Why Can’t I Sleep Even Though I’m Tired and What Can I Do?

You lie in bed tossing and turning for hours but can’t get to sleep even though you’re exhausted. You’re lethargic all day but then stay wide awake at night. Friends and family call you the night owl even though you desperately wish to turn into an early bird. On top of that, your sleeplessness makes you anxious, worsening your “tired-but-wired” mind, and holds you back even more from those elusive zzzs.

If this sounds like you, don’t worry — there’s light at the end of the tunnel. Ahead, we explain why you can’t sleep even though you’re tired. From poor sleep hygiene and circadian misalignment to medical conditions like insomnia, you’ll learn how to remove these obstacles and get your energy back again. 

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To figure out why you might have trouble dozing off at night, it helps to understand how sleep “works”. We’ll use the Two Laws of Sleep — sleep debt and circadian rhythm — to explain it. The Two Laws are based on the two-process model of sleep regulation, the dominant scientific theory explaining the timing, duration, and structure of sleep that was first established by sleep scientist Alexander Borbély in the 1980s.

Sleep Debt

Sleep debt refers to the amount of sleep you’ve missed in the past 14 days relative to your sleep need (the genetically determined amount of sleep your body needs – not everyone needs eight hours). Sleep debt is a function of sleep homeostasis, a process in which sleep pressure builds up during the daytime and depletes at night when you sleep .

You can picture the sleep homeostat as a seesaw that always wants to be level. Here’s how:

• From the moment you’re awake, adenosine (a drowsiness-inducing chemical) steadily accumulates in your brain. This creates a constant, rising sleep pressure throughout the day.
• Near your bedtime, sleep pressure is at its peak, tilting the sleep homeostat to one side. This is one of two reasons (the other being the circadian process, which comes next) why you feel sleepy at night and again, one of two main catalysts for helping you fall asleep.
• When you meet your sleep need, your brain has enough time to flush out the accumulated adenosine and rebalance the homeostat.

Unfortunately, when you don’t get enough sleep, leftover adenosine means you’re groggier in the morning and sleepier during the daytime — common side effects of accrued sleep debt in the short term. If that sleep debt accumulates over time and isn't repaid, acute sleep deprivation becomes chronic. Consequently, your overall well-being deteriorates as you face an increased risk of health issues like heart disease, obesity, Type 2 diabetes, and even cancer. 

RISE users on iOS 1.202 and above can click:

• here to see their sleep need
• here to see their sleep debt

Circadian Rhythm

So far, you’ve learned how sleep pressure works in getting you to sleep at night and the consequences of sleep deprivation. But things aren’t as simple as that — remember, there’s a second part of the story we’ve yet to explore.

For one thing, if sleep pressure keeps rising from wake time to bedtime, why do we not succumb to sleep during the day (or in the case of napping, can sleep easily at some times and not at others)? For another, if sleep pressure evaporates with sleep, why do we only wake up when the alarm clock goes off and not (hopefully) before that, say, at 3 a.m.?

The answer to these questions lies in your circadian rhythm (the internal body clock), which helps regulate the timing and consolidation of both sleep and wakefulness. 

Light, especially natural, bright light, is the greatest time-giving cue for your circadian rhythm. When you wake up, your eyes receive light that kick-starts a series of interrelated processes throughout the body: the master clock in your brain releases circadian alerting signals, which promote wakefulness to counter the now rising sleep pressure. At the same time, the body steps up its production of cortisol, norepinephrine, and serotonin to help you feel more awake and alert. The internal body clocks also govern your core body temperature (CBT). From 4 a.m. onward, CBT gradually rises to prime you for wakefulness.

Circadian-alerting signals rise steadily throughout the day, with a temporary drop in the early to late afternoon. This lull, combined with growing sleep pressure, is why you feel less energetic and more lethargic post-lunch, otherwise known as the “Afternoon Dip” in the RISE app.

