# Should I get up if I can’t sleep?

> You’ve turned the pillow to the cool side, tried the other shoulder, tried lying perfectly still, and each attempt has started to feel like another small test. Somewhere in all that comes the question of whether to leave the warm bed for a while, or stay and keep trying.

**In short:** If you’ve been lying awake long enough to feel restless or annoyed, it’s fine, and often helpful, to get up for a while, and you don’t need to time it. You could sit somewhere warm and dim with something undemanding, and go back when your eyes grow heavy. For people whose sleep has been poor for months, it pays off over a few weeks of nights rather than tonight, and it’s meant to work by letting the bed stop being the place you lie awake.

The bed is warm and the house beyond the bedroom door is cold, and every time you look, there are fewer hours left until the alarm. Getting up can feel like conceding the night, as if leaving the warmth means letting go of any chance of sleep. It’s hard to think anything through when you’re this tired.

## Is it all right to get up now?

If you’ve been lying here long enough to feel restless or annoyed, or to notice you’re working hard at sleeping, that feeling is your sign. It’s fine to get up for a while, and you don’t need to time it[^1].

You may have heard of a twenty-minute rule. Richard Bootzin, who wrote the first instructions for getting up with insomnia in 1972, didn’t pin down a time at all. He left the timing vague on purpose, so that people wouldn’t watch the clock[^1]. The twenty minutes came later, as trials wrote the rule down in their own ways[^1][^2], and it isn’t a line anyone has measured. Was he right to worry about the clock? In two small experiments, people asked to keep an eye on a clock while trying to sleep worried more and took longer to drop off[^3] than people who weren’t. So you can let the time go, turn the clock to the wall if it helps, and go by how you feel.

**If you’d like to try something tonight**

You could pull a blanket or a robe around your shoulders, switch on a small lamp, enough to see by, and go and sit somewhere warm with a book you don’t mind putting down. When your eyes start to feel heavy, you can come back to bed.

## Why does my bed feel like the place I lie awake?

Perhaps you’ve noticed that you can be sleepy on the sofa all evening and then wide awake the moment you get into bed, or that you sleep better in a hotel or a spare room than in your own. For someone who sleeps easily, night after night in bed has meant sleep that comes when it’s expected[^4][^1]. When nights of lying awake pile up, the bed starts to mean something else: turning over, working out the hours left until the alarm, and trying.

A bed learns what happens in it. In time, the bed itself can become a cue for wakefulness and frustration[^1][^4]. The moment you lie down, your body braces for another long stretch, and the one place meant for sleep starts to feel like the place you can’t. This is the model the treatment was built on[^1][^4], though researchers are still debating[^5][^6] whether it’s the whole reason getting up helps.

You’ve probably been trying very hard as well. Sleep isn’t something you can will into being[^7], yet people with insomnia tend to strive for it all the same, as those who treat them have long noticed. Many think that effort can help keep the trouble going[^7][^1]. For now, that’s an idea researchers are testing more than something they’ve shown.

So getting up is for more than this one night. Its real aim is loosening the link between the bed and being awake over the nights to come, and letting you stop trying so hard, more than bringing sleep tonight[^1]. Many people hold back because they think they won’t fall asleep unless they stay in bed[^1]. What getting up does is stop the bed from rehearsing another hour of wakefulness, so that when you come back drowsy, it has a chance to learn sleep again.

**If the bed isn’t simply learning, why else might getting up help?**

In 2024, a team gathered twenty-three randomised studies of adults with diagnosed insomnia[^5], most of them of poor quality, and pulled stimulus control apart to see which instructions made the difference. The ones meant to recondition the bedroom didn’t all seem to be essential. The authors wrote that this challenges the conditioning explanation, and asked for their results to be read with caution.

Others tell the story differently. The authors of the largest analysis of CBT for insomnia, 241 trials in all, think stimulus control may help by cutting sleep effort[^6]. The team behind a trial in older adults, writing of stimulus control and sleep restriction together, put it down to the way the two build the sleep drive and consolidate sleep[^2].

So the bed that learns is a useful picture, though it may be only part of what’s going on. You don’t need to know which explanation is right to follow the advice, because each of them asks the same of you on a hard night: less time spent lying in bed awake and striving for sleep.

## What can I do once I’m up?

So you’re up, in a chair with a blanket around you, and the question now is what to do with the time. What follows comes from the people who teach this rather than from trials, since little research has looked at this part[^1]. Their advice is to leave aside eating, exercise and getting jobs done, along with anything so gripping it keeps you up for hours. As one of them puts it, “don’t give your insomnia a function”[^1]. If you can, sit upright in a chair. That way you’re more likely to notice sleepiness coming on before you drop off on the sofa[^1].

