You're awake. Here is what to do right now.
Lying awake in the night is common, and it is not a sign that something is wrong with you. Let's take the next few minutes one step at a time.
Three things that help, tonight.
Start with the breath. If your mind is racing, put it down. Then, if you have been awake a while, the 20-minute rule. One step at a time.
Slow, steady breathing can help you settle. Follow the light.
There is no wrong pace. Let the light lead, and breathe in a way that feels easy for you.
A racing mind at night is trying to protect you. Give each worry one small step for the daylight, then set it down. Tap what is keeping you up.
Nothing here is saved on this phone. Printing is the only copy, so it is safe on a shared or borrowed phone.
The one skill that retrains sleep: the bed is for sleeping, not for lying awake.4 Here is the whole thing, all at once.
- 1
Awake about 20 minutes? Get up.
Do not lie there trying to force it. No clock-watching, a rough guess is fine. Lying awake teaches the brain that bed is where worrying happens.
- 2
Leave the bedroom. Keep the lights low.
Go to another room. Bright light tells your body it is morning, so keep it dim.
- 3
Do something calm and a little boring.
Page through a magazine. Listen to quiet music. Take a few slow breaths on your own. Leave the phone and TV off. Let the pull toward sleep build back up.
- 4
Eyelids heavy? Go back to bed.
Sleepiness decides, not the clock. If sleep still does not come, get up and repeat. Every round is training, not failure.
A rough patch of sleep has a reason, and a way back.
Sleep often frays after a hard stretch: an illness, a health scare, or a heavy worry.2 The good news is that the way out is a set of skills you can practice, and doctors recommend starting there before sleep medicine.1
After 60, sleep runs lighter and surfaces more often. That part is normal.2 The need itself stays at 7 to 8 hours.3 Lying awake for hours is the part you can retrain.
Broken sleep and depression
Broken sleep, waking in the middle of the night, and waking too early can be symptoms of depression.13 If sadness or worry has been heavy for weeks, that is worth telling your doctor. Depression is treatable, and talk therapy can be aimed at sleep problems too. You do not have to sort it out alone at night.
About sleep pills
If you take something for sleep, many people keep taking it as prescribed and make any change with the doctor who prescribes it, together and slowly. Some of these medicines carry more fall and confusion risk in older adults, so that conversation is worth having at the next visit.1214
Sleep is retrained a week at a time.
This is the same first-line treatment doctors recommend, called CBT-I, a set of habits that rebuild the tie between your bed and sleep.1 Here is the honest shape of it, rough patches and all.
- Week 1
Anchor the mornings
Pick one wake time and keep it every day, weekends too. Start the morning-light habit. Keep a diary so you and your doctor can see the pattern.
- Week 2
Protect the bed
The bed is for sleep only. Practice the 20-minute rule every time you are awake too long. It works by repetition, so keep at it.
- Weeks 3-4
The honest part
This is where many people quit, because progress is often uneven at first. Rough nights still happen. Keep going, and keep the habits steady.
- Weeks 5-6
It starts to hold
For many people, nights begin to steady. Bring your diary to your doctor and ask about CBT-I by name, or a digital CBT-I program you can do from home.
Build tonight's wind-down
Tap the habits you want to try. Each one lands on your schedule below. All of them come from the sleep-medicine sources on this page.468
Tap a habit above and it will land here, on your schedule.
The morning diary
Each morning, write one line. Rough guesses are fine, and never watch the clock at night. A printed week makes your appointment count, and two weeks is even better.5 Saved on this phone only.
| Night | Lights out | Woke up | Times awake | Rested? 1-5 |
|---|---|---|---|---|
| Thu, Sep 3 | ||||
| Fri, Sep 4 | ||||
| Sat, Sep 5 | ||||
| Sun, Sep 6 | ||||
| Mon, Sep 7 | ||||
| Tue, Sep 8 | ||||
| Wed, Sep 9 |
Your sleep, explained.
See what changed at night, in two calm minutes. Pick what your care team told you, and we walk it through one picture at a time. No hard words.
FunctionalHealth
What did your care team say is going on?
Tap the one that sounds like you. There is no wrong answer. If you are not sure, your discharge papers usually say, or ask your care team.
Care teams use many names, and not every condition is here yet. That is completely OK. Ask your care team what to call what happened, and you can read about most conditions in plain words at MedlinePlus.
MedlinePlus health topics (NIH)Loud snoring with gasping or pauses in breathing11
These can be signs of sleep apnea. It is treatable, but it needs a doctor. If someone shares your room, ask what they hear.
Falling asleep in the day, especially while driving11
Heavy daytime sleepiness is treated as a safety issue, not just a night problem. Many people talk this over with their doctor, and rest before driving.
Trouble sleeping 3 or more nights a week, for 3 months or more2
Sleep this broken for this long is what doctors call chronic insomnia. It is worth raising with your doctor, and CBT-I is a good thing to ask about by name.
You take a sleep medicine most nights, or you want to change one1214
Some sleep medicines carry more fall and confusion risk in older adults. Changes to these are usually made with the doctor who prescribes them, together and slowly, not on your own.
Chest pain, trouble breathing, or feeling unsafe is not a sleep question. Symptoms like these are treated as emergencies.
Guided daily recovery
Keep tonight's plan going.
A free account saves your sleep diary and gives you a guided daily session, plus our full sleep library: plain-language guides to the same first-line skills doctors recommend.
Create free accountYour next step
Get tonight ready now
Choose your wind-down while it is still daylight, so it is there when you need it.
- 1CBT-I is the recommended first treatment for chronic insomnia, before sleep medication. American College of Physicians
- 2Insomnia is the most common sleep problem in adults 60 and older; chronic means 3+ nights a week for 3+ months; sleep gets lighter with age. National Institute on Aging
- 3Adults 65 and older need 7 to 8 hours of sleep a night. CDC
- 4Healthy sleep habits: fixed wake time, bed is for sleep, up after 20 minutes awake, screens off before bed. American Academy of Sleep Medicine
- 5Keep a sleep diary each morning and bring it to your doctor. American Academy of Sleep Medicine
- 6Stop caffeine at least 8 hours before bedtime. Sleep Foundation
- 7Alcohol disrupts the second half of the night: lighter sleep, more wakings, less REM. Sleep Foundation
- 8Morning light anchors your body clock and improves nighttime sleep. Sleep Foundation
- 9What CBT-I includes, including sleep restriction done with a clinician; digital CBT-I is an accessible option. Sleep Foundation
- 10Naps: keep them short (10 to 20 minutes) and before 3 p.m.. Mayo Clinic
- 11Loud snoring with gasping or breathing pauses is a sign of sleep apnea; see a doctor. Mayo Clinic
- 122023 Beers Criteria: benzodiazepines and 'Z-drug' sleep medicines are linked to confusion, delirium, falls, and fractures in older adults. American Geriatrics Society
- 13Trouble sleeping and waking too early are symptoms of depression; depression is treatable, and CBT can target insomnia. National Institute of Mental Health
- 14Do not stop a sleep medicine like zolpidem without talking to your doctor; stopping suddenly can bring withdrawal symptoms. MedlinePlus (NIH)
Guidance on this page is educational and reviewed against the sources above.
This page is for information only and is not medical advice. Sleep needs and treatments vary from person to person. Always follow your doctor's instructions and contact your care team with concerns.
Sources: American College of Physicians, National Institute on Aging, American Academy of Sleep Medicine, Mayo Clinic, CDC, American Geriatrics Society, National Institute of Mental Health, MedlinePlus (NIH)