Stop Trying to Sleep

How Fighting Insomnia Makes It Worse

It’s 3:30 AM. You’re awake. Again.

Your heart is pounding. That familiar pit opens up in your stomach. And right on cue, your brain helpfully chimes in: “Oh no. I’ll never get back to sleep. I’m going to be completely dysfunctional tomorrow.”

Welcome to sleep anxiety. Or as I like to call it, anxiety eating your sleep. This is one of the most common things that I see in my anxiety clinic. My patients describe it this way: as soon as their head hits the pillow, because they’re not focused on other things or distracting themselves with their phones, their anxiety takes that as a cue to start talking. And talking. And talking.

Here’s what makes this loop so frustrating for my patients: they’re anxious about being anxious about not sleeping. And the more they try to fix it—do a body scan, take deep breaths, tell themselves to relax—the more wound up they get.

My lab recently completed a randomized controlled trial on exactly this problem. We recruited 80 people whose worry interfered with their sleep and taught them mindfulness training through an app. After two months, they reported a 27% reduction in worry-related sleep disturbances compared to only 6% in the control group. We found clear evidence of how it works: increased ability not to get caught up in thoughts and emotions led to decreased worry, which led to improved sleep. When the control group got access to the app, they showed basically the same results: a 29% reduction in worry-related sleep disturbances.

With this replication of the results, the science seems pretty solid. But to get these results, it requires doing something that sounds completely counterintuitive.

You have to stop trying to sleep.

The Sleep Anxiety Habit Loop

The top 5 themes that I’ve seen in my clinical programs over the past decade are: #1: Waking up in the middle of the night and not being able to fall back asleep; #2: Early morning anxiety; #3: Difficulty falling asleep; #4: Racing thoughts/worry loops; #5: Panic (and other physical symptoms).

One of my patients, I’ll call her Amy, described a mixture of these themes perfectly: “I wake up at 4:30 and immediately think, ‘Oh no. I will never get to sleep again and I won’t be able to function.’ That tape has been going off in my head this whole week as I lie awake hoping to go back to sleep and getting increasingly frustrated.”

This is reward-based learning in action. The same process that helps us remember where to find food also keeps us stuck in anxiety loops. We only need three elements to form a worry habit: trigger, behavior and result. For Amy it looked like this:

Trigger: Wake up at 3:30 AM.

Behavior: Panic thoughts (”I’ll never get back to sleep”), check the clock, mental math about remaining sleep time, try to force relaxation, catastrophize about tomorrow.

Result/Reward: More anxiety. Heart racing. Wide awake. Self-fulfilling prophecy confirmed.

All habits need to have some reward from a brain standpoint to get set up as a habit in the first place. That’s why it’s called reward-based learning. So what’s the reward for Amy or anyone else who gets stuck in this cycle? When you worry, your brain feels like it’s doing something. It feels productive, like you’re addressing the problem. That’s the illusory reward that keeps the worry loop going.

Amy asked me: “What is the reward for worrying that I won’t get back to sleep?”

She later figured it out herself: “I get nothing from this.”

What’s Going on in Your Brain?

The relationship between anxiety and sleep runs both ways. Persistent sleep disturbance predicts the development of anxiety disorders, and worry plays a major role in increasing bedtime arousal and perceived sleep disturbances. In fact, there’s about a 70% overlap between generalized anxiety disorder and insomnia, and roughly three-quarters of primary care patients with anxiety report sleep problems.

Here’s how anxiety and sleep feed on each other: High levels of worry predict more sleep problems such as increased nighttime awakenings, and lower sleep efficiency. Stress-related worry exacerbates something called sleep reactivity, which means your sleep system becomes hypersensitive to stress. Eventually your body starts having consistent sleep responses to stress regardless of what’s actually happening. Your bed itself can become a conditioned stimulus that triggers worry, leading to maladaptive behaviors like staying in bed despite not being able to sleep.

Yes, unhelpful sleep habits that you didn’t even know that you had. Now add in worry.

The mental processes of worry and rumination create additional stress surrounding poor sleep. Your brain gets stuck in cycles of “What if I never fall asleep? What if I’m exhausted tomorrow? What if this becomes chronic?” These thought patterns contribute to the very sleep disturbance you’re trying to avoid.

Meanwhile, your prefrontal cortex. where all that rational thinking happens, goes offline when you’re stressed and tired. The neural structures associated with cognitive control shut down exactly when you need them most.

