June 20, 2024

Insomnia refers to when a person has difficulty falling and staying asleep. Some reasons you might want to fall asleep—but your body won’t let you—include lifestyle habits, medications, or physical or mental health conditions. Read on for nine reasons why it may be hard to sleep and what to do, including when to see a healthcare provider.

Anna Tabakova/Stocksy

While alcohol can make you sleepy at first, it can make it challenging to get a good night’s sleep later. Drinking alcohol affects how long you’re in the rapid-eye movement (REM) stage of sleep, which is essential for processing emotional memories.

Sometimes what you do before bedtime can affect your ability to fall asleep. For example, taking naps during the day—especially in the evening—may make sleeping harder when desired. Other potential sleep-affecting habits include:

  • Doing activities that increase your heart rate or eating heavy meals within two hours of bedtime
  • Engaging in screen time right before bed
  • Lying in bed awake for more than 15 to 20 minutes

While eating or drinking a lot of caffeine earlier in the day is fine, having it close to bedtime can be problematic. Consuming caffeine can provide an energy boost and help you feel more awake, but you can feel those effects for up to six hours. 

If you have a caffeinated beverage within six hours of your typical bedtime, the caffeine can keep you from feeling sleepy and falling asleep.

Individuals with chronic pain—which is pain that lingers beyond three months—often don’t get enough sleep or complain of interrupted sleep. The link between chronic pain and sleep is bidirectional. Chronic pain not only results in difficulty falling and staying asleep, but a lack of sleep may lead to:

  • Decreased functioning
  • Increased physical inactivity
  • Longer pain duration
  • More severe pain

Jet lag happens when your circadian rhythm, your 24-hour sleep-wake cycle, does not match up with a new time zone. It can be hard to fall asleep temporarily if you experience jet lag as your body tries to adjust to that time zone. You can also feel tired during the day and have trouble waking, among other symptoms.

Certain types of medications can lead to or play a role in insomnia, such as:

  • Antidepressants
  • Antiseizure drugs
  • Asthma medications
  • Heart medications (e.g., albuterol)
  • Oral contraceptives
  • Over-the-counter allergy, cold, or flu medications
  • Steroids
  • Thyroid hormone preparations

Sleep problems and mental health disorders—especially mood disorders—are linked. Some mental health disorders associated with insomnia include:

Research has found that night-shift workers experience sleep loss and are sleepier during their shifts. Like jet lag, working night shifts can affect a person’s circadian rhythm. 

During their shifts, night shift workers are forced to be awake during darkness when they would be asleep. This can make it hard to fall asleep when a shift ends at daylight as sunlight prompts them to stay awake.

Experiencing stressful events can make it difficult to fall asleep—something that can be measured by sleep reactivity.

Sleep reactivity refers to how much stress interrupts a person’s sleep. Researchers found that, on the one hand, individuals who have low sleep reactivity tend to have fewer problems with sleep when they’re stressed. On the other hand, people with high sleep reactivity experience greater sleep disturbance during stressful periods.

When you’re at a point of being unable to sleep, there are a few things you can do:

  • Focus on breathing: Another way to quiet your thoughts can be through simple breathing exercises. Deep, slow breathing can also slow your heart rate, which can be helpful if you’re anxious or stressed about something.
  • Get out of bed: If you lie awake for more than 20–30 minutes, you should get out of bed and do something quiet until you’re sleepy again.
  • Listen to a podcast: Podcasts or audiobooks can be good alternatives to reading if you don’t want to turn on a light or strain your eyes. Just remember to find a topic that’s not too exciting or upsetting.
  • Make a to-do list: Try writing a specific one for at least five minutes before falling asleep. One found that writing out a long, detailed to-do list of future tasks helped people fall asleep much faster than those who wrote about tasks they’d already accomplished that day.
  • Read a book: Since digital screens can further disrupt sleep due to the blue light that emits, reading a physical book can be a great alternative to reading on an electronic device.
  • Try soothing sounds: A white noise machine or app may help remind you of relaxing times and ease your mind.

Everyone has a sleepless night once in a while. If you can’t fall asleep regularly, it’s time to talk to a healthcare provider. They can help you evaluate whether any current medications or lifestyle habits contribute to your insomnia and offer some solutions.

People can have a hard time falling asleep for many reasons. Those reasons range from bedtime habits and stress to chronic pain or mental health disorders. Some ways to help you fall asleep include doing relaxing activities or using soothing sounds. If at-home remedies don’t help, it’s best to see a healthcare provider for persistent sleep problems.


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