Past your energy dip and nearing the evening, the circadian-alerting signals are in full force to counter sleep pressure that’s now at its peak. Your CBT also climaxes at around 6 p.m. to keep you awake and give you what feels like a second wind (fun fact: most world records are broken at this time). This is the second of your two  energy peaks in the RISE app. Going to bed within this period is, under normal conditions, next to impossible.

In an ideal world, your internal body clock is in sync with the external light-dark cycle. So, when dusk falls and darkness settles in, the circadian alerting signals slowly disappear. Your CBT also declines to initiate sleep.

Meanwhile, your body starts to produce melatonin (a sleep-promoting hormone) 2-3 hours before you sleep in a process initiated by the so-called dim light melatonin onset (DLMO). DLMO marks the start of your Melatonin Window in RISE when the rate of melatonin production peaks. Per a 2012 article in the Psychiatric Times, the circadian rhythm for sleep propensity (readiness to fall asleep and stay asleep) intensifies when melatonin steps up its production. This, coupled with sleep pressure at its zenith, is what allows you to fall asleep at bedtime. 

During the night, the CBT drops, until it hits its lowest at 4 a.m. To keep you asleep till morning (or whenever your alarm clock rings), sleep scientist Derk-Jan Dijk and colleagues found that the circadian rhythm for sleep propensity “peaks at or shortly after.” They also found that wakefulness only surges 4-8 hours after the trough of the CBT. This is why your nighttime sleep patterns aren’t in fits and starts but mostly continuous from nighttime till morning (barring middle-of-the-night awakenings).

As you can see, when sleep homeostasis and the internal clock are in sync, their well-timed push-pull dynamic keeps you awake for the most part during the day and helps you fall asleep and stay asleep at night. Any disturbances to the carefully orchestrated ecosystem — due to poor sleep hygiene, circadian misalignment, certain health conditions, or a mix of all three — are likely why you can’t sleep even though you’re tired (see next section).

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Although it can be challenging to identify the exact cause(s), the inability to sleep even though you’re tired is usually due to poor sleep hygiene, circadian misalignment, certain health conditions, or a mix of all three.

Missing out on a good night’s sleep (or several) doesn’t necessarily mean your sleep health is in jeopardy. Just like how we all have bad days, sleep issues can pop up from time to time, whether it’s because you have a heavier workload lately or you’re caring for a sick child.

While temporary sleep problems are certainly challenging, it’s important to take a longer-term view of your sleep health while inspecting your daily sleep hygiene practices. It helps that acute sleep debt is measured over the past two weeks rather than from last night alone.

That being said, a chronic lack of sleep is cause for concern. Sleep debt and its debilitating effects mount quickly. It’s easy to move from acute implications like lower energy and poorer mood the next day to chronic consequences like an increased risk of metabolic health issues.

If you’ve had trouble sleeping well for some time now, take a look at the following possible causes to see which one(s) resonate with you most. 

Poor Sleep Hygiene

Sleep hygiene refers to behaviors that help keep the sleep drive and internal body clock in harmony. That way, you feel sleepy at the right time, stay asleep throughout the night, and feel awake and energetic throughout the day (save for the mid-afternoon dip).

While it’s easy to be confused by the term ‘sleep hygiene', these behaviors don’t only relate to sleep itself, like perfecting your sleep environment. Many healthy sleep habits actually take place during the day. Pivotally, most of these behaviors concern not just what to do, but when to do them. Carrying out these sleep-promoting behaviors sets you up for sufficient healthy, naturalistic sleep at the right time. Conversely, if you don’t carry out these sleep-promoting behaviors, or perform them at the wrong time, not being able to sleep when you’re tired becomes an unfortunate reality. 

