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Bed is for sleep only: how to help your body relearn falling asleep

3 min read

You go to bed tired — and sleep vanishes. You lie there for an hour, scroll your phone, count how long until the alarm. The longer this goes on, the more firmly the brain links the bed not with sleep but with being awake and anxious. This step restores the right link.

Why it works

This is the core of the behavioural approach to sleep — according to studies, it is more effective than both sleeping pills and a simple list of "sleep hygiene" rules. The idea is simple: the bed should mean sleep again. When you only sleep in it, the brain relearns to fall asleep as soon as your head touches the pillow.

How to do it

Who should take more care

If you take blood pressure medication or are over 70: don't get up suddenly at night — sit on the edge of the bed for a minute first. Keep the hallway light dim but bright enough not to trip.

If daytime sleepiness makes driving difficult, don't drive when you are tired.

What can get in the way

What to expect

Notice how long you lie awake and how many times you wake. Log your sleep in VIA-L to see the difference week by week.

When to see a doctor

If poor sleep lasts more than three months despite these steps, or if you snore with pauses, have unrefreshing sleep or fall asleep during the day — it is worth seeing a doctor or sleep specialist. More in the article "Why sleep gets worse after 40".

What this is based on

This article is based on topics from the VIA-L knowledge base. These are the published studies behind them:

