Why Can't I Sleep Even Though I'm Tired?

Apr 18, 2024 | Written by Priyanka Puranik, MSc | Reviewed by Scott Sherr, MD and Marion Hall

Why Can't I Sleep Even Though I'm Tired?

Have you ever felt exhaustion dragging at your eyelids, only to find yourself wide awake staring at the ceiling as you lie in bed, not feeling sleepy at all despite being tired all day?

It's a frustrating paradox — you're feeling tired but can't sleep. This experience, known as paradoxical insomnia, affects millions of people worldwide alongside those with sleep disorders. While a restless night might be occasional, persistent sleep deprivation can significantly impact your health.

The reasons behind this phenomenon are multifaceted, ranging from lifestyle habits to underlying medical conditions. Understanding these reasons is the first step toward a good night's sleep. In this article, we'll explore some of the common culprits that can contribute to your difficulty falling asleep even though you feel tired.
But if you'd first like to learn more about sleep and why it's important to sleep better, read here. We also have another article on medications that can disrupt sleep that you can take a look at here.

1. Poor sleep hygiene can exhaust you

Sleep hygiene refers to the habits and environmental factors that influence your sleep quality. Good sleep hygiene is the foundation for restful sleep. Erratic sleeping habits or irregular sleep schedules can disrupt your circadian rhythm (your body's internal clock), making it harder to fall asleep at the right time and wake up feeling refreshed. A bedroom that's too noisy, bright, or cluttered, along with pre-sleep activities that stimulate rather than calm, can signal to your brain that it's time to be active instead of preparing for rest.
In today's digital age, our evenings are often filled with screens and stimuli that can disrupt the body's natural preparation for sleep. Electronic devices such as smartphones, tablets, and computers emit blue light, which can interfere with the production of melatonin, a hormone crucial for sleep regulation. This overstimulation extends beyond light exposure, encompassing mentally engaging activities that can keep the mind too active for sleep. Establishing a digital curfew, opting for calming activities before bed, and creating a sleep-conducive environment — dim lights and minimal noise — can help mitigate these effects, paving the way for a smoother transition to sleep.
Poor sleep hygiene has serious consequences – it increases your risk of daytime drowsiness, impaired concentration, mood problems [1], and long-term health issues like obesity, heart disease, and depression [2].


Countering the effects to better your sleep

  • Consistency is key: Aim for regular sleep and wake times, even on weekends, to strengthen your circadian rhythm [3].
  • Create a sleep sanctuary: Make your bedroom dark, quiet, cool, and clutter-free.
  • Pre-sleep wind-down: Establish a relaxing bedtime routine that might include a warm bath, reading, or gentle stretching. Avoid screens for at least an hour before bed [4].
  • Seek professional help: If poor sleep hygiene is a persistent problem, consider consulting a sleep specialist for personalized guidance.

2. The stimulating after-effects of caffeine can keep you awake

Caffeine, a common pick-me-up found in coffee, tea, some soft drinks, and chocolate, is a known sleep disrupter. It acts as a central nervous system stimulant, working by blocking the action of adenosine, a neurotransmitter that builds up during wakefulness and signals the brain to slow down in preparation for sleep [5]. This interference by caffeine keeps you feeling alert and makes it harder to both fall asleep and stay asleep.
Caffeine's effects and duration in the body vary from person to person [6]. Some individuals are more sensitive and may find that even a late afternoon cup leaves them wired at bedtime, while others are less affected.


Countering the effects to better your sleep

  • Cut-off time: Experiment to find your personal caffeine cut-off time, generally several hours before bedtime.
  • Be mindful of hidden sources: Remember that chocolate, certain medications, and some energy drinks also contain caffeine.
  • Gradual reduction: If you're a heavy caffeine user, taper your intake gradually to avoid withdrawal headaches.

