7 Possible Reasons You Can’t Sleep, and What You Can Do to Get Rest

An estimated 35% of American adults have trouble falling asleep or staying asleep — the hallmark symptoms of insomnia.

So why are so many people having trouble catching enough z’s? People have trouble falling and staying asleep for a variety of reasons, from insomnia to mental health conditions and medication side effects. But understanding the cause of your sleep issues can help you understand how to address them.

Quiz: Do I have insomnia?

Why can’t I sleep?

There are many reasons you could be having trouble falling or staying asleep. Below, we discuss seven common reasons people can’t sleep.

1. Insomnia

Insomnia results in an inability to fall asleep, stay asleep, or get a good night’s sleep. It’s a common sleep disorder. In fact, an estimated 30% of people worldwide have insomnia. The symptoms of insomnia include:

• Laying awake for a long time after going to bed, unable to fall asleep

• Waking up throughout the night or staying awake most of the night

• Waking up too early and not being able to fall back asleep 

• Feeling tired when waking up and throughout the day

You’ve probably had a poor night’s sleep at least once in your life. But that doesn’t necessarily mean you have insomnia. Insomnia typically lasts longer than a few nights. There are two types of insomnia:

• Short-term insomnia: Short-term insomnia can last up to 3 months. Researchers think it’s caused by changes in your body that trigger alertness. Sleep specialists also point to an increase in chemicals in your body designed to wake you up. 

• Chronic insomnia: Chronic insomnia lasts longer than 3 months and may be a symptom of another condition (such as clinical depression). Or it can be a condition on its own.

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2. Other sleep disorders

It’s also possible you can’t sleep because you may have another sleep disorder. Other common sleep disorders that can keep you up at night include: 

• Restless leg syndrome

• Sleep apnea

• Parasomnia

• Disorders that affect your natural sleep-wake cycle, also called your circadian rhythm

3. Stress

If you’re experiencing stress, that could be another reason you can’t sleep. Stress-inducing situations, like having a bad week at work or worrying about an upcoming event, can cause short-term insomnia. 

Your body is more activated when you’re stressed, because it’s preparing to respond to a threat. As a result, you may feel more tense, have an increased heart rate, or have trouble relaxing and falling asleep.

4. Mental health issues

Many mental health conditions can impact your sleep and make it difficult to fall or stay asleep. Common conditions that lead to difficulty sleeping include:

• Anxiety disorders

• Major depression

• Post-traumatic stress disorder (PTSD)

5. Medication side effects

Several medications can interfere with sleep. Examples of medications that can lead to trouble sleeping are: 

• ADHD medications like mixed amphetamine salts (Adderall) and methylphenidate (Ritalin) 

• Beta blockers like carvedilol (Coreg), metoprolol succinate (Toprol XL), and propranolol

• Cholinesterase inhibitors, which treat Alzheimer’s disease, including donepezil (Aricept, Adlarity)

• Decongestants like Sudafed (pseudoephedrine)

• Levothyroxine (Synthroid)

• Nicotine skin patches (Nicoderm CQ)

• Selective serotonin reuptake inhibitor (SSRI) antidepressants like citalopram (Celexa) and fluoxetine (Prozac)

• Steroids like dexamethasone (Decadron) and methylprednisolone (Medrol)

• Theophylline (Elixophyllin, Theo-24)

6. Physical health conditions

A medical condition could be the underlying reason you can’t sleep. The following conditions are often associated with difficulty getting enough sleep:

• Gastroesophageal reflux disease (GERD)

• Asthma and other chronic respiratory conditions

• Heart disease

• Cancer

• Diabetes

• Joint diseases

• Parkinson’s disease

• Chronic pain

7. Sleep environment issues

Your sleep environment can have a big impact on your ability to sleep well. The best sleep environment is cool, quiet, and dark. If your sleep space is too hot, loud, or bright, it may be difficult to fall or stay asleep. Factors such as having an uncomfortable mattress or pillow may also make it difficult to sleep.

In addition, neighborhood noise can make sleep a challenge for even the soundest of snoozers.

15 things to try when you can’t fall asleep

A restful sleep begins before you hit the sack. It starts with careful planning, strategizing, and having the right tools. A good sleep routine can help even if your struggles are caused by a medical condition or your medications. Just keep in mind that addressing any underlying issues with your healthcare provider is also key to your sleep success. 

The following tips may help you fall asleep faster and stay asleep longer:

1. Be consistent. Go to bed at the same time and get up at the same time each day to get your body and mind into a good routine.

2. Shoot for 7 to 9 hours. Studies show that adults should sleep 7 to 9 hours a day to get the best health benefits.

3. Create a relaxing environment. Make sure your bedroom is dark, quiet, cool, and comfortable for optimal sleep conditions. 

4. Go wireless. Turn off your cell phone at least 30 minutes before bedtime and remove it from your bedroom. A small study suggests that using a cell phone after turning off the lights before bed disrupts sleep.

5. Limit your bed to sleep and sex. Don’t use your bed for things that may keep you awake, like eating, reading, or watching TV. Sleep experts say sex should be the only stimulating activity you do in bed. This will help you associate your bed primarily with sleep.

6. Get moving. Studies show