Insomnia left me wide awake at 3 a.m. — a doctor shares the 20-minute rule that helps me fall back asleep in seconds

Last year, I experienced a bout of insomnia that constantly left me wide awake at 3 a.m. and wondering if I'd ever fall back asleep. Whenever I did eventually drift back off, it felt like my alarm would immediately start ringing.

Battling exhaustion and tired of being tired, I decided to call on Dr Bhavini Shah, a GP at LloydsPharmacy Online Doctor, to give me some advice on what to do when I wake up in the middle of the night.

"This is something most of us will be able to relate to at some point, and there are several different ways to try and combat this..." she replied, which immediately made me feel better. Below, I explore the method that's helping me fall back asleep fast whenever I experience nighttime awakenings.

Key takeaways

• If you wake up at night, it should take you no more than 20 minutes to fall back asleep.
• If you've been awake for more than 20 minutes, it's best to get out of bed to avoid associating your bed with wakefulness.
• Try a low-energy activity, such as reading or listening to a podcast, until you feel sleepy enough to go back to bed.
• If the 20-minute rule doesn't work for you, you can also try deep breathing or muscle relaxation techniques.

The 20-minute rule for falling back asleep fast

Dipping in and out of light sleep is a normal part of our sleep cycles, so it's normal to wake up at night. In fact, nighttime awakenings are so normal that we usually have no memory of them.

However, waking up in the middle of the night becomes a problem when it occurs frequently at you struggle to fall back asleep. And that's where the 20-minute rule comes in handy.

Research shows that it should take us around 15-20 minutes to fall asleep, so a key component of Cognitive Behavioral Therapy for Insomnia (CBT-I) is the 20-minute rule: If you can't fall back asleep in 20 minutes, get out of bed to prevent you from associating your bed with being awake.

"This may sound counterproductive but if you do find that you’re lying awake for long periods of the night, you might find that getting up and doing something might help," says Dr. Shah.

According to the health expert, the trick is to find a low-energy, screenless activity, such as folding laundry, to do before you crawl back into bed.

"You could get up and read a book, listen to a podcast or calming music, and go back to bed when you feel like you might be able to fall asleep," she advises.

There's also 15-minute rule, which states that you should get up if you can't fall asleep in 15 minutes, but I usually wait until 20 minutes as this is the maximum amount of time it should take to drift off.

3 other sleep methods to try when you're wide awake at 3 a.m.

If the 20-minute rule (or the 15-minute rule) doesn't work for you, then Dr. Shah shares other methods to try. From breathing exercises to ditching clock watching, here are three other sleep techniques to try if you want to fall back asleep fast...

1. No time-checking method

The first things you should never do is check your phone, alarm clock, or smart watch. Not only will checking the time make you hyperaware of how early it is, research warns your phone or smart watch will also expose you to sleep-disrupting blue light.

While a 2022 study found that the effects of blue light don't last as long as we once believed, Dr. Shah explains that the emitted light can still suppress the body's production of melatonin, which the hormone that's crucial for regulating sleep cycles, making it harder to fall back asleep.

"Blue light from device screens actually makes us feel more awake so while it can be tempting to check the time, resist the urge," she warns.

2. Deep breathing methods

If nighttime anxiety has woken you up at 3 a.m. you could try a breathing exercise to help reset your nervous system.

"Deep breathing can be simple and effective, helping to calm and relax the body," says Dr. Shah.

There are plenty of sleep-promoting breathing methods you can try. The 4-7-8 technique, which has been proven to reduce anxiety and improve sleep quality. Meanwhile, box breathing has also been found to "statistically significant improvement in sleep quality".

3. Muscle relaxation technique

Another sleep method that reduces stress is progressive muscle relaxation, which Dr. Shah says works the same as deep breathing in helping to relax and calm the body.

"It involves gradually tensing and relaxing your muscles starting from your feet and working upward toward your head," she explains.

The good news is that there are just six steps to performing progressive muscle relaxation, and you can listen to guided muscle relaxation videos on YouTube if you need help getting started.

How to stop waking up at 3 a.m.

The causes of nighttime awakenings vary wildly but Dr. Shah shares that common factors include stress or anxiety, as well as external factors, such as noise and room temperature. However, lifestyle habits can also contribute, particularly the consumption of caffeine, alcohol, and nicotine.

"Because of this, it’s best practice to avoid these six hours before going to bed," the doctor warns.

What we eat can also cause awakenings, but the timing of what we eat can disrupt sleep, too.

"There is evidence that eating before bed or late-night snacking can impact how well you sleep," says Dr Shah.

"Eating a heavy meal before bed means your body must digest it overnight which can sometimes cause discomfort and impact the quality of your sleep," she adds.

Other causes of 3 a.m wake ups have nothing to do with diet or lifestyle, but health conditions.

"Insomnia can also be triggered due to hormonal changes, especially for women during their menstrual cycle, pregnancy, and menopause," says Dr Shah.

She also adds that some medications can trigger insomnia symptoms.

"It’s always important to be aware of any possible side effects and check with your doctor if you have any concerns beforehand," says the health expert.

• Read more: Stop waking up at 3am — 7 quick fixes you can do today, according to a sleep expert