When you can't fall asleep, a few minutes can feel like an hour — and consciously chasing those ZZZs only makes them seem farther away. If you're starting to get concerned about your troubled relationship with sleep, take comfort in the fact that it's actually pretty easy to determine whether or not your issues go beyond what's normal.
If this is a new problem, you might need to run a few basic questions by your body, says Sanjeev Kothare, MD, professor of neurology at the NYU Langone Comprehensive Epilepsy Center—Sleep Center. Are you having aches and pains? Are you dealing with anxiety? Have you been taking more daytime naps than usual?
If you answered "yes" to one of those questions, your main problem isn't how long it's taking you to fall asleep. Your issues probably have more to do with your work or travel schedule, Dr. Kothare says, as jet lag and odd shifts can certainly affect your sleep. Or, your sleep problem may be a side effect of significant change or stress in your personal life.
But if you answered "no" to all of those questions, there's one more question you should ask: Exactly how long does it normally take for you to fall asleep? Dr. Kothare explains that adults between the ages of 18 and 58 should be able to fall asleep within 30 minutes. If you're still awake after being in bed — with the lights off and screens away — for a half hour every night, you may be dealing with sleep onset insomnia.
Although you might associate insomnia with the total inability to get to sleep, this particular type of insomnia indicates that you have a hard time falling asleep (which offers its own set of adverse effects). You may very well still be able to get to sleep eventually with sleep onset insomnia, it just takes you a while longer than normal.
As far as treatment goes, Dr. Kothare and the Journal of Sleep Medicine both recommend cognitive behavioral therapy (CBT), which usually focuses on solving problems by adjusting how you perceive those problems. In other words, you may need to reframe how you view your problems with sleep. And no, forcing yourself to go to sleep will not work. In fact, putting that pressure on yourself can build into insomnia-related anxiety, which just tends to make the whole issue worse.
Dr. Kothare says that following a CBT-approved sleep routine means getting into bed only when you're ready to go to sleep — don't hang out in bed while you're on your phone or answering emails. And, if you're still wide awake after 30 minutes, actually get out of bed. "Leave the bed, go somewhere else, and do something else, then try [to sleep] again in 20 minutes," Dr. Kothare says.
If you're worried you have the opposite problem (you're in a dead slumber the moment your head hits the pillow), don't worry. Unless you have reason to believe you have narcolepsy (meaning you have intense, sudden episodes of sleepiness even during the day), Dr. Kothare says you're most likely in fine standing.