Why can't I sleep at night even when I'm tired?

We’ve all had nights when we were so tired that we went to bed hoping to get a good night’s sleep but all we did was stare at the ceiling for hours. We’re not alone. 30% of adults in the U.S. have insomnia.* It’s frustrating and makes us ask: why can’t I sleep at night even when I’m tired? 

In this article, we cover insomnia and explore things that disrupt our sleep patterns. Whether you’re struggling with occasional sleep problems or chronic insomnia, understanding why you can’t sleep can help you find ways to get better sleep and feel better overall. 

What makes us sleep?

Have you ever wondered why we need to sleep? It’s not just about feeling rested; sleep plays an essential role in our overall health and well-being. But how do we fall asleep and what happens when we do?

Circadian rhythms are our bodies’ internal clocks. They control the sleep-wake cycle during an approximate 24-hour period. These rhythms help us feel awake during the day and tired at night. Outside variables, like light and darkness, influence these rhythms. And factors like jet lag or shift work disrupt circadian rhythms and can hurt the quality of our sleep overall and lead to sleep disorders.

There’s also our sleep drive. Ever find yourself wanting to sleep more the longer you’ve been awake? The reason for this is the build-up of adenosine, which is a chemical in our cells. Adenosine encourages sleep and builds up in the brain throughout the day. Our bodies receive a signal from the accumulation of adenosine that it’s time to relax and replenish our energy. This is known as sleep pressure or sleep drive.

The hypothalamus also plays an important role in what makes us sleep too. The hypothalamus is a little but mighty organ deep within our brains. It serves as the central nervous system for controlling sleep. It helps regulate our sleep cycles’ length and timing by receiving signals from different body parts and outside stimuli. A major component of this process is the hormone melatonin. It’s secreted by the pineal gland in the brain in response to darkness and marks the start of the sleep cycle.

We can better understand why sleep is crucial for maintaining both our physical and mental health when we’re aware of these mechanisms. We also know where to look when we can’t sleep.

What is insomnia?

Insomnia is a sleep disorder characterized by trouble getting to sleep, staying asleep, or waking up too early and not being able to go back to sleep. Lack of sleep affects both physical and mental health by causing fatigue, irritation, and difficulty concentrating. 

Insomnia can be acute or chronic. Acute insomnia (also called short-term insomnia) typically only lasts a few days or weeks. Chronic insomnia (also called long-term insomnia) is characterized by insomnia at least 3 times a week for 3 or more months.

Insomnia is also divided into 2 main types:

• Primary insomnia happens on its own and not as a result of other health conditions. 
• Secondary insomnia is typically associated with (secondary to) underlying problems, including medical illnesses, medications, or substance misuse.  

And insomnia is common. It affects people of all ages, although it tends to be more prevalent in women and older adults. The effects of insomnia on relationships, day-to-day functioning, and general quality of life can be profound.

Other sleep disorders besides insomnia can interrupt our sleep cycles and impact our health too, even those that don’t directly contribute to secondary insomnia. Some of the most common are restless legs syndrome, narcolepsy, and sleep apnea. 

To get the right diagnosis and treatment for insomnia or another sleep disorder, you need to recognize the signs and symptoms. With the right support and insomnia treatment, you can manage what’s keeping you from a good night’s sleep. Understanding what might be causing your insomnia is a good first step in having a conversation with a treatment provider, like one you find on Klarity.

What causes insomnia and keeps us up even when we’re tired?

Even when our bodies need sleep, common culprits can lead to insomnia and keep us awake. Let’s examine a few. 

Anxiety

Anxiety can disrupt your sleep. It might be challenging to unwind and sleep when your mind is racing, you’re worried about the future, or you just feel uneasy. Anxiety disorders impact more than 40 million adults in the U.S. And many of them have trouble sleeping.

Depression 

Depression and sleep disorders frequently coexist. Individuals with depression may experience hypersomnia (excessive daytime fatigue), insomnia, or both. The feelings of sadness, hopelessness, and despair that are part of depression can interfere with sleep cycles and lead to chronic exhaustion.

Napping 

A little nap can give you a burst of energy, but taking too many naps or napping too late in the day can keep you from getting enough sleep at night. Research on napping and its potential benefits is inconclusive, but if you’re napping and not sleeping at night, consider cutting back.