So, ironically, your “willpower” isn’t available when you actually need it. And the PFC isn’t exactly at full capacity in the middle of the night anyway…

Watch Out for the Expectation Trap

A lot of my patients try to use mindfulness techniques such as the body scan to GET to sleep. I’ve used this myself years ago, and it really helped.

But these practices don’t work as an “if I do X, then I get Y” tool.

The moment you do a body scan in order to fall asleep, you’re still in fix-it mode. You’ve added another layer: “If this doesn’t work, I’m really screwed.” Just like high performance situations on stage and in sports, the higher the expectation, the more pressure you put on a practice to get a result, the less likely it is to work. So, too, with doing things in order to get to sleep.

Amy discovered this when doing a body scan didn’t make her fall asleep but instead turned into a distraction technique. She noted, “After the body scan, I listened to an audio book and fell asleep.” Then she astutely wondered, “Am I feeding a habit loop by listening to the audio book with the hope that I will drift back to sleep?”

Yes. Any “in-order-to” behavior, like listening to audiobooks, still feeds the underlying loop.

So, I pointed this out to Amy, and then suggested to her something radical: “Let go of the goal of getting to sleep.”

One More Problem: Measurement

In general, I’m not anti-wearables. And personally, I wear a watch at night that measures my sleep duration and stages to an accurate-enough degree that I can see how things like how late I eat dinner and how sugar and alcohol intake affect my sleep.

My wife takes sleep-tracking a little too seriously: she set up some arbitrary competition in her head about our sleep scores, always asks what mine was, and seems disappointed when she doesn’t get a “good” score (whatever that is). Sometimes when we wake up in the morning, she’ll even check her watch before our usual good-morning kiss.

A patient, I’ll call her Natalie, got caught in this tracking mentality: “I wake up and want to know what time it is. As soon as I look at my watch it wakes me up completely. If it’s too early I start panicking. If it’s not too early, I still can’t fall back asleep. If I don’t look at my watch, I get very anxious about not looking.”

Sleep diaries, wearables, tracking apps, whatever it is, if we aren’t careful, these can all feed the anxiety loop.

Once we notice that we’re falling into these habits, we can step out of them. Another patient reported on her simple solution: “I stopped doing sleep diaries altogether. The tracking was causing more stress than helping. I turned my clock completely away.”

So, if wearables are giving you useful information, great, keep using them. If, paradoxically, they are making your sleep worse, it might be helpful to place them off to the side for now.

A Paradox as a Solution: Let Go of the Goal

What if trying is the problem? What if you just didn’t care whether you slept or not?

I know this sounds a bit wacky, especially if we’re half-awake at 3:30 AM. But this is what fits with the science, and works in my clinic: letting go of the goal of sleeping is what allows sleep to happen. Here’s what I mean by this.

Map What You Can Control

You can’t control waking up. That’s just something that happens.

You CAN control how you respond: worrying, catastrophizing, trying to force sleep. And by working with the worry, you change the result, and step out of the loop. The key is to not feed the worry beast. This is where reinforcement learning comes in: by seeing that worrying only amps us up and makes it harder to sleep, we can become disenchanted with it.

Get Disenchanted with Worry

When you see clearly–and by this I mean experientially, not intellectually–that worry gets you nothing and, in fact, makes your sleep worse, your brain starts to wake up to this reality. This helps you become disenchanted with worrying, which in turn, helps you let go of that habit. [See my previous articles for more on this]

Find the Bigger Better Offer

Our brain’s reward system is relative. By this, I mean that they are always comparing A to B to decide which one is better. Disenchantment helps drop the value of worrying. But this is a relative drop, meaning that if you compare it to something else that is better, that disenchantment can feel even stronger. What can you compare worrying to? Curiosity.

My lab has found that worry and anxiety correlate with feeling closed down or contracted, while curious awareness correlates with feeling open and expanded. In our studies, people reported that the expanded feeling has higher reward value. You can do this experiment yourself. Which feels better? Worrying or being curious?

When worry comes up—”Oh no, I’ll never get back to sleep”—get curious: “Hmm, that’s interesting. There’s that thought again.” Getting curious helps bring in the observer effect so we can notice worry thoughts without being swept away by them.

You can also get curious about what anxiety feels like in your body. Where is it? Right or left? Front or back? Tight? Hot? Pressure? What happens when you turn toward your experience rather than the habitual reaction of running away from it? Do the sensations change the more curious you get?

One patient described developing the new habit of curiosity this way: “I felt a wave of panic, and instead of immediate dread, my automatic response was, ‘Hmm, that’s interesting.’ That took the wind right out of its sails!”

