I can't sleep at night — what should I do?

Why does trying harder to sleep make it worse?

Because effort keeps you alert. Sleep is not something you do. It is something that happens when the conditions are right and you stop interfering. The moment you start monitoring whether it is working — am I drifting off yet? — you have introduced effort and vigilance, which are the two states furthest from sleep.

This is why the advice to "just relax" is useless. You cannot instruct yourself into relaxation. What you can do is change something physical, and let the mental state follow. Breathing is the most direct lever available, because it is the one part of your autonomic nervous system you can operate on purpose.

What should I do first when I can't sleep?

Stay where you are and breathe in for four seconds and out for eight, for about five minutes. You do not need to sit up, change position, or do anything visible.

1. Exhale firstEmpty your lungs through your mouth before you begin. Starting on an out-breath stops you from gulping air on the first inhale.
2. Inhale for fourThrough the nose, slowly, letting your belly rise rather than your chest. Do not fill to capacity — around seventy percent is enough.
3. Exhale for eightSlow and unforced, through the mouth or nose. The exhale should feel like a sigh being let out over time, not a blow.
4. Repeat for five minutesRoughly twenty-five breaths. Do not count cycles, count the seconds within each breath. Losing count is fine — start again from wherever you are.

If eight seconds feels like straining, use four in and six out. The ratio matters more than the absolute numbers: an exhale longer than the inhale is the core idea.

Why does a long exhale help?

Because the out-breath is the settling half of each breath. Your heart rate rises slightly on every inhale and falls on every exhale. Lengthening the out-breath relative to the in-breath tips the balance toward the recovery side of your nervous system. This is a general property of breathing, not a trick — it is why sighing feels like relief, and why people breathe fast and shallow when frightened. A 2018 systematic review linked slow breathing with more “rest and digest” (parasympathetic) activity and lower anxiety (Zaccaro et al., see Sources).

Practically, this means the common instruction to "take deep breaths" is half wrong. Deep, fast breaths raise alertness. Slow breaths with a long, unhurried exhale do the opposite.

If holding your breath feels uncomfortable — and for many people at 2am it does — drop the hold entirely. 4-7-8 breathing is worth trying but not compulsory. Not sure which pattern suits you? Compare the four sleep breathing patterns.

What if I'm still awake after twenty minutes?

Get up, keep the lights low, do something dull and go back to bed when you feel sleepy. Do not keep lying there accumulating frustration. Every night spent awake and annoyed in bed teaches your brain that bed is a place where you lie awake and feel annoyed. That association is the thing that turns one bad night into a pattern.

1. Get upGo to a different room if you can. Keep the lights as low as you can manage — enough to move safely, no more.
2. Do something undemandingA dull book. Folding laundry. Sitting. Not your phone, not email, nothing with a scroll or a notification.
3. Wait for the signalReturn to bed when you feel genuinely sleepy — heavy eyes, losing the thread of what you're reading — not when you decide enough time has passed.
4. Breathe again once you're backFive minutes of long exhales. If it doesn't work a second time, repeat the whole loop without treating it as a failure.

What should I change tomorrow?

Keep a fixed wake time, get daylight early and move caffeine earlier; tonight is only about getting through. These are for the daytime, when you actually have the capacity to change something:

• Fix the wake time, not the bedtime. The NHS recommends waking up and getting out of bed at the same time every day, weekends included.
• Get daylight early in the day. Morning daylight helps set your body clock: the Sleep Foundation notes that natural light keeps your circadian rhythm in step with sunrise and sunset.
• Move the caffeine cut-off earlier. The NHS suggests no tea or coffee for at least six hours before bed, so a 4pm coffee is already too late for a 10pm bedtime.
• Give the day an ending. Not a two-hour ritual — ten minutes is enough. The point is a boundary, not a spa.

When should I see a doctor about not sleeping?

The NHS suggests seeing a GP if changing your sleep habits hasn't helped, you've had trouble sleeping for months, or your insomnia is making daily life hard to cope with. A GP may offer cognitive behavioural therapy for insomnia (CBT-I), and the NHS notes that GPs now rarely prescribe sleeping pills. Also worth raising with a doctor: loud snoring with gasping or pauses, persistent daytime sleepiness despite adequate time in bed, or sleeplessness that arrived alongside low mood or anxiety. None of these are things to breathe your way through alone.

Common questions

Sources

Checked on 15–16 October 2026.

ATHA is a breathing and mindfulness app, not a medical device or a substitute for professional care. If sleeplessness is persistent, severe or distressing, speak to a qualified healthcare professional.