Insomnia

Why Can't I Sleep?

Feldenkrais Sleep · Updated 2026-09-24

"I am exhausted but I cannot sleep" is one of the most common sentences in medicine, and it is usually not a contradiction. Sleepiness and the ability to fall asleep are governed by different systems, and they can be out of alignment for years. Here are the causes worth checking, roughly in order of how often they turn out to be the actual answer.

1. Too much time in bed

The most common cause and the least suspected. If you are in bed nine hours and sleep six, you have spent three hours a night teaching your brain that bed is a place for lying awake. The fix is sleep restriction, and it feels wrong until it works.

2. Trying to sleep

Sleep is not a voluntary act. Effort activates the systems that block it. If your main experience is trying harder as the night goes on, see paradoxical intention and stimulus control.

3. Arousal that never came down

You finished work hours ago but your body is still organised for it — jaw set, shoulders up, breathing shallow, lower back braced. This is the case that Feldenkrais work addresses most directly, and it is missed by most sleep advice because it is not a thought.

4. Caffeine you stopped noticing

Half-life is five to six hours and sensitivity is largely genetic. A 2pm coffee still has meaningful levels at 10pm for many people. Run a two-week trial with nothing after 12pm before deciding it does not affect you.

5. Alcohol

Sedating at first, arousing as it clears. If your pattern is falling asleep fine and waking at 3am, this is often the answer. See sleeping after drinking.

6. Worry with a plot

Narrative rumination: one concern leads to the next, each one raising arousal a notch. Cognitive shuffling is designed for exactly this.

7. An inconsistent wake time

The circadian system anchors to when you wake and get light, not to when you go to bed. A wake time that varies by three hours at the weekend is a weekly dose of jet lag.

8. Sleep apnoea

Snoring, observed pauses in breathing, morning headaches, dry mouth, daytime sleepiness despite adequate hours. It is common, under-diagnosed, and no sleep technique fixes it. This one needs a clinician.

9. Restless legs syndrome

An unpleasant urge to move the legs, worse at rest and in the evening, relieved by movement. Often mistaken for anxiety. Also needs assessment — and it is worth checking iron status.

10. Depression or an anxiety disorder

Sleep disturbance is both a symptom and a driver. If low mood, loss of interest, or persistent worry has accompanied the insomnia, treat that as the primary target.

The pattern check

What to do this week

  1. Fix your wake time. Same clock time, every day, for two weeks.
  2. Write down time in bed and time asleep for seven nights. Calculate the gap.
  3. Cut caffeine after noon and alcohol within four hours of bed.
  4. If the gap is more than an hour, read sleep restriction.
  5. If three months or more, or if snoring and leg discomfort are present, book an assessment.

Frequently Asked Questions

Why am I tired but cannot sleep?
Sleepiness and the ability to fall asleep are separate systems. You can have plenty of sleep drive and still be unable to sleep because arousal is too high — the classic tired-but-wired state.
Why can I sleep on the sofa but not in bed?
Conditioned arousal: the bed has become associated with frustrated wakefulness while the sofa has not. Stimulus control reverses this.
Is insomnia a medical condition?
Chronic insomnia — difficulty sleeping at least three nights a week for three months with daytime impact — is a recognised disorder and is treatable.
When should I see a doctor?
After three months of persistent difficulty, immediately if you snore loudly or someone has observed pauses in breathing, or if low mood or loss of interest accompanies it.

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