Trouble falling asleep usually traces back to a few things you can look at yourself: a mind that keeps running at bedtime, caffeine or alcohol later in the day, screens, a bedroom that is too warm or bright, and a body clock that is out of step. Start with the habits you can change this week. If the problem keeps happening on most nights, Cleveland Clinic says that difficulty falling asleep at least three times a week that affects your days may be chronic insomnia, and that is worth raising with a clinician.
Is it normal to take hours to fall asleep?
Cleveland Clinic says that without any sleep issues, most people fall asleep within 10 to 20 minutes. It also says that if it takes you 45 minutes, “that’s OK, too,” because everyone has a different circadian rhythm, or internal clock. Lying awake for hours is different. Cleveland Clinic describes it as the common picture of a brain “racing” at bedtime, and says that trying harder to sleep usually makes it harder.
Clinical guidance also uses frequency to decide when a pattern counts as a problem. UCLA Health describes chronic insomnia as difficulty sleeping three or more nights a week for more than three months. One bad night does not qualify, and UCLA Health notes that more than 60% of people may have one or more insomnia symptoms at some point in their lives.
Why can’t I fall asleep even when I’m tired?
Tiredness and sleepiness are not the same thing for your body. Healthline puts it simply: “If your mind can’t sleep, it’s difficult for your body to follow, too.” It also notes that the act of trying too hard to fall asleep can create a cycle of anxious energy that keeps you awake. The common factors below are the ones these guides and Johns Hopkins list most often.
| Factor | What the guidance says |
|---|---|
| Stress and anxiety | Cleveland Clinic calls stress and anxiety “major causes” of difficulty falling asleep. |
| Caffeine | The NHS says tea, coffee and some soft drinks contain caffeine, which can make you feel more awake. |
| Alcohol and nicotine | The NHS advises avoiding them 1 to 2 hours before bed. Cleveland Clinic notes that as alcohol wears off, it can wake people during more restorative stages of sleep. |
| Screens | Cleveland Clinic says anything that activates the brain as you wind down “can keep us going.” |
| Bedroom conditions | The NHS suggests a room that is quiet, dark and cool. Healthline lists light, loud noise and an uncomfortable bed. |
| Hot shower or bath | Johns Hopkins Medicine says a steamy shower before bed raises core body temperature, which normally drops during the night. |
| Spicy food late in the day | Johns Hopkins Medicine says spicy foods close to bedtime can cause acid reflux or heartburn. |
| Smoking | Johns Hopkins Medicine says people who smoke wake more often during the night, and smokers were shown to be four times as likely as nonsmokers to report sleep that is not refreshing. |
| Medications | UCLA Health says certain medications, including some allergy, cold and blood pressure drugs, can affect sleep. |
| Body clock and napping | Healthline lists an off circadian rhythm and daytime napping as possible reasons. |
What does the research say about trouble falling asleep?
Several studies link everyday factors with trouble falling asleep. They show associations, which means they point to what goes along with the problem, not what caused it in any one person. Here are three of them.
| Study | Who was studied | What it found |
|---|---|---|
| A 2026 analysis of noise and tinnitus | 36,697 U.S. adults in the 2014 National Health Interview Survey | Among adults with tinnitus, 41.8% reported trouble falling asleep. Combined occupational and leisure noise exposure was associated with the highest odds (aOR 1.69). |
| A 2019 study of trouble falling asleep after concussion | 261 children and adolescents aged 6 to 19 seen after a sport-related concussion | 45% reported trouble falling asleep. Those who did reported more severe symptoms (median 38 versus 18). |
| A 2025 study of minority stress and sleep | 11,282 LGBTQ+ adolescents in a 2017 U.S. survey | Violent victimization was associated with more trouble falling asleep, and familial warmth with less. |
How do I get better sleep?
The NHS describes these as small changes to habits and routines, often called sleep hygiene, that can make a real difference over time. Its guidance includes:
- Keep the room quiet, dark and cool.
- Go to bed and wake at the same time each day. Cleveland Clinic says a consistent schedule, even on weekends, helps you fall asleep at those set hours.
- If you are still awake after about 20 minutes, get up, sit somewhere comfortable and do something calm, such as gentle yoga, reading or quiet music. Go back to bed when you feel sleepy.
- If worries keep you up, write them down, or list what you need to do the next day before bed.
- Be active during the day. Cleveland Clinic advises avoiding intense workouts right before bed.
- Put devices away about half an hour before bedtime.
What drinks help you fall asleep?
