomnia.

It sounds like a trick and works for the reason described above.

Progressive muscle relaxation and body scanning, which address physiological arousal and which have modest evidence.

Slow breathing with extended exhalation, which shifts autonomic balance measurably.

The wind-down period

Which does more than any single technique.

Sleep is a transition rather than a switch, and a period of decreasing stimulation is what allows it.

Practical elements: a consistent hour before bed with reduced light, no work, no difficult conversations, and no problem-solving.

Whether screens matter is more nuanced than usually stated — the content and the timing matter more than the light for most people, and a calm book on a device is not equivalent to an argument on social media.

The strongest recommendation is to end the working day properly, since people who work until bedtime have no transition at all.

What does not work

Trying harder.

Lying in bed awake for long periods, which associates the bed with wakefulness.

Clock watching.

Alcohol, which is covered elsewhere on this site.

Reviewing the day's events, which is rumination in a comfortable position.

And planning tomorrow in your head, which is the same problem in the other direction and which is exactly what the written list is for.

Sleep effort

A concept worth understanding.

People with insomnia typically try to sleep, which no good sleeper does.

Going to bed earlier to allow more time, lying in longer, cancelling plans to protect sleep, and monitoring how sleepy you feel are all forms of effort, and all reduce the likelihood of sleeping.

Reducing effort — going to bed only when sleepy, getting up at a fixed time, getting out of bed when awake — is the counterintuitive core of effective treatment.

The realistic expectation

Falling asleep takes most people somewhere between ten and twenty minutes, and expecting it to happen immediately produces alarm when it does not.

Occasional bad nights are normal and do not require intervention.

What warrants attention is a persistent pattern lasting months with daytime consequences, at which point the treatment described elsewhere on this site is considerably more effective than any single technique.