Some examples of poor sleep hygiene include:

• Ill-timed light exposure: Not basking in light first thing in the morning and getting too much of it (especially blue light) near your bedtime is the most common culprit behind your sleeplessness. Remember, light helps to start your body clock when you wake up, and its later absence signals to your body it’s time for sleep. Light also modifies your body’s chemical balance in favor of sleep by increasing serotonin concentration (which is converted to melatonin later). 
• Ill-timed consumption of sleep-disrupting stimulants: Drinking coffee, tea, and alcohol too late in the day can delay your sleep schedule and disrupt your sleep patterns. In fact, caffeine can stay in your system for up to 10 hours! Crucially, caffeine blocks the adenosine receptors in your brain, so if you’re trying to fall asleep a few hours after an afternoon coffee, you’ll likely have some difficulty.
• Late-night stress and anxiety: Watching a thriller on your laptop and arguing with your partner just before bed are common examples of activities that hike up your blood pressure and heart rate, along with your stress and anxiety levels. This hyperstimulation raises your cortisol levels, so you’re tired but too wired for bed.

Of course, the full spectrum of unhealthy sleep habits goes beyond the above instances. What’s more, these behaviors not only make it hard to fall asleep, but they can also make it difficult to stay asleep and fall back asleep if you woke up during the night. On top of that, you may also find it challenging to nap during the day, even if the nap is timed correctly to your afternoon circadian energy dip.

Solution

To tackle sleep-detracting behaviors, use the 20+ science-backed sleep habits in the RISE app. 

RISE users on iOS 1.202 and above can click here to set up their personalized habits.

You’ll also want to check out The Rise Science Guide to Improving Your Sleep to perfect your sleep hygiene.  

Circadian Misalignment

An out-of-tune body clock can make it challenging to sleep even when you’re tired.

The most relevant modern-day manifestations of circadian misalignment include:

• Social jetlag: This mismatch between the social and biological clocks happens to 87% of the general public. It usually comes in the form of an early sleep schedule on your work days and a late one on your days off. (Learn more about social jetlag here.)
• Travel jet lag: You experience sleeplessness when traveling, especially when crossing multiple time zones within a short period. It could be that you landed in the destination country at night, but your body clock is still keeping morning hours. (Find out how to get over travel jet lag here.)
• Virtual jet lag: Similar to travel jet lag, your body clock is tuned to a different time zone than the one it’s originally in, minus the actual travel. Think staying up for a Zoom meeting at midnight or attending a virtual conference at the crack of dawn.
• Shift work: Many shift workers, especially those with a predominantly night-shift schedule struggle to sleep during the day and stay awake at night.

Triggers for circadian misalignment can usually be traced to poor sleep hygiene. A classic example would be late-night light exposure from our phones in a bout of sleep procrastination that causes us to miss our Melatonin Window. 

Circadian misalignment could also be due to life obligations that are out of sync with our biological preferences for when we want to be awake and asleep. For example, the aforementioned night shift workers or night owl chronotypes living in an early-bird world. 

To complicate matters, poor sleep hygiene can also be compounded by life obligations to throw your body clock off course. To illustrate, a night shift worker may drink coffee to stay awake during their shift and have trouble sleeping once they get off work. In such cases, you can’t sleep even though you’re definitely tired from working all night.

Solution

RISE’s in-app habits can help you beat circadian misalignment for better sleep. In particular, try the “Blue Light Control,” “Evening Routine,” and “Melatonin Window” habits for well-timed light exposure, a relaxing wind-down routine, and learn the best time to go to bed, respectively.

RISE users on iOS 1.202 and above can click here to set up their personalized habits.

Insomnia 

The International Classification of Sleep Disorders defines insomnia as “difficulty in either initiating sleep, maintaining sleep continuity, or poor sleep quality” (even though there’s no scientific consensus on what quality sleep means).

On a societal level, this sleep disorder plagues one-third of the general public. You may have acute insomnia (lasting about three months) or chronic insomnia (sleep problems occurring at least thrice a week in the last three months).