The NHS suggests swapping caffeinated drinks for a warm milky drink or herbal tea in the evening. Here is how the main drinks compare.
| Drink | What the guidance says |
|---|---|
| Tea, coffee, some soft drinks | Contain caffeine, which can make you feel more awake (NHS). |
| Warm milky drink or herbal tea | A suggested alternative to caffeine in the evening (NHS). |
| Alcohol | Can seem to help you drop off, but can wake you later. Avoid it 1 to 2 hours before bed (NHS). Cleveland Clinic also notes it can worsen sleep apnea symptoms. |
What should I do if I lie in bed for hours, or wake at 2am or 4am and can’t fall back asleep?
Lying awake for a long time is the situation the NHS addresses directly: get up after about 20 minutes and return when you feel sleepy. UCLA Health lists waking often during the night and not being able to fall back asleep after waking among the signs of insomnia. A particular wake-up time does not point to one cause by itself, so note the time you wake, what happened that day and how often it happens, then bring those notes to your clinician. Smoking, alcohol and an unfamiliar night routine are among the factors described above that can affect how often you wake. If your nights also involve waking unable to move, our guide Sleep Paralysis Symptoms, Safety and Treatment Options covers that separate experience.
Do relaxation tricks really help you fall back asleep fast?
Healthline describes several methods it calls anecdotal, and reports what research there is for each. Cleveland Clinic adds progressive muscle relaxation and guided imagery.
| Method | What the guidance reports |
|---|---|
| Military method | Cleveland Clinic says there is no scientific evidence that this method works. Healthline says it takes a full 120 seconds to complete. |
| Progressive muscle relaxation and guided imagery | Cleveland Clinic says these bring about a relaxed state of mind that is more conducive to falling asleep. |
| Paradoxical intention | Healthline cites 2021 research suggesting it may help reduce sleep performance anxiety, and says research is limited. |
| Imagery distraction | Healthline cites a 2002 University of Oxford study in which people using imagery distraction fell asleep faster than those with general distraction or no instructions. |
| Acupressure | Healthline cites a 2019 meta-analysis suggesting it may slightly decrease the time to fall asleep, and says there is limited research. |
| Steady background sound | Cleveland Clinic says a steady soundtrack of noise, such as a fan or white noise, is enough for some people to relax. |
Can magnesium or melatonin fix trouble falling asleep?
Cleveland Clinic’s magnesium guidance says the evidence for magnesium as a sleep aid is thin, although some people find it helps them. It also says that if you take prescription medications or have kidney problems, talk to your healthcare provider before taking magnesium. Cleveland Clinic’s sleep guidance says melatonin works best if you are a night owl with a delayed circadian rhythm, and that other causes should be evaluated first.
Can insomnia be cured?
UCLA Health says there is no cure for insomnia. It also says that if you live with chronic insomnia, a physician can help you find ways to cope with it and improve your sleep. Those options can include cognitive-behavioral therapy for insomnia, mindfulness-based behavioral therapy and, when appropriate, medication.
Cleveland Clinic calls cognitive behavioral therapy for insomnia (CBT-I) a first-line treatment, and says it tends to have much better long-term outcomes than sleep aids or sleep medication. It also says providers may see a person for four to six sessions before progress shows up in their sleep behaviors.
When should I see a clinician about trouble falling asleep?
Cleveland Clinic advises scheduling an appointment with a sleep medicine specialist if you have trouble falling asleep on a regular basis, especially after trying the usual habits. The NHS says its website details treatments available from a GP or pharmacist. Johns Hopkins Medicine says frequent snoring or being a restless sleeper can be signs of a serious health condition, and those should go to your provider. UCLA Health says the first step is usually a visit to your primary care physician, who may review your medical history and medications, examine you, take a sleep history and suggest a sleep study.
Before that visit, bring:
- How many nights a week it happens and how long it has gone on.
- The times you wake and what you notice during the day.
- Any medications and any caffeine or alcohol you use.
- Any snoring or restless sleep.
If you take prescription medicines, check with your pharmacist or clinician before starting a supplement. If poor sleep has you worried about your memory, see Why Is My Memory Getting Worse? Causes, Signs & When to Worry.
What to expect in the first few weeks
Expect the early weeks to be about building a routine rather than an overnight change. Cleveland Clinic notes that the more your body gets used to a fixed schedule, the easier it will be to fall asleep during those set hours. If you start CBT-I with a clinician, Cleveland Clinic says progress in sleep behaviors can take four to six sessions to appear.
Your first step this week
Pick one habit from the list above. A fixed wake time is a good place to start, because it sets up the other changes. Put devices away earlier, move caffeine to the early afternoon, or try writing tomorrow’s list before bed. If better sleep is part of your new-year plans, this is a realistic way to begin, and if trouble falling asleep keeps happening on most nights, book a visit with your clinician.
By the Global MH Summit Research Team