3. Underlying medical conditions can make you feel tired

Sleep is a complex process that can be easily disrupted by various medical conditions. Conditions like sleep apnea and restless legs syndrome (RLS) can significantly disrupt sleep quality, often without you even realizing it. Obstructive sleep apnea (the most common type) causes the airway to collapse repeatedly during sleep, leading to brief but frequent awakenings triggered by oxygen deprivation [7]. These awakenings might go unnoticed, but they prevent you from reaching deeper, more restorative stages of sleep. This results in feeling tired even after a seemingly full night's rest.
Restless legs syndrome (RLS) creates unpleasant sensations in the legs and a strong urge to move them, often worsening at night and when at rest [8]. This discomfort, and the involuntary movements that accompany the urge, can significantly delay sleep onset and lead to frequent awakenings throughout the night.


Countering the effects to better your sleep

  • Consult a sleep specialist: If you suspect an underlying sleep issue, consult with a doctor or sleep specialist. Proper diagnosis is crucial for getting the right treatment.
  • Treatment for sleep apnea: This may include lifestyle changes, oral devices, or CPAP (continuous positive airway pressure) therapy, which keeps the airway open during sleep [9].
  • Managing RLS: Treatment options can include lifestyle modifications, medications that target brain chemicals (dopaminergic agents), or medications used for other conditions that sometimes help RLS [10].

4. Diet and exercise can hinder better sleep

The adage "you are what you eat" also holds true for sleep quality. Diets high in sugar, saturated fats, and processed foods can disrupt sleep patterns. These foods lead to blood sugar fluctuations, triggering nighttime awakenings [11]. They can also contribute to inflammation, which has been linked to sleep problems [12]. On the other hand, a balanced diet rich in fruits, vegetables, and whole grains supports restful nights by providing essential nutrients and promoting a healthy gut microbiome, which plays a role in sleep regulation [13].
Timing also matters when it comes to food and sleep. Eating heavy or large meals too close to bedtime can lead to indigestion, heartburn, or discomfort that can keep you up [14]. Ideally, give your body a few hours to digest food before attempting to sleep.
Similarly, exercise plays a dual role in promoting sleep. Regular physical activity is a powerful sleep enhancer. It reduces stress hormones, helps regulate your circadian rhythm, and increases the amount of deep, restorative sleep you get [15]. However, exercise timing is crucial. Vigorous workouts too close to bedtime elevate body temperature, heart rate, and alertness, potentially hindering your ability to wind down and fall asleep [16]. It's generally wiser to schedule moderate or vigorous exercise earlier in the day, allowing your body time to cool down and relax before bed.


Countering the effects to better your sleep

  • Mindful eating: Choose whole, unprocessed foods, favoring fruits, vegetables, and whole grains. Avoid sugary drinks and snacks, especially before bed.
  • Timing is key: Finish your last substantial meal at least 2-3 hours before bedtime. If you're prone to nighttime hunger, opt for a light, sleep-friendly snack like a small banana with nut butter.
  • Early bird workouts: Schedule moderate-intensity exercise in the morning or afternoon. If evening workouts are unavoidable, opt for lighter activities like yoga or stretching.
  • Wind-down time: Allow at least an hour between vigorous exercise and bedtime to give your body time to cool down and relax.

5. Hormonal imbalances can disrupt your sleep

Hormones act as powerful messengers within our bodies, and they play a significant role in regulating sleep-wake patterns. Disruptions in several hormones can significantly impact your sleep quality.


Often called the stress hormone, cortisol levels naturally drop in the evening, paving the way for relaxation. However, chronic stress, anxiety, and even overstimulation can keep cortisol elevated when you need it to be low, making it difficult to fall and stay asleep [17].
This hormone may also elevate in the early morning due to hypoglycemia in some people due to a phenomena know as the Somogyi effect. When blood sugar drops, stress hormones like cortisol rise which can disrupt sleep. This can be diagnosed with a continuous glucose monitor. 


This hormone, primarily produced by the pineal gland, tells your body when it's time to sleep. Light exposure (especially blue light), inconsistent sleep-wake schedules, or certain medical conditions can disrupt melatonin production, which can lead to a struggle to fall asleep [18].

Thyroid imbalances

Thyroid hormones play a significant role in regulating metabolism. An overactive thyroid (hyperthyroidism) can create a state of hyperarousal, causing insomnia, restlessness, and temperature sensitivity [19].


