Sleep Hygiene Protocol: What to Do When Your Brain Won’t Let You Sleep

(DBT Skill: Sleep Hygiene & Middle-of-the-Night Rumination Tools)

If you’ve ever climbed into bed worn out and then found yourself suddenly wide awake, welcome to the club. Somehow, your brain decides that bedtime is the perfect moment to schedule your week, rethink your life choices, or replay every conversation from the last decade. Suddenly, you’re replaying conversations, making tomorrow’s to-do list, solving world problems, and reliving events from 1998. That’s where the DBT Skill sleep hygiene protocol comes in. Practical steps that make restful sleep more likely.

Sleep struggles are incredibly common, especially for people dealing with emotional dysregulation, anxiety, trauma, ADHD, or chronic stress. And while we can’t force ourselves to sleep, we can create the conditions the brain needs to settle.

Why Sleep Feels Hard When Your Mind Won’t Slow Down

The nervous system doesn’t magically shut off because it’s bedtime. If your brain still feels alert, threatened, or stuck in problem-solving mode, it will stay awake even when your body is exhausted.

Some common reasons sleep gets disrupted:

• Rumination: replaying, rewinding, overthinking
• Background anxiety
• Nighttime catastrophizing (“Tomorrow will be awful if I don’t sleep”)
• A brain that struggles to “transition” into rest mode
• Trauma history
• Irregular sleep patterns.

So if sleep feels effortful or inconsistent — please know this isn’t a failure. It’s your nervous system doing what nervous systems do when they feel overwhelmed.

DBT Sleep Hygiene: What Helps Before Bed

Think of these as habits that increase the likelihood of sleep.

1. Try to keep your sleep and wake times steady from day to day, weekends included. Your body responds well to consistency

Your brain loves routines. Going to bed and waking up at the same time trains your internal clock to expect rest.

2. Use your bed only for sleep.

Avoid using it for TV, scrolling, phone calls, or reading. Let your brain associate bed = rest.

3. Avoid stimulants, alcohol, heavy meals, nicotine, or intense exercise late at night.

These keep your system alert when you need it to wind down.

4. Create a sleep-friendly environment.

Dark, quiet, cool, and comfortable. Try earplugs, a sleep mask, a fan, white noise, or temperature adjustments, depending on what your body needs.

5. Give yourself 30–60 minutes to fall asleep.

If sleep isn’t coming, pause and check in:

• Am I calm but awake?
• Anxious?
• Stuck in rumination?

What you do next depends on the answer.

If You’re Calm but Just… Awake

This is the “my body is tired, but my brain is not shutting down” moment.

6. Get out of bed. Yes — really.

Staying in bed while wide awake trains the brain to associate bed with “struggle.”

Move to another room and do something low-stimulation:

• Light reading
• Gentle stretching
• Quiet music
• Sitting peacefully

Return to bed when you feel sleepy again.

7. Try a light snack if hunger is keeping you alert.

Something simple like an apple or a few crackers can help the body settle.

DBT Sleep Hygiene Tools for Middle-of-the-Night Rumination

Rumination is one of the most significant barriers to sleep — and one of the most treatable with skills.

8. Use the DBT TIP skill to lower physiological arousal.

Cold water on your face or a cold pack helps activate the dive reflex and lower your heart rate.

Then use paced breathing as you return to bed.

9. Try the 9–0 countdown meditation.

On each exhale, count down from 9 to 0.

Then start from 8 to 0.

Then 7 to 0.

Continue until sleep takes over.

Most people don’t make it through the sequence before falling asleep.

10. Notice the physical sensations of rumination.

This shifts attention away from the storyline and toward the body, interrupting the spiral.

11. Remind yourself: “This is middle-of-the-night thinking.”

You don’t need to solve anything right now.

Your brain will see this differently in the morning.

12. Read something lightly engaging.

Just a couple of minutes.

Then close your eyes and imagine the story continuing in your mind.

13. If rumination persists, use DBT’s Cope Ahead skill

• Ask yourself: Is this solvable right now?
• If yes → imagine the steps.
• If not → imagine the worst-case scenario and yourself coping with it.

This often releases the urgency that blocks sleep.

My Favorite Sleep Skill: Tracing the United States + “The.”

This is one of my personal go-to tools for racing thoughts when trying to sleep.

How to Do It

1. Close your eyes.
2. Visualize the outline of the United States.
3. Slowly “trace” the border in your mind.
4. As you trace, repeat the word “the” over and over.

Why It Works

• Tracing the outline requires light, steady focus.
• The shape isn’t emotionally charged or stimulating.
• “The” is neutral — no emotional meaning.
• Repetition calms the nervous system.
• Your brain can’t simultaneously ruminate and trace with repetition.

I rarely make it through more than two rounds before I’m asleep.

If Nothing Else Works

Turn on quiet public radio (NPR, BBC, etc.).

Their stable tone and minimal emotional content can gently help you drift.

What Matters Most

Sleep difficulty is not a character flaw – it may be your nervous system needing support.

With practice, these skills become more natural, and your mind learns how to settle again. You know that you can feel restless or overwhelmed and still support yourself into a calmer state.

That’s emotional regulation in action.

To learn more about Dialectical Behavior Therapy and the foundations of these skills, you can visit: Behavioral Tech — The Linehan Institute

If you’re curious about the science behind sleep and why it matters, here’s a helpful resource from the National Institutes of Health:
National Institutes of Health (NIH): Brain Basics — Understanding Sleep
https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep

Your Challenge This Week

Choose one small sleep-hygiene habit to try this week — something realistic and doable for your life right now. It might be keeping a steady bedtime, turning off screens a little earlier, or using the U.S. tracing + “the” skill the next time your mind starts spinning.
Small shifts add up, and your body learns from repetition.

Ready to Learn More?

If you’d like to explore how DBT therapy can help you manage emotions and respond more effectively, visit my DBT Therapy page or explore the full DBT Skills Series for more ways to build emotional balance and resilience.  Or contact me. I offer DBT and EMDR therapy in Las Vegas, NV and Torrance, CA, with online sessions available across California, Nevada, and Oregon.