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6 Reasons You Feel Tired But Can't Fall Asleep, According to Doctors

These are the most common causes for your sleeplessness.

It's a common misconception that if you feel tired, you should be able to fall asleep. But as anyone who's struggled with insomnia knows, feeling tired as you toss and turn at night is exceedingly common—and it's exactly what makes insomnia so excruciating.

Nilong Vyas, MD, the pediatrician and sleep expert behind the website Sleepless in NOLA and a Medical Review Expert at, says there's a difference between feeling sleepy and being tired.

"Feeling tired can occur for many reasons, including emotional stress, fatigue from overexertion secondary to exercise, a busy day, or even repeated days of interrupted sleep. Being sleepy results from chemical reactions in the brain that indicate to the body that it is time for rest," she tells Best Life.

Read on to learn which six things could make you feel tired without being able to fall asleep, according to doctors and sleep experts.

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You have poor sleep hygiene.

Woman watching TV in bed

Lifestyle habits factor in heavily when it comes to falling asleep, says Monique May, MD, acting Medical Advisor of Aeroflow Sleep and a board-certified family physician. She recommends practicing good sleep hygiene for a quicker transition to rest.

"Eating right before bed, drinking caffeine or alcohol before bed, using recreational drugs, smoking cigarettes, and poor sleep hygiene also can prevent one from falling asleep," May says. "Poor sleep hygiene means watching TV or any screens in bed, keeping irregular sleep hours, and using the bedroom for activities other than sleep and sex. Keeping the bedroom cool, dark, and quiet helps maintain sleep."

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Your medication is causing side effects.

Mature Man Scrutinizing His Perscription Medications Holding a Pill in One Hand and the Bottle in the Other In a Modern Home

Side effects from your medication may also leave you feeling physically tired but unable to fall asleep, the sleep specialist says.

In particular, "stimulating medications, such as those used to treat ADHD or depression, and diet pills can make falling asleep difficult," notes May. "Diuretics and laxatives, if taken too late in the day, can disrupt sleep by causing frequent bathroom trips. Other medicines that may cause problems include steroids, blood pressure, seizure, and pain medications," she adds.

If you are unsure of whether your medication or a combination of medications could be causing your sleeplessness, it's important to review your complete list of daily medications with your doctor or pharmacist. They can help identify whether your medication or a drug interaction is causing the problem.

Chronic pain is keeping you up.

A woman in pajamas sitting up in bed with her hand on her forehand as though she can't sleep
brizmaker / Shutterstock

Chronic pain is another common cause for sleeplessness, says Sean Ormond, MD, a dual board-certified doctor specializing in anesthesiology and interventional pain management with Atlas Pain Specialists in Glendale, AZ.

"Patients suffering from chronic pain conditions often struggle to find comfortable positions for sleep or may be awakened by pain," he tells Best Life. "Conditions like arthritis, fibromyalgia, and chronic back pain can significantly disrupt sleep. Pain-related insomnia can often be a vicious cycle, as lack of sleep can increase sensitivity to pain."

You're struggling with a mental health issue.

Anxious woman holding her hand up to her head.
fizkes / Shutterstock

Sometimes your body is ready for sleep, but your brain has other ideas. This is particularly common in people who are diagnosed with depression or anxiety, both of which are linked to higher rates of insomnia. In fact, according to Johns Hopkins Medicine, up to 75 percent of people with depression suffer from insomnia.

"People with these illnesses may find it difficult to 'turn their brains off' at bedtime. Schizophrenia and bipolar disorders can also make sleep difficult to find," says May.

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You have a sleep disorder.

Woman with insomnia lying in bed
Photoroyalty / Shutterstock

People with sleep disorders often have little trouble falling asleep, but find it difficult to stay asleep. However, "certain sleep disorders, such as sleep apnea, restless leg syndrome, and periodic limb movement disorder, can interfere with the ability to fall asleep or stay asleep," says Ormond.

That may be because the interruptions to your night-time sleep can disrupt your natural sleep cycle, leading to over-tiredness or disruptions to your circadian rhythm. Speak with a doctor if you experience frequent night wakings. They may be able to help you treat or mitigate the problem.

You have another underlying medical condition.

Doctor and Patient going over Treatment Plan

Finally, if you feel tired but can't fall asleep, it's possible that an underlying condition is to blame, says Ormond. "Medical conditions like heart disease, lung disease, diabetes, and neurodegenerative conditions can also impact sleep. Hormonal changes during the menstrual cycle and in menopause can also affect sleep," he says.

Speak with your doctor about your full range of symptoms to identify or rule out any underlying conditions that could be causing your insomnia.

Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. If you have health questions or concerns, always consult your healthcare provider directly.

Lauren Gray
Lauren Gray is a New York-based writer, editor, and consultant. Read more
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