Countering the effects to better your sleep

  • Manage stress: Stress reduction techniques like deep breathing, meditation, and regular exercise can help regulate cortisol levels.
  • Optimize sleep hygiene: Consistent sleep-wake times, a dark and quiet sleep environment, and minimizing light exposure before bed promote healthy melatonin production.
  • Support thyroid health: If you have a diagnosed thyroid condition, following your doctor's treatment plan is crucial for managing its impact on sleep.
  • Seek medical advice: If you suspect a hormonal imbalance, consult your doctor. They may be able to diagnose underlying conditions and recommend appropriate treatments.

6. Disrupted circadian rhythm can make you unable to sleep

Our bodies have an internal clock known as the circadian rhythm, which governs our sleep-wake cycles along with various other bodily functions. This master clock, located in the brain's hypothalamus in a region called the suprachiasmatic nucleus (SCN), is highly sensitive to light [20]. Inconsistencies in your sleep schedule, traveling across time zones (jet lag), or nighttime light exposure can disrupt the SCN's timing. This misalignment leads to a mismatch between your body's internal clock and the external environment, hindering your ability to fall asleep when it's actually bedtime [21].
Light suppresses the production of melatonin, a hormone secreted by the pineal gland that promotes sleepiness [22]. A misaligned circadian rhythm can cause abnormal melatonin production patterns, making it difficult to fall asleep at the appropriate times.


Countering the effects to better your sleep

  • Consistent sleep schedule: Maintain regular sleep and wake times, even on weekends, to strengthen your circadian rhythm.
  • Strategic light exposure: Get bright light exposure in the morning to help reset your clock. Limit light exposure in the evening, especially blue light from electronic devices.
  • Melatonin supplementation: Under a doctor's guidance, consider timed melatonin supplementation to help regulate your sleep-wake cycle, particularly for jet lag or shift work [23].

7. Psychological stress and anxiety can cause fatigue

When stress and worry take over, it's like your mind switches into overdrive and your body follows suit. Racing thoughts, anxieties, and an inability to switch off mentally can keep you tossing and turning, making sleep feel impossible. Chronic stress leads to persistently elevated levels of cortisol, known as the "stress hormone." Cortisol has an alerting effect on the body, which is helpful in moments of genuine danger but detrimental when you're trying to wind down for sleep [24].
Anxiety disorders can induce a state of hyperarousal, in which the sympathetic nervous system (responsible for the fight-or-flight response) remains overly active [25]. This heightened physiological state is fundamentally incompatible with the relaxation needed for sleep. Anxious ruminations and worries often focus on the sleeplessness itself, creating a vicious cycle that further exacerbates difficulties falling or staying asleep.


Countering the effects to better your sleep

  • Relaxation techniques: Practice relaxation techniques like deep breathing, progressive muscle relaxation, or meditation to calm both your mind and body [26].
  • Worry time: Set aside a designated "worry time" earlier in the day to address concerns rather than letting them keep you up at night.
  • Cognitive behavioral therapy for insomnia (CBT-I): CBT-I helps address thoughts and behaviors that perpetuate sleep difficulties, making it a highly effective treatment [27].
  • Seek professional help: If stress and anxiety significantly impact your sleep, consider therapy or talk to your doctor about potential medication options if appropriate.


The journey to improving sleep is a multifaceted endeavor that encompasses understanding and addressing the biological, psychological, and environmental factors that influence the quality of your sleep. By acknowledging the complexity of sleep and the various factors that disrupt it, individuals can take informed steps toward getting a good night's sleep. Embracing a holistic approach that includes lifestyle modifications, medical intervention when necessary, and fostering a conducive sleep environment can improve your sleep quality and, by extension, your overall health.
This article navigated through the intricacies of sleep disturbances, offering insights and actionable strategies to overcome challenges that hinder sleep even when you're tired. By prioritizing sleep and consciously addressing the underlying causes of sleep difficulties before you finally go to bed, we can unlock the door to improved health, productivity, and quality of life.
Troscriptions also has Tro Calm and Tro Zzz to help you out, our buccal troches formulated for relaxation and sleep, respectively. You might even be interested in trying a combination of the two, which we've aptly named the GABAmic Duo for their effects on the GABA system.


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