  1. Cognitive Behavioural Therapeutics for Insomnia Symptoms in the Perimenopause Through to the Early Postmenopausal Period — The Cochrane Database of Systematic Reviews, 2026 doi
  2. Insomnia and women: exploring vulnerability, impact, and intervention — Sleep & Breathing = Schlaf & Atmung, 2026 doi
  3. OSA in Women: Associations With Reproductive Aging and Screening Challenges — Chest, 2026 doi
  4. Pharmacological and Non-Pharmacological Treatments for Chronic Insomnia in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Sleep Medicine, 2026 doi
  5. Reframing menopause and menopause hormone therapy as opportunities for healthy aging — Science, 2026 doi
  6. Cognitive-Behavioral, Acceptance-Based, and Mindfulness-Based Interventions for Psychological and Sleep-Related Symptoms During Menopause: A Systematic Review — Acta Psychologica, 2026 doi
  7. Integrative Approaches to Perimenopause — The American Journal of Medicine, 2026 doi
  8. Effectiveness of Non-Pharmacological Interventions for Insomnia Related to Natural Menopause: A Meta-Analysis of Randomized Controlled Trials — Maturitas, 2026 doi
  9. Nutritional Modulators of Sleep: A Narrative Review of Vitamins, Minerals, Amino Acids, and Their Neurobiological and Chronoepigenetic Mechanisms — Chronobiology International, 2026 doi
  10. A Digital Mindfulness Intervention Improves Sleep Efficiency and Heart Rate Variability in Healthy Adults — Scientific Reports, 2026 doi
  11. Hormonal Modulation With Withania Somnifera: Systematic Review and Meta-Analysis of Randomized-Controlled Trials — Planta Medica, 2026 doi
  12. Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: A Phase 3 Randomized Clinical Trial — JAMA Internal Medicine, 2025 doi
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  1. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-Analysis — Obstetrics and Gynecology, 2025 doi
  2. Menopause and Movement: Exercise for Better Sleep and Psychological Well-Being-a Systematic Review — Menopause (New York, N.Y.), 2025 doi
  3. Omega-3 Fatty Acids and Sleep: Recent Advances in Understanding Effects and Mechanisms — Current Opinion in Clinical Nutrition and Metabolic Care, 2025 doi
  4. Infertility Evaluation and Treatment — The New England Journal of Medicine, 2025 doi
  5. Effect of a Novel Nutraceutical Combination of EstroG-100 and Γ-Aminobutyric Acid (GABA) in Attenuating Symptoms of Menopause in Healthy Adult Women: A Randomized Double-Blinded Placebo-Controlled Study — Menopause (New York, N.Y.), 2025 doi
  6. Adrenal Insufficiency in Adults — JAMA, 2025 doi
  7. An Integrative Approach to HPA Axis Dysfunction: From Recognition to Recovery — The American Journal of Medicine, 2025 doi
  8. The Combination of Physical Exercise and Slow-Paced Breathing on Psychophysiological Indices of Emotion Reactivity, Psychosocial Stress Reactivity and Recovery: A Multimodal Investigation — Behaviour Research and Therapy, 2025 doi
  9. Role of Circadian Health in Cardiometabolic Health and Disease Risk: A Scientific Statement From the American Heart Association — Circulation, 2025 doi
  10. Effectiveness of 2 Just-in-Time Adaptive Interventions for Reducing Stress and Stabilizing Cardiac Autonomic Function: Microrandomized Trials — Journal of Medical Internet Research, 2025 doi
  11. Chrononutrition Interventions for Mental Health: Addressing Atypical Depression, Ultra-Processed Food Use Disorder, and Circadian Dysregulation — Frontiers in Psychiatry, 2025 doi
  12. Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults — JAMA Psychiatry, 2024 doi
  13. Network Meta-Analysis Examining Efficacy of Components of Cognitive Behavioural Therapy for Insomnia — Clinical Psychology Review, 2024 doi
  14. Effects of Mind-Body Exercise on Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2024 doi
  15. Stimulus control for insomnia: A systematic review and meta-analysis — J Sleep Res, 2024 doi
  16. Social jetlag and obesity: A systematic review and meta-analysis — Obes Rev, 2024 doi
  17. Shoden Promotes Relief From Stress and Anxiety: A Randomized, Double-Blind, Placebo-Controlled Study on Healthy Subjects With High Stress Levels — Heliyon, 2024 doi
  18. Hypopituitarism — Lancet (London, England), 2024 doi
  19. European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-Induced Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  20. Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
  21. GABA-ergic Modulators: New Therapeutic Approaches to Premenstrual Dysphoric Disorder — CNS Drugs, 2023 doi
  22. The Effect of Caffeine on Subsequent Sleep: A Systematic Review and Meta-Analysis — Sleep Medicine Reviews, 2023 doi
  23. Clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for insomnia in primary care (HABIT): a pragmatic, superiority, open-label, randomised controlled trial — Lancet, 2023 doi
  24. Oral Micronized Progesterone for Perimenopausal Night Sweats and Hot Flushes a Phase III Canada-Wide Randomized Placebo-Controlled 4 month Trial — Scientific Reports, 2023 doi
  25. Optimizing Sleep Across the Menopausal Transition — Climacteric : The Journal of the International Menopause Society, 2023 doi
  26. Relationship between daytime napping with the occurrence and development of diabetes: a systematic review and meta-analysis — BMJ Open, 2023 doi
  27. Effects of Sleep Fragmentation and Estradiol Decline on Cortisol in a Human Experimental Model of Menopause — The Journal of Clinical Endocrinology and Metabolism, 2023 doi
  28. Changes in Cortisol Awakening Responses (CAR) in Menopausal Women Through Short-Term Marine Healing Retreat Program With Specific Factors Affecting Each CAR Index — PloS One, 2023 doi
  29. Progesterone and Its Metabolites Play a Beneficial Role in Affect Regulation in the Female Brain — Pharmaceuticals (Basel, Switzerland), 2023 doi