Many triggers exist for insomnia, from post-surgical pain to anxiety and stress over job loss. Arthur Spielman (a pioneer in the field of sleep science who helped create the non-pharmacological method for tackling insomnia) and his colleagues came up with the 3P model to explain how chronic insomnia comes about:

• Predisposing factors include genes (like parents with sleep problems) or noisy surroundings (say, road traffic). These factors predispose you to insomnia.
• Precipitating factors can be due to caring for a newborn, losing a job, or going through a breakup. These triggers “push” you from acute insomnia into the chronic territory.
• Perpetuating factors happen when you adopt poor sleep hygiene protocols to get you through the days of tiredness from not sleeping well. Think caffeine consumption at the wrong times and in large doses and daytime naps that release too much sleep pressure. More often than not, there’s a vicious cycle of stress and sleeplessness: anxiety about not sleeping well increases pre-bedtime cortisol levels, which, in turn, worsens sleeplessness, setting the stage for chronic insomnia.

Solution

Improving your sleep hygiene is usually recommended. Sleep experts also favor cognitive behavioral therapy for insomnia (CBT-I) over temporary quick fixes like sleeping pills, as sleep medicine comes with unwanted side effects.

Your sleep specialist trained in CBT-I may walk you through protocols like sleep restriction, stimulus control (sleep reset), and cognitive techniques to reframe your fears regarding sleep deprivation. 

Delayed Sleep Phase Syndrome

Delayed sleep phase syndrome (DSPS) is a circadian disorder in which your biological clock significantly lags behind the societal clock.

For instance, you only feel sleepy at 2 a.m. when a conventional bedtime is around 10 p.m. Unsurprisingly, you have difficulty falling asleep if you go to bed at this hour. On your Energy Schedule in RISE, you may even see that this period is your last energy peak of the day, making sleep near physiologically impossible. To worsen matters, most people with DSPS rack up sleep debt that intensifies daytime sleepiness.

Solution

The good news is there are things you can do to shift your body clock forward and minimize sleep debt, mainly in the form of good sleep hygiene, such as:

• Get light first thing in the morning to jumpstart your body clock and encourage melatonin production earlier in the evening. Sleep with the curtains open or use time-controlled blinds to allow light to stream in once the sun is up.
• Try a melatonin supplement in the short-term as you shift your sleep schedule. To determine the ideal dosage for resetting your sleep schedule, read our guide on how to fix your sleep schedule.

If you still feel DSPS significantly affects your lifestyle after trying these tips, it’s worth speaking to a sleep specialist about your condition.

Other Medical Conditions

Besides sleep and circadian disorders, other medical conditions make dozing off challenging even though you’re tired:

• Obstructive sleep apnea (OSA) is a sleep disorder in which your breathing patterns are disrupted during sleep. You may wake up during the night due to breathing difficulties like gasping and choking, resulting in frequent middle-of-the-night awakenings. One study noted that sleep apnea usually coexists with insomnia, and “insomnia symptoms can predict OSA.”
• Mental health issues, like depression and anxiety, are closely associated with sleeplessness. For instance, roughly 75% of depressed individuals and about one-third of people with anxiety disorders have insomnia.
• Narcolepsy is a brain disorder that affects your sleep-wake cycle. It’s characterized by sleep fragmentation (frequent awakenings during the night) and excessive daytime sleepiness. The National Institutes of Health (NIH) highlights that sleep disruptions could be due to insomnia, sleep apnea, and vivid dreams.
• Restless legs syndrome (RLS) is another brain disorder featuring an uncontrollable urge to move the legs. The sensations usually intensify from evening onward, especially with a lack of physical activity. As expected, this makes for restless sleep even though you’re tired.

If you suspect any of the above health conditions, make an appointment with a licensed healthcare provider to get the treatment you need and meet your sleep need.

It’s Time To Regain Your Sleep

Not being able to sleep even though you’re tired means you aren’t meeting your sleep need and racking up sleep debt. There’s also a high chance of circadian misalignment that’s challenging your sleep and your energy. All of these point to the fact that you aren’t feeling and functioning at your best.

Determine why you can’t get the rest you need and work toward the right solution. Depending on whether the root cause is medical or non-medical, you may need to consult a healthcare professional.

With that said, healthy sleep hygiene paired with your circadian rhythm is a critical first step in fixing your sleep problems. That’s where RISE can help. It helps you cultivate 20+ science-backed sleep habits so you can sleep at night when you’re tired. Download the RISE app today for better sleep for better days.

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