Any time you’re worrying, whether in the middle of the night or in broad daylight, you can leverage your brain’s reward system to develop the habit of curiosity too.

One practical thing to note here is that curiosity is often energizing. A number of people in my Going Beyond Anxiety have pointed this out: when we’re interested in something, we naturally lean in and wake up a little more, whether it’s day or night.

So if you find yourself moving in the opposite direction of sleep when bringing in curiosity, that’s normal, even expected. Here, you can teach yourself to use curiosity to unhook and step out of worry habit loops (which are both energizing and agitating), and then switch to a practice like the body scan or breath awareness that might be more calming. Then, see if your body naturally drifts off to sleep. If not, it’s all good: you can simply let your body rest while you meditate, and see what happens next.

Remember to keep an eye out for expectations or trying.

Practical Tools

A very common practice that I teach my patients to help them disengage with worry habit loops uses the acronym RAIN.

Recognize what’s here right now

Allow it to be here without trying to fix it

Investigate what it feels like in your body by getting curious

Note and nurture - note or label what you’re experiencing, with an attitude of kindness toward yourself.

Just get curious. Don’t try to change it. Use this to awaken your curiosity. And then you can leverage the observer effect by simply noting or labeling your thoughts, emotions and sensations moment to moment. For example, noting “future thinking,” “Catastrophizing,” “Worrying,” “Planning” and so on.

Remember, this isn’t about stopping thoughts. It’s about leveraging the observer effect. By observing, you’re creating space between you and the thought.

Amy put it this way: “I don’t have to be anxious about being anxious. With curiosity, body scans and RAIN, I am now getting better at observing the anxious thoughts and associated body sensations and I can ride them out.”

Patience and Practice

After a few months in my anxiety program, Amy sent me a note stating, “This morning, at 4am, I could not get back to sleep and I noted all the worry thoughts around not sleeping. I also noted my body sensations of rapid heart beat and fatigued eyes. I also got very curious about my body sensations and I saw that I was getting nothing from worrying. The heart beat and the worry thoughts passed with my doing RAIN. I also did a body scan and a breathing meditation. And yet, I could not get back to sleep. So I feel that I am winning the battle and losing the war.”

I wrote back, “Have you played with separating the behaviors over which you have no control (waking up early) from those that you might be able to not feed (worry)? For example, focusing on driving in 2nd gear with worry (not the waking up bits), and when thoroughly disenchanted, shift into 3rd gear and play with exercises such as the body scan. Even if you’re not able to get back to sleep, you might notice a difference in being rested if you’ve practiced the body scan vs. being frustrated or worried.” (The gears are the framework that we use in our Going Beyond Anxiety program)

She took this suggestion to heart. By March, breakthroughs, including seeing old habits of feeling like she had to get up very early to be productive and successful, but that these were not helpful in the long run. By May, real progress with disenchantment with worry and improvements in sleep. It took months. But it worked.

Someone else in the program put it nicely: “Well I totally failed at accepting being awake last night. Lol. I got frustrated and definitely fell into my old habit loops. But unwinding habits takes time and setbacks are all a part of it.”

Practice and progress, not perfection.

Don’t Try This Tonight (Play With it)

To sum it up, remember these key takeaways. Let go of the goal of sleeping. See how much you can notice and let go of expectation, and instead use curiosity to loosen up so that you can play with practices such as RAIN and the body scan. When anxiety or worry comes up, be curious about what’s happening at that moment. What a great time to meditate! You’re already awake, lying down in a quiet place. Make the best of it.

As Amy wrote after months of practice: “This program is definitely helping me to unwind the stress during the day. Slowly, I am having a few nights of good sleep. I am noticing all the times when I contract. I have been using my mantra, ‘Let it Flow’ when I feel contracted and I then breathe through the contraction until I feel more expanded. This is good evidence that the program is helping me to change my old ingrained habits one day at a time.”

One day at a time. One night at a time. One moment at a time.

Judson Brewer MD PhD is a psychiatrist and neuroscientist and professor at Brown University. He is the author of Unwinding Anxiety (NYTimes bestseller), The Craving Mind, The Hunger Habit and The Unwinding Anxiety Workbook. He co-founded MindshiftRecovery.org which provides free support for people with any type of addiction.

If you are struggling with anxiety, Dr. Brewer’s Going Beyond Anxiety program brings together his research and clinical experience to help people build effective skills to reduce anxiety and cultivate calm (www.goingbeyondanxiety.com).

Copyright © 2025, Judson Brewer, MD, PhD. All rights reserved.

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