5/7/2021 Tired but Can't Sleep: Why It Happens and What to Do About It

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Why Am I So Tired, but Can’t Sleep?

Medically reviewed by Janet Hilbert, MD — Written by Brittany Risher on October 26,
2020

Circadian rhythm Tired vs. sleepy Why you're tired Drawbacks

How to fall asleep Takeaway

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Some days — no matter how much coffee you consume — it’s a struggle
to keep your eyes open, let alone complete the tasks you need to do at
the office or home.

Yet all too often, when you finally climb into bed, you find yourself wide
awake.

It’s frustrating. What the heck is going on? 

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Before you reach for those sleeping pills, discover all the things that could
cause you to be tired all day but awake at night. Once you identify what
might be going on, you can take action to support better sleep.
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Your circadian rhythm, explained

The circadian rhythm is like an internal timekeeper for everything our
bodies do in a 24-hour period, explains sleep specialist W. Christopher
Winter, MD, author of “The Sleep Solution: Why Your Sleep Is Broken and
How To Fix It.”

This system uses light, dark, and our biological clock to regulate body
temperature, metabolism, hormones (including melatonin), and sleep.

The body’s master clock is called the suprachiasmatic nucleus (SCN).

Located in the brain, the SCN controls melatonin production. This
hormone helps regulate sleep.

During the day when it’s light outside, melatonin levels remain low. Later
in the day as it begins to grow darker, our bodies produce more
melatonin, with levels peaking between 2 and 4 a.m. before falling again.

Our bodies are best primed to fall asleep about 2 hours after melatonin
levels start to rise.

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Everybody has their own circadian rhythm, Winter explains, which

to some extent is genetic. So, unlike what your parents told you
when you were a kid, there’s no reason you “need” to go to bed
at a certain time.

“I don’t care what someone’s schedule is, as long as it feels right for them
and is healthy,” Winter says.

However, if you’re tired but can’t sleep, your circadian rhythm may be off.

This could be a sign of delayed sleep phase syndrome. This occurs when
you fall asleep 2 or more hours later than what’s considered “normal” (10
p.m. to 12 a.m.), making it difficult to wake up in the morning for school or
work.

It often affects young people more — between 7 and 16 percent — but

also occurs in about 10 percent of people with chronic insomnia.

Is there a difference between being tired, sleepy,

and fatigued?
Many people use the words “tired,” “sleepy,” and “fatigued”
interchangeably, but there’s a subtle difference, says Winter.

At the end of a marathon, you feel fatigued — you likely don’t have the
energy or motivation to run another marathon and perhaps not even walk
the distance to your car. But you’re not sleepy — you wouldn’t doze off
laying on the grass beyond the finish line. Rather, being sleepy is when
you can barely keep yourself awake, Winter says.
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Why am I tired during the day?

If you’re tired but can’t sleep once the sun sets, it could be a sign of
delayed sleep phase disorder. If not that, it could be something else or a
combination of things.

Below are some reasons why you might constantly be tired, especially
during the day.

1. Napping

Naps aren’t inherently bad. In fact, napping has several health benefits.
However, the wrong nap strategy can keep you up when you should be
getting deeper Zzz’s.

Research  suggests that long naps and napping later in the afternoon
can cause you to take longer to fall asleep at night, sleep poorly, and
wake up more during the night.

Winter recommends keeping naps 20–30 minutes long, and napping at

the same time every day so your body can anticipate it.

2. Anxiety

A racing mind isn’t conducive to peacefully nodding off.

No wonder sleep disturbance is a diagnostic symptom for some anxiety

disorders, which older research says 24 to 36 percent  of people with
insomnia also have.


Anxiety also leads
A D Vto
E R Tincreased
ISEMENT arousal and alertness, which can delay
sleep even further.

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3. Depression

According to a review  published in 2019, up to 90 percent of people

diagnosed with depression also complain about their sleep quality.

Insomnia, narcolepsy, sleep disordered breathing, and restless legs

syndrome were all reported.

The relationship between sleep issues and depression is complicated. It

appears to disrupt circadian rhythms.

Inflammation, changes in brain chemicals, genetic factors, and more may

all affect the sleep-depression relationship.

4. Caffeine

Maybe it’s time to reconsider that afternoon latte or energy drink.

On average, caffeine has a half-life of 5 hours. It may be no surprise, then,

that research suggests that even 200 milligrams (mg) of caffeine — about
16 ounces of brewed coffee — 16 hours before bed may impact your
sleep.

A 2013 study reported that downing 400 mg of caffeine 6 hours or less

before bed had significant effects on sleep disturbance. Winter
recommends cutting off caffeine consumption 4–6 hours before bedtime.

5. Screen time

Put down the smartphone! The blue light emitted from phones, tablets,
laptops, and TV screens suppresses evening melatonin production and
decreases sleepiness.

