For those that struggle with insomnia (or even with milder forms of “I just can’t sleep”), the list of solutions is slim and even dangerous. The most popular treatments are sleeping pills, but the negative impacts of sleeping pills don’t seem to have been widely publicized.

Currently, sleeping pills do not have the ability to naturally imitate sleep. Instead, they more closely resemble a sedative rather than mimicking natural sleep patterns. Put more simply: when people use sleeping pills, they aren’t getting any of the necessary restorative benefits of sleep. And to go one step further: sleeping pills are tied with earlier death across the board.

So where does that leave a bleary-eyed sleeper in the middle of the night, lying awake, tossing and turning?

This is where cognitive behavioral therapy for insomnia (or CBT-I) comes into the picture.* Right now, it’s being used in medical communities around the country as the front-line treatment plan for insomnia. The best part? No pills necessary.

How does CBT-I work? Well, it’s a collection of behavioral principles for better sleep health, and it’s also built on your body’s remarkable ability to form associations. You want to make your bed a place that you (and your body) associates calm, rest, and sleep rather than middle-of-the-night mind racing. Here’s the short list:

1. Go to bed and wake up at a consistent time.

Your circadian rhythm loves consistency. The more you can get your body into a wake/sleep consistent habit (within an hour, even on weekends), the easier it will be to feel tired when it’s bedtime and alert when it’s morning.

2. Go to bed only when sleepy.

Many insomniacs have trouble falling asleep, which becomes a downward spiral of sleepiness. Although the principle of delaying bedtime until sleepy seems counterintuitive at first, the reason behind this one is simple and goes back to association. If your body isn’t tired when you go to bed, you’re missing out on that clear signal that tired equals bedtime. This principle also uses sleep pressure to its advantage, so the longer you stay awake the stronger your urge for tiredness. We need that sleep pressure to build a bit so you’re body is actually tired when you go to bed and sometimes that might take sleeping a little less than recommended to start.

3. Get out of bed if you can’t sleep.

If you are lying in bed and your mind starts racing, it’s best to get out of bed. Again: you don’t want to associate your bed with stress. Go to a different room (dim lights, no screens) and do something relaxing like read a book, meditate, or listen to music until you find yourself getting sleepy (at which point, return to bed).

4. “Mentally decelerate” before bed.

Give yourself 30-60 minutes to wind down at the end of the day. Take up a bedtime routine and do everything in the same order each day. The best mental deceleration doesn’t involve TV, reading the news, or scrolling through social media (as these are all very brain-stimulating activities). Do try listening to calming music, journaling, reading books, or even just catching up on the day with your partner.

5. Remove visible clock faces from bedroom.

This one might seem a little odd, but the idea behind it is that you want to avoid the feeling of waking up in the middle of the night and looking at the clock, which just adds stress to the fact that you can’t sleep.

Next time you find yourself in a period of stress and have a few nights of angsty wakeups, try a few of these principles as an all-natural return to better sleep.


*We are not attempting to diagnose or treat insomnia. If you feel you or a family member is struggling with insomnia, visit your health care provider.