Whether it needs to be dull is where they part ways. Many suggest something boring[^1]. Others feel that forcing yourself to be bored turns getting up into a punishment, and becomes one more way of trying to sleep[^1], so they suggest something mildly pleasant you’ve picked out in advance, such as a book you’ve read before. Nobody has tested either view. What they agree on is something unhurried, nothing productive and nothing too absorbing, chosen before the night begins.

If you’ve tried getting up before and decided it doesn’t work, it may be that the night went the wakeful way: the big light on, a look at email, a tidy of the kitchen or a long watch of the clock until you felt allowed back. The dim, unhurried version can be quite a different night.

The light you get up into matters as well. In lab studies, brighter white light tended to make people feel more alert[^8]. Many of those studies were small, and some found no effect. Even so, it costs nothing to keep the light low. A small lamp or a hall light is plenty: enough to move around safely, and little more. A phone is a light held close to your face, so if you use one, it helps to keep it dim and what’s on it dull.

If you’re older, unsteady on your feet or take sleeping medicine, a fall is the main risk of getting up in the night[^4][^9], and seeing the floor clearly matters more for you than keeping it dim. Please put that light on before you stand, and keep the way to your chair clear.

## How will I know it’s time to go back to bed?

The sign to wait for is sleepiness, which is a different thing from feeling tired or bored. Ask someone who uses this with patients what that looks like, and you’ll hear about heavy eyes, a heavy head, your chin starting to nod, the sense of dropping off in the chair[^1]. Boredom can feel close to it, but boredom isn’t sleepiness[^1]. If you can’t tell which you’re feeling, heavy eyes are enough to go on. When they come, you can go back to bed.

If you get back into bed and find yourself awake again, you can get up again, as many times as the night asks[^1]. That’s been part of the instructions from the start. On a hard night it may mean more than one trip, though it can be better to stay up a little longer, so that you’re sleepy enough when you go back, than to go back and forth.

If you’ve lain awake for a long time, you may feel you hardly ever get sleepy, since long spells awake in bed may leave you out of touch with it[^1]. Then a rough marker can stand in, such as the end of a chapter, and you can go back when you reach it without looking at the clock.

## How much does getting up help, and how soon?

By the third or fourth bad night in a row, you’ll want to know whether this helps, and how soon. The research gives a slow answer, measured over weeks rather than in a single night, and one trial shows it well.

Researchers worked with 179 people aged 55 and over who had slept badly for at least six months and took no sleeping medicine. They met in small groups for four weeks, then had two sessions by phone, to learn stimulus control, the short set of habits that getting up belongs to. After six weeks, fifty-seven in every hundred were clearly better, against fifteen in every hundred of those on a waiting list[^2]. Thirty in every hundred no longer had insomnia, against four of those waiting, and the gains in their sleep were still there a year later[^2]. It was a single trial of older adults, and more than a third of those who began it dropped out along the way.

The habits themselves are simple to say: going to bed only when sleepy, getting up when you can’t sleep, keeping the bed for sleep and sex, getting up at the same time every morning and not napping in the day[^4][^6]. Together they are a core part of CBT for insomnia, which is the recommended first treatment for long-term insomnia in adults[^10][^4]. Used on their own, they help more modestly, and the figure below shows roughly how much.

**Sooner to sleep, less time awake: the best guess and how far it might be off**

In the analysis behind the American guideline, adults with long-term insomnia using stimulus control alone fell asleep about ten minutes sooner and spent about nineteen fewer minutes awake in the night[^4], by their own sleep diaries. Each dot is that best guess, and each line the range the true difference could fall in. Both lines reach past no difference, so the guideline’s panel couldn’t be sure of either[^4]. The gain may be real, but these few studies can’t pin down its size, and it may be small.

- **Time to fall asleep** -25 to 4 minutes: Four studies pooled

- **Time awake in the night** -42 to 4 minutes: Three studies pooled

Where benefit showed, it built up over weeks, in adults who had slept poorly most nights for months[^9][^2]. If yours is a few bad nights rather than months of them, getting up hasn’t been tested for that, though it costs little to try. If the run stretches into months, [CBT for insomnia](https://nitez.com/cbt-for-insomnia) brings getting up together with the other parts that help.

**How strong is the evidence for getting up on its own?**

Picture the trials of CBT for insomnia laid side by side: 241 of them, in the largest analysis yet. Stimulus control turns up in more than nine in ten of the CBT treatments[^6]. When the researchers teased the parts apart, it was one of four that seemed to help, linked above all with falling asleep faster and spending more of the time in bed asleep[^6]. They called their own analysis hypothesis-generating[^6], so it’s a strong lead more than a verdict.

On its own, getting up has been tested far less. The American guideline suggests stimulus control for adults with long-term insomnia, but as a conditional recommendation, based on a small body of low-quality evidence from eight studies[^9].

Put together, the method looks well supported as part of CBT for insomnia and thinly tested by itself. If your nights have been poor for months, the full treatment is the stronger bet.

