It's 2:30 a.m. You've been awake for what feels like forever. You've flipped your pillow, tried breathing exercises, and told yourself to relax at least a dozen times. You're exhausted, so you stay put. Getting up feels like admitting defeat.
Here's the surprising advice from cognitive behavioral therapy for insomnia, or CBT-I: get up.
When I interviewed Jill Hasso, LPC, on October 2, 2026, about how she treats insomnia, this was one of the first things she described. "If you're up in the middle of the night for more than fifteen minutes," she said, "I'm telling you, get out of bed."
It sounds backwards. But there's a good reason for it.
Why does lying there make insomnia worse?
Your brain learns by association. Over time, it figures out what usually happens in certain places. Your kitchen means food. Your car means driving. Ideally, your bed means sleep.
But if you've spent weeks or months lying in bed wide awake, worrying, scrolling, and watching the clock, your brain starts to learn something else. Jill put it this way: when you're in bed scrolling or up anxious, "your brain essentially doesn't know how to determine, like, am I sleeping, or am I gonna be up anxious all night?"
That's why some people feel sleepy on the couch, then walk into the bedroom and suddenly feel wide awake. Their brain has learned that the bed is a place for being awake.
The goal of getting out of bed is to undo that. "The idea with CBT-I is that you're increasing, like, the connection between sleep and your bed itself," Jill said. "And so when you're in bed, you're asleep. And so the more that you can do that, the better that sleep is gonna be."
Every time you get up instead of lying there frustrated, you're teaching your brain that bed is for sleeping.
What should I do when I get up?
Jill's instructions are simple. If you've been awake for more than about fifteen minutes, "or you just know that you're not gonna go back to sleep again, you get yourself up out of bed."
Then go somewhere else and do something calm and a little boring. "Like, read a really boring, like, math textbook if you don't like math, that kind of thing," she said. "Like, a non-stimulating activity, or even a book that you've already read before."
The point isn't to entertain yourself. It's to give your brain something low-key to do until sleepiness comes back. "By the time you do get sleepy, you can put it down and then try to go to sleep," Jill said.
Then you go back to bed. If you're still awake after another fifteen minutes or so, you get up again.
What counts as boring enough?
You're looking for something quiet, low-light, and not very interesting. A few ideas:
Rereading a book you already know the ending to
Folding laundry
A simple puzzle or coloring page
Listening to a calm podcast or audiobook you've heard before
Sitting with a cup of decaf tea or warm water
What should I avoid?
Some activities make it harder to get sleepy again:
Your phone, tablet, or a new TV show. Scrolling and new content are designed to keep you engaged. That's the opposite of what you want.
Bright lights. Use a dim lamp instead of the overhead light.
Checking the clock. Doing the math on how much sleep you have left usually ramps up the anxiety. A rough sense of time is enough.
Work or problem-solving. Answering emails or planning tomorrow wakes your brain up.
Anything you look forward to. If getting up starts to feel like a treat, your brain may start waking you up for it.
It can help to set things up ahead of time. Leave a dim lamp, a blanket, and your boring book in another room before bed, so it's easy to follow through at 2 a.m., when deciding anything feels hard.
Why is this so hard to do?
Because everything in you wants to stay put. Your bed is warm. You're tired. And getting up can feel like you're giving up on sleep altogether.
Jill doesn't sugarcoat it. "That's hard to do," she said. And when I asked what part of CBT-I clients push back on most, her answer was immediate: "Well, it gets worse before it gets better."
In the first week or two, you may feel more tired during the day, because you're spending less time lying in bed. That tiredness is actually part of how it works. It builds up your body's natural drive to sleep, so you fall asleep faster and wake up less over time.
Jill put it plainly. These are "short-term" sacrifices. And when you've been sleeping badly for months, "you're desperate to figure out a way to sleep better... you have to be willing to kinda withstand that part of it. But, eventually, your sleep's gonna get substantially better once you do some of these changes."
Common questions
What if I have to get up five times in one night?
That can happen, especially early on. Keep doing it. Each time teaches your brain the same lesson. Most people find they need to get up less as the weeks go on.
Should I sleep in or nap to make up for it?
Usually not. Keeping the same wake-up time every morning, even after a rough night, is one of the most important parts of CBT-I. Sleeping in or napping can make it harder to fall asleep the next night. If you're unsafe to drive or work because you're so tired, talk with your therapist or doctor about how to handle that.
What if I share a bed with someone?
This comes up a lot, whether it's a partner, a pet, or a kid who ends up in your bed. Jill's advice is to talk it through with them and find a short-term workaround. If someone moves to the guest room for a while, it should be the person who isn't doing CBT-I, since you're the one rebuilding your connection to your own bed.
Is getting out of bed enough on its own?
It's one important piece, but CBT-I usually includes a few others. You track your sleep with a sleep log, set a consistent sleep window, and work on the worried thoughts that keep you up. Our post on why sleep hygiene isn't enough and what CBT-I does differently walks through all of it. And if it feels strange to cut back on time in bed, why sleeping less can help you sleep better explains the reasoning.
What if my mind won't stop racing?
Getting out of bed helps break the habit of lying there with your thoughts. But if racing thoughts are the main problem, these may help too: why can't I turn off my brain at night and why depression and insomnia feed each other.
When should I talk to a doctor?
If you snore loudly, gasp or stop breathing in your sleep, have restless legs, or have bipolar disorder or a seizure disorder, check with your doctor before starting CBT-I. If you get up at night, use a nightlight so you don't trip. And if you take sleep medication, don't stop without talking to your prescriber.
Begin Insomnia Treatment in Missouri
At Aspire Counseling, we believe in doing what works. We're not going to hand you another list of sleep hygiene tips you've already tried. What you're paying for when you come to counseling is our expertise, our knowledge, and a structured treatment that actually changes how you sleep.
Jill is trained in CBT-I, the treatment the American College of Physicians recommends first for chronic insomnia. She'll help you track your sleep, set a schedule that fits how much you're really sleeping, and work through the parts that feel hardest, like getting out of bed at 2 a.m. And because sleep problems so often travel with depression, anxiety, or trauma, she can work on those too, using behavioral activation and Cognitive Processing Therapy.
Start by calling our office at (816) 287-1116 (Lee's Summit) or 573-328-2288 (Columbia), scheduling a time to chat with our intake team, or emailing us through our contact page. We have offices in Lee's Summit and Columbia, or we can meet with you online from anywhere in Missouri.
About the Author
This blog post is one of a series that grew out of an interview on October 2, 2026, with Jill Hasso, LPC, one of our Missouri therapists who provides CBT-I for insomnia along with behavioral activation for depression. Jessica Oliver, MSW, LCSW, our clinic founder and director, has training in CBTn to treat nightmares and basic training in CBTi as well. Jessica led the interview and wrote this blog post. So it's a true joint effort, representing the expertise of two experienced Missouri therapists who want to help people finally get some real rest.
