Why Am I Tired All Day But Can't Sleep at Night?

It’s frustrating—you feel drained all day, but when your head finally hits the pillow, your mind won’t shut off, and you just can’t fall asleep. Or maybe you’re falling asleep only to wake up a few hours later and not be able to get back to sleep. You’re not alone. Many adults struggle to fall asleep, and 10-15% of adults in the US have chronic insomnia. So what’s the deal—why can’t you sleep?

Common Causes of Feeling Tired by Day but Can't Sleep at Night

Our sleep is maintained by a sleep system and a wake system. These systems are a set of cues your body sends to help you feel awake and alert, and then to help you feel drowsy. They are influenced by factors like sunlight, body temperature, our schedule, activity level, hormones, and substances like nicotine, caffeine, and alcohol. The balance of our sleep and wake systems can be thrown off by various factors, thus impacting sleep.

Stress and Hyperarousal

If you have anxiety, a lot of stress, or issues that cause hyperarousal, such as PTSD, this can impact your sleep. This is particularly true if bedtime is your first quiet moment of the day. Your mind may race with thoughts, making it hard to relax.

Fatigue, Napping, and Lack of Activity

There’s a vicious cycle of insomnia where difficulty sleeping leads to naps or inactivity. This, in turn, leads to more problems sleeping. Throughout the day, our body builds up sleep pressure that helps make us feel drowsy at night. However, if you’re not active or are taking naps, you may not be building up enough sleep pressure.

Learned Sleeplessness

When you lie awake in bed, tossing and turning, your mind can begin to associate the bed and bedtime with frustration and worry. This results in stress and hyperarousal being turned up right when you want to fall asleep. It’s a tough cycle to break, but it’s possible.

Lifestyle Interruptions

Inconsistent sleep schedules, unmanaged anxiety, and substance use can all impact sleep. Medical problems such as sleep apnea, restless leg syndrome, and hormonal changes during perimenopause and menopause can also lead to insomnia.

Evidence-Based Solutions for Insomnia

While helpful, research shows that sleep hygiene alone does not resolve chronic insomnia. Additionally, sleep aid medications can have a laundry list of side effects and risks. The gold-standard treatment for insomnia, recommended as the primary treatment by physicians, is Cognitive Behavioral Therapy for Insomnia (CBT-I).

CBT-I targets:

• Restructuring unhelpful thoughts about sleep

• Sleep restriction therapy (resetting sleep pressure)

• Stimulus control (retraining the bed-sleep connection)

• Relaxation techniques for hyperarousal

  
  

The Importance of a Consistent Sleep Schedule

One of the most effective strategies in managing insomnia is establishing a consistent sleep schedule. Going to bed and waking up at the same time every day helps regulate your body’s internal clock. This consistency can significantly improve your sleep quality over time.

Creating a Relaxing Bedtime Routine

Another helpful approach is to create a calming bedtime routine. Engage in relaxing activities before bed, such as reading, taking a warm bath, or practicing mindfulness meditation. These practices signal to your body that it’s time to wind down, making it easier to transition into sleep.

The Role of Environment in Sleep Quality

Your sleep environment plays a crucial role in your ability to fall asleep. Make sure your bedroom is conducive to sleep. This means keeping it dark, quiet, and cool. Consider using blackout curtains, white noise machines, or fans to create an ideal sleeping atmosphere.

Nutrition and Sleep

What you eat can also affect your sleep. Avoid heavy meals, caffeine, and alcohol close to bedtime. Instead, opt for light snacks that promote sleep, such as bananas or almonds. These foods contain nutrients that can help relax your body and prepare you for sleep.

Physical Activity and Sleep

Regular physical activity can greatly improve your sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week. However, try to avoid vigorous workouts close to bedtime, as they may energize you and make it harder to fall asleep.

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