It’s a self-fulfilling prophecy that’s familiar to many: When you worry that you’ll have trouble falling asleep, that worry activates your nervous system, making it harder to nod off. If this cycle repeats for even just a few nights in a row, your body begins to anticipate that it will occur again. This can lead to what’s called conditioned arousal. No matter how tired you are, when your head hits the pillow, you suddenly feel wired.
“Anything can cause sleep difficulty in the short term, but the key to preventing it from turning into a long-term problem is not to let it take root,” said Michael Grandner, PhD, director of the Sleep and Health Research Program at the University of Arizona, during his 2025 Embody webinar, “How Better Sleep Promotes Mental, Metabolic, and Cardiovascular Health.” This is why many insomnia treatment approaches aim to decondition the arousal response and reprogram your brain so sleep is de-coupled from stress or worry.”
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Learn how to break conditioned arousal.
“Sleep is not something you do,” Grandner said. “Sleep is something that happens to you when the situation allows for it.” Since it is outside of your control, trying to force it isn't going to work. It's just going to keep you awake longer and strengthen that bed-wake connection.
To prevent or reprogram conditioned arousal, follow three principles:
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1. Give your brain time to wind down.
You can’t run around in a flurry of activity, jump into bed, and expect your mind to instantly turn off. “You need time and space to allow your mind and body to wind down — ideally about 30 to 60 minutes of reduced activity before you get into bed,” Grandner said. It's helpful to have a regular nighttime wind-down routine that includes these five elements.
- It's repeatable and reliable.
- It's not too long.
- It has nighttime signals, including dimmed lights.
- It calms both your mind and your body.
- It rolls downhill, starting with stimulating activities and ending with relaxing ones.
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2. Your bed is for sleeping (and sex) only.
“Bed” and “sleep” should seem synonymous to your brain, so that when you lie in bed, a sleep response is automatically triggered. If, however, you do other things in your bed, like reading, phone scrolling or working, the bed-sleep association gets diluted. If you habitually lie in bed worrying and thinking, Grandner said, “The bed stops being the sleeping place and becomes the worrying place.”
Consequently, when you climb under the covers, instead of your brain thinking, “Ah, sleep!” it thinks, “Ah, worry!” Reserve your bed for sleeping and sex.
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3. Follow a morning routine.
Your body loves predictability, and it runs best when it can anticipate what’s coming next. A regular schedule will help regulate your energy level during the day and cue your body that it’s time to wind down at night.
“Sleep regularity is an important element of sleep health,” Grandner said. “While bedtime plays an influential role in this schedule, wake time is just as important.”
Waking around the same time every morning helps you fall asleep at the same time every night. Sleeping too late in the morning will delay your bedtime and throw your circadian rhythm off, which has downstream effects for many body systems.
Once you wake in the morning, get out of bed, open the blinds to let in the sun, and get moving. “The combination of light and movement will help wake you faster and help you fall asleep more easily the next night,” Grandner said.
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What should I do when sleep is elusive?
For occasional sleep issues, you can try a few strategies:
- To reduce your arousal and rumination in bed, try using relaxation or meditation practices.
- Try to reduce screen time before bed.
- Consider taking a low dose of melatonin (.5 to 1 mg) about 30 to 60 minutes before bed.
- Get out of bed if you can't sleep. Only stay in bed awake for about 20 to 30 minutes; after this point, relocate to a couch or chair (and keep the screens off) until you feel sleepy. This will protect against conditioned arousal and help prevent chronic sleep problems.