## What if getting up winds me up, or I can’t?

- If you’re resting comfortably and not straining for sleep, staying where you are is a reasonable choice. The grounds for that are early ones. In a 1979 study, known now only through a later commentary, people with insomnia who stayed in bed but sat up and did something else when they couldn’t sleep did as well as those who got up[^1]. A 2024 analysis also found the bedroom rules weren’t all essential[^5]. The version tested still meant sitting up rather than trying to sleep, which suggests the striving matters more than where you lie.

- Then it may have turned into another way of trying hard, the very thing it’s meant to ease. It’s fine to follow it loosely. You could sit up against the pillows with a small lamp and a book instead, a version known as counter control[^1].

- Maybe there’s no warm room to go to, or getting up in the dark feels risky. Sitting up in bed is the version people use when getting up is unsafe or impossible[^1]. You keep to a position that’s clearly not for sleeping until you feel sleepy, then lie down again. Nobody has tried it for this, but I’d say it makes just as much sense if what stops you is the thought of waking someone asleep beside you.

## What if tonight is still a long one?

Some nights will still be long, because what getting up changes builds slowly, over nights and then weeks. If you got up tonight and sat for a while in a dim room with a blanket around you, you’ve done the thing itself, whether sleep came quickly afterwards or not. Each time you go back to bed drowsy, you bring the bed one more night of lying down ready for sleep.

## Related questions

- [What is CBT for insomnia, and what would it ask of me?](https://nitez.com/cbt-for-insomnia)
- [Why can’t I fall asleep?](https://nitez.com/cant-fall-asleep)
- [How do I stop my mind racing at night?](https://nitez.com/busy-mind-at-night)
- [Why do I keep waking up at 3am?](https://nitez.com/waking-at-3am)
- [How do I get through the day after a bad night?](https://nitez.com/after-a-bad-night)

## Sources

[^1]: Cuddihy LJ, Grandner MA, Nowakowski S. Implementation of Stimulus Control and Sleep Restriction Therapy for Insomnia: Standard Definitions and Best Practices. Journal of behavioral and cognitive therapy. 2025:100542. [PubMed](https://pubmed.ncbi.nlm.nih.gov/40857475/) · [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC12356610/) · [DOI](https://doi.org/10.1016/j.jbct.2025.100542)
[^2]: Epstein DR, Sidani S, Bootzin RR, Belyea MJ. Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial. Sleep. 2012;35(6):797–805. [PubMed](https://pubmed.ncbi.nlm.nih.gov/22654199/) · [DOI](https://doi.org/10.5665/sleep.1878) · [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC3353033/)
[^3]: Tang NK, Schmidt DA, Harvey AG. Sleeping with the enemy: clock monitoring in the maintenance of insomnia. Journal of Behavior Therapy and Experimental Psychiatry. 2007;38(1):40–55. [PubMed](https://pubmed.ncbi.nlm.nih.gov/16793001/) · [DOI](https://doi.org/10.1016/j.jbtep.2005.07.004)
[^4]: Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine. 2021;17(2):263–298. [PubMed](https://pubmed.ncbi.nlm.nih.gov/33164741/) · [DOI](https://doi.org/10.5664/jcsm.8988) · [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC7853211/)
[^5]: Verreault MD, Granger É, Neveu X, Delage JP, Bastien CH, Vallières A. The effectiveness of stimulus control in cognitive behavioural therapy for insomnia in adults: A systematic review and network meta-analysis. Journal of sleep research. 2024;33(3):e14008. [PubMed](https://pubmed.ncbi.nlm.nih.gov/37586843/) · [DOI](https://doi.org/10.1111/jsr.14008)
[^6]: Furukawa Y, Sakata M, Yamamoto R, Nakajima S, Kikuchi S, Inoue M, et al. Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults: A Systematic Review and Component Network Meta-Analysis. JAMA Psychiatry. 2024;81(4):357–365. [PubMed](https://pubmed.ncbi.nlm.nih.gov/38231522/) · [DOI](https://doi.org/10.1001/jamapsychiatry.2023.5060) · [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC10794978/)
[^7]: Broomfield NM, Espie CA. Towards a valid, reliable measure of sleep effort. Journal of Sleep Research. 2005;14(4):401–7. [PubMed](https://pubmed.ncbi.nlm.nih.gov/16364141/) · [DOI](https://doi.org/10.1111/j.1365-2869.2005.00481.x)
[^8]: Souman JL, Tinga AM, te Pas SF, van Ee R, Vlaskamp BNS. Acute alerting effects of light: a systematic literature review. Behavioural Brain Research. 2018;337:228–239. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28912014/) · [DOI](https://doi.org/10.1016/j.bbr.2017.09.016)
[^9]: Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2021;17(2):255–262. [PubMed](https://pubmed.ncbi.nlm.nih.gov/33164742/) · [DOI](https://doi.org/10.5664/jcsm.8986) · [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC7853203/)
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https://nitez.com/getting-up-at-night · What helps · updated 2026-10-14