Winter recommends ceasing the use of any devices 2 hours before bed.
You may also consider wearing blue-light blocking glasses at night.

6. Other sleepA Ddisorders

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Delayed sleep phase syndrome isn’t the only disorder that can make you
sleepy but not tired at night.

Sleep apnea and restless legs syndrome can do the same. In sleep
apnea, breathing repeatedly stops or is very shallow, then starts again.
With restless legs syndrome, your legs feel uncomfortable, triggering you
to want to move them.

Both conditions can disrupt nighttime sleep, which then causes daytime
sleepiness.

7. Diet

The connection between diet and sleep is a bit unclear.

In a 2019 study  , researchers looked at excessive daytime sleepiness

and diet. They found that replacing 5 percent of one’s daily caloric intake
from protein with equal amounts of saturated fats or carbs increased risk
of daytime sleepiness.

On the other hand, replacing saturated fats with unsaturated fats, protein,
or carbs reduced the risk of excessive daytime sleepiness.

They conclude that dietary changes may help people with sleep
disorders.

A 2016 review found that high-fat diets were associated with less REM
sleep, more deep sleep, and increased arousal from sleep. High-carb
intakes were associated with more REM sleep, less deep sleep, and
falling asleep faster.

However, the study’s authors say more research is necessary to

determine if any one eating pattern promotes or impairs nighttime sleep
and daytime energy.

Is it bad to be tired? ADVERTISEMENT

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Naturally, being tired during the day can sap productivity — and possibly
make you irritable.

The Centers for Disease Control and Prevention (CDC)  says that not
getting quality, restful sleep on a regular basis puts you at increased risk
of:

high blood pressure

diabetes

Alzheimer’s

stroke

heart attack

obesity
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How can I fall asleep?

A regular, consistent sleep and wake schedule is Winter’s top suggestion
for anyone who’s tired but can’t sleep.

You may also want to shift your bedtime, he says.

Think aboutA itD Vlike

E R T I S Ethis:
M E N T You don’t sit in a restaurant for an hour


just because it’s lunchtime — you go when you’re hungry. Why lie
in bed and wait around for sleep? Hold off on getting between
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the sheets until you’re tired, and only do things that won’t
stimulate your mind leading up to that time.

Then, follow the usual good sleep practices:

Keep your bedroom dark and cool, between 60–67°F (15–19°C).

Consider leaving your phone and other devices in another room.

If noises disturb your slumber, try earplugs or a white noise machine.

Also stick to calming activities before bed, such as reading, journaling, or

meditation.

If anxiety makes your brain hum at night, set aside 20 to 30 minutes of

designated “worry time” during the day, ideally at least 2 hours before
bedtime, suggests Michelle Drerup, PsyD, a psychologist with the
Cleveland Clinic Sleep Disorders Center.

Journal on what’s worrying you. Then write down solutions to address

those concerns.

At night, when you’re tempted to let your mind race, simply remind
yourself that you’ve dealt with things and need to let it go. Or tell yourself
that you’ll worry during your set time tomorrow — but now is the time to
sleep.

If you try a few of these remedies and still wonder “Why am I tired, but
can’t sleep?” talk to your doctor.

“Nobody comes into my office and says, ‘I kick my legs 400 times in the
night,’” Winter says. “They say, ‘I can’t sleep.’” By telling your doctor about
your sleep problems, they can ask questions and, if necessary, run some
sleep tests to diagnose what the underlying problem is. Then you can
receive the proper treatment to address the cause and help you sleep
better.
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Winter doesn’t recommend sleep medications unless someone has a

condition such as restless legs syndrome, is a shift worker, or is trying to
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prevent jet lag before a trip.

“When we use a sedative like Ambien, Benadryl, or melatonin, we

confuse sedation with sleep. That reinforces the belief that something is
wrong with your sleep,” he says. “But it does nothing positive for sleep, it
just induces sedation.”

If you’re still curious, since sleep medications can have side effects and
impact certain health conditions, always try other remedies first and talk
to your doctor or a sleep specialist before taking any sleeping pills. They
can help you determine which may be best for you.

The bottom line 

If you’re tired but can’t sleep, it may be a sign that your circadian rhythm is
off.

However, being tired all day and awake at night can also be caused by
poor napping habits, anxiety, depression, caffeine consumption, blue light
from devices, sleep disorders, and even diet.

If you keep saying, “I’m so tired but can’t sleep!” and everyday sleep
remedies don’t help, talk to your doctor. They can help determine the
underlying problem and recommend solutions that will help you get
restful sleep so you have daytime energy.

Brittany Risher is a writer, editor, and digital

strategist specializing in health and lifestyle
content. She’s written for publications including
Elemental, Men’s Health, Women’s Health, and
Yoga Journal.

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Last medically reviewed on October 26, 2020

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