  30. Ocimum Tenuiflorum Extract (HOLIXERTM): Possible Effects on Hypothalamic-Pituitary-Adrenal (HPA) Axis in Modulating Stress — PloS One, 2023 doi
  31. Systematic review and meta-analyses on the effects of afternoon napping on cognition — Sleep Med Rev, 2022 doi
  32. A Portrait of Obstructive Sleep Apnea Risk Factors in 27,210 Middle-Aged and Older Adults in the Canadian Longitudinal Study on Aging — Scientific Reports, 2022 doi
  33. Disruption of Sleep Continuity During the Perimenopause: Associations With Female Reproductive Hormone Profiles — The Journal of Clinical Endocrinology and Metabolism, 2022 doi
  34. Relating Neurosteroid Modulation of Inhibitory Neurotransmission to Behaviour — Journal of Neuroendocrinology, 2022 doi
  35. Role of Inflammation, Oxidative Stress, and Mitochondrial Changes in Premenstrual Psychosomatic Behavioral Symptoms with Anti‐Inflammatory, Antioxidant Herbs, and Nutritional Supplements — Oxidative Medicine and Cellular Longevity, 2022 doi
  36. Human adaptative behavior to Antarctic conditions: A review of physiological aspects — WIREs Mechanisms of Disease, 2022 doi
  37. Modulation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis by Plants and Phytonutrients: A Systematic Review of Human Trials — Nutritional Neuroscience, 2022 doi
  38. Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial — JAMA, 2021 doi
  39. Omega-3 Fatty Acids for Depression in Adults — The Cochrane Database of Systematic Reviews, 2021 doi
  40. Omega-3 Long-Chain Polyunsaturated Fatty Acid and Sleep: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Longitudinal Studies — Nutrition Reviews, 2021 doi
  41. Sleep During Menopausal Transition: A 10-Year Follow-Up — Sleep, 2021 doi
  42. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis — Int J Environ Res Public Health, 2021 doi
  43. Diagnosis and Treatment of Luteal Phase Deficiency: A Committee Opinion — Fertility and Sterility, 2021 doi
  44. Chrono-Nutrition: From Molecular and Neuronal Mechanisms to Human Epidemiology and Timed Feeding Patterns — Journal of Neurochemistry, 2021 doi
  45. The Allopregnanolone to Progesterone Ratio Across the Menstrual Cycle and in Menopause — Psychoneuroendocrinology, 2020 doi
  46. Hormone Therapy for Postmenopausal Women — The New England Journal of Medicine, 2020 doi
  47. The Effects of Dietary Nutrition on Sleep and Sleep Disorders — Mediators of Inflammation, 2020 doi
  48. Improving Diet for Psychiatric Patients : High Potential Benefits and Evidence for Safety — Journal of Affective Disorders, 2020 doi
  49. Chronotype and Social Jetlag: A (Self-) Critical Review — Biology (Basel), 2019 doi
  50. Allopregnanolone and Reproductive Psychiatry: An Overview — International Review of Psychiatry (Abingdon, England), 2019 doi
  51. Effect of Omega-3 Supplements on Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis — European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2018 doi
  52. Symptoms of menopause — global prevalence, physiology and implications — Endocrinology, 2018 doi
  53. Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-Reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials — Sleep, 2018 doi
  54. Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series — Journal of the American College of Cardiology, 2018 doi
  55. A New Model for Adrenarche: Inhibition of 3β-Hydroxysteroid Dehydrogenase Type 2 by Intra-Adrenal Cortisol — Hormone Research in Paediatrics, 2018 doi
  56. Effects of Mind⁻Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review With Meta-Analysis of Randomized Controlled Trials — Journal of Clinical Medicine, 2018 doi
  57. Omega-3 Versus Isoflavones in the Control of Vasomotor Symptoms in Postmenopausal Women — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2017 doi
  58. Why Are Women So Vulnerable to Anxiety, Trauma-Related and Stress-Related Disorders? The Potential Role of Sex Hormones — Psychiatry, 2017 doi
  59. Understanding Adaptogenic Activity: Specificity of the Pharmacological Action of Adaptogens and Other Phytochemicals — Annals of the New York Academy of Sciences, 2017 doi
  60. Altered Diurnal Pattern of Steroid Hormones in Relation to Various Behaviors, External Factors and Pathologies: A Review — Physiology & Behavior, 2016 doi
  61. Duration of menopausal vasomotor symptoms over the menopause transition — JAMA Intern Med, 2015 doi
  62. Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms — Obstetrics and Gynecology, 2015 doi
  63. Efficacy of Omega-3 for Vasomotor Symptoms Treatment: A Randomized Controlled Trial — Menopause (New York, N.Y.), 2014 doi
  64. Luteal Phase Deficiency in Regularly Menstruating Women: Prevalence and Overlap in Identification Based on Clinical and Biochemical Diagnostic Criteria — The Journal of Clinical Endocrinology and Metabolism, 2014 doi
  65. Protective role of melatonin in progesterone production by human luteal cells — Journal of Pineal Research, 2011 doi
  66. Cortisol Stimulates Secretion of Dehydroepiandrosterone in Human Adrenocortical Cells Through Inhibition of 3betaHSD2 — The Journal of Clinical Endocrinology and Metabolism, 2011 doi
  67. Acute Emotional Stress and Cardiac Arrhythmias — JAMA, 2007 doi
  68. Suppression of the Hypothalamic-Pituitary-Ovarian Axis in Normal Women by Glucocorticoids — Biology of Reproduction, 1993 doi

The strength of this evidence varies: some are large reviews and meta-analyses, some are small single studies. The steps in the article are simple, low-risk self-care measures, not treatment, and they may not suit everyone.

This is general information, not a prescription.

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VIA-L is an app for women from 35 and men from 40: sleep, energy, mood and body through midlife hormonal change. In plain words, based on your own data — and with a check of what actually helped.

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