Caffeine

Caffeine is a staple for 90% of Americans, but if you drink it too soon before bed, it may interfere with your sleep by prolonging alertness and delaying the beginning of sleep.

Blue light

Electronic devices emit blue light, which can disrupt the body’s natural production of melatonin. Blue light exposure before bedtime can decrease melatonin production and make it difficult to fall asleep.

Hormonal changes

Sleep patterns can be impacted by hormonal changes, particularly for women, such as those that occur during menstruation, pregnancy, or menopause. Hormone fluctuations can cause insomnia and other sleep disorders.

Alcohol

Drinking alcohol can cause fragmented, restless sleep by interfering with the later stages of sleep, even if it initially makes you feel sleepy. Avoiding alcohol close to bedtime may help improve the quality of your sleep.

Shift work

The body’s internal clock can be thrown off when working non-traditional hours, such as rotating shifts or nights, because it makes it difficult or impossible to stick to a regular sleep routine. Many people who work in healthcare, transportation, and hospitality, for instance, are impacted by shift work sleep disorder.

Jet lag

Traveling across time zones disrupts the body’s circadian rhythms and can lead to exhaustion, sleeplessness, and trouble focusing. To help reset your internal clock and recover from jet lag disorder, modify your sleep routine before your trip and expose yourself to natural sunlight.

Lifestyle factors

Our everyday routines and behaviors can have a big impact on how well we sleep. Your body’s internal clock can be thrown off by irregular sleep schedules, excessive screen time before bed, bad food choices, and inactivity. These factors can make it more difficult to fall and stay asleep.

Other factors 

Other variables that can cause sleep disruptions include temperature, noise, and uncomfortable bedding. Certain medications can also disrupt sleep patterns, especially those that impact the central nervous system. 

By understanding these factors and their potential impact on sleep, you can make informed decisions to improve your sleep hygiene and general welfare. 

Addressing these underlying causes often requires a comprehensive approach. This can include lifestyle modifications, stress management techniques, therapy, and maybe even medications used with the guidance of a healthcare professional.

What’s the risk of not sleeping?

Our cognitive, emotional, and physical well-being all depend on getting enough quality sleep. If we can’t sleep, we expose ourselves to a sleep debt and a host of negative effects. But lack of sleep isn’t just a minor inconvenience. It impacts health and can even lead to death. 

According to the Centers for Disease Control and Prevention (CDC), 1 in 3 adults in the U.S. doesn’t get enough sleep regularly. 

Short-term lack of sleep is one thing, but long-term sleep deprivation can impair memory, decision-making skills, and cognitive function. It can also weaken the immune system and raise the risk of chronic illnesses including obesity, diabetes, and heart disease. Chronic sleep deprivation can also lead to premature death. 

To minimize the negative effects of sleep deprivation, it‘s important to practice healthy sleep habits and have good sleep hygiene.

What is sleep hygiene?

Sleep hygiene refers to a collection of behaviors and routines that support a healthy sleep pattern and good, restful sleep. Adopting healthy sleep hygiene habits can improve the quantity and quality of your sleep.

When you have poor sleep hygiene, you can’t sleep even when you’re tired. Or, you can wake up multiple times throughout the night. Blue light exposure, coffee consumption before bed, irregular sleep schedules, and other possible activities contribute to poor sleep hygiene.

But don’t force yourself to sleep. Asking ourselves over and over again “why can’t I sleep at night even when I’m tired” won’t help put you to sleep any faster.

If you’re laying in bed for a long time and can’t fall asleep, don’t force it. Go to a different room and do a relaxing activity. Whatever helps you relax, whether it’s reading a book or doing yoga. When you start to feel sleepy, you can return to your bed and try to fall asleep. 

Practice good sleep hygiene to get a good night’s sleep

Having a restful night’s sleep is essential for maintaining overall health and well-being. Here are some strategies to help improve sleep quality when you find yourself asking “Why can’t I sleep at night even when I’m tired.”

Maintain a regular sleep schedule: Your sleep quality improves when you go to bed and wake up at the same time every day. This includes weekends. You also need to get enough sleep. It’s recommended that adults get at least 7 hours of sleep.

Create a calm bedtime routine: Before going to bed, try some relaxing activities to let your body know it’s time to unwind. This can be curling up with a book, having a warm bath, or doing deep breathing exercises or meditation. Relaxation and other techniques to calm anxiety may also help.

Create a comfortable sleep environment: A comfortable sleep environment can include keeping your bedroom cool, quiet, and dark, choosing a cozy mattress and cushions, and minimizing disturbances by using a white noise machine or blackout curtains to block out light.

Reduce screen time before bed: The blue light that electronic gadgets emit can disrupt your body’s melatonin production. At least one hour before going to bed, try to avoid using screens or use electronics with blue light filters.

Watch your food and exercise: Getting regular exercise can help you sleep better, but avoid doing too much just before bedtime. Also, pay attention to what you eat, particularly in the hours before bedtime. Also avoid large meals, coffee, and alcohol as they can cause sleep disturbances.

When good sleep hygiene alone isn’t enough

Sometimes do-it-yourself sleep practices aren’t enough. In its Clinical Practice Guidelines, the American College of Physicians (ACP) recommends that the best therapy for insomnia is a combination of mental health therapy, sleep hygiene, lifestyle changes, and medications that line up with the insomnia sufferer’s goals and preferences. 

Therapy

Cognitive-behavioral therapy for insomnia (CBT-I) or brief behavioral therapy for insomnia (BBT-I) can be tried alone or, per the ACP guidelines, combined with sleep hygiene, lifestyle changes, and medications.

Medications to help with sleep

Medication may help manage insomnia. These medications include prescription and over-the-counter options. 

Prescription sleep medications

Prescription sleep medicines that are approved by the U.S. Food and Drug Administration (FDA) to treat insomnia include:

• Benzodiazepines receptor agonists, such as Ambien (zolpidem tartrate), Restoril (temazepam), Lunesta (eszopiclone), and Sonata (zaleplon)
• Silenor (low-dose doxepin), which is a tricyclic antidepressant
• Rozerem (ramelteon), which is a melatonin receptor agonist
• Dual orexin receptor agonists (DORAs), such as Quviviq (daridorexant),  Dayvigo (lemborexant), and Belsomra (suvorexant)

There are also prescription drugs used off-label for insomnia, which means they’re used for a purpose they’re not FDA-approved to treat, in this case sleep. These include trazodone, Remeron (mirtazapine), Elavil (amitriptyline) and Pamelor (nortriptyline) among others.

Over-the-counter (OTC) sleep aids and herbal therapies

OTC sleep aids include melatonin supplements to induce drowsiness and help you fall asleep faster. Note that OTC sleep aids may not be appropriate for long-term use. And OTC products that contain diphenhydramine or doxylamine may cause side effects. They may also increase the risk of falls and cause hangover effects, dizziness, and cognitive impairment. 

When to seek help from a healthcare provider

If you can’t sleep for extended periods, experience impairment during the day, and/or a lack of sleep is affecting your physical or mental health, talk to a healthcare provider. It’s important to see a specialist if you frequently can’t sleep, have trouble staying asleep, observe mood swings associated with sleep disorders, or suffer daytime fatigue that affects your functioning.

A healthcare provider will diagnose a sleep disorder by asking you about your symptoms as well as your medical and mental health history.

Key takeaway if asking, “Why can’t I sleep at night even when I”m tired?”

Understanding the factors influencing your sleep quality is crucial for general health. You may be able to improve sleep by having a regular sleep schedule, creating a good sleep environment, minimizing stimulants before bedtime, understanding the potential causes of insomnia, and following healthy sleep practices. 

If your own attempts don’t work to solve your sleep issues, it’s time to identify underlying illnesses or disorders and manage persistent sleep issues by getting professional assistance from one or more healthcare providers. 

Get help of a healthcare provider on Klarity

If you’re asking yourself, “Why can’t I sleep at night even when I’m tired?” turn to Klarity. On Klarity, you can find a sleep specialist who can help you effectively address your sleep difficulties. Start your journey to better sleep by connecting with a healthcare provider on Klarity today.

*Sleep Statistics and Facts About Sleep Deprivation, National Council on Aging (NCOA), Jan. 2024, https://www.ncoa.org/adviser/sleep/sleep-statistics/

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.