How long should I follow this plan before changing it?
Follow your plan for at least 7 nights. Sleep patterns often improve gradually, and switching too fast makes it hard to see what is actually working.
What should I prioritize first: bedtime or wake time?
In most cases, wake time is the stronger anchor. A stable wake time helps rebuild rhythm and sleep pressure, which then makes bedtime easier.
Can this improve without medication?
Many people improve significantly with consistent routine, stress regulation, and environment fixes. Medication decisions should always be discussed with a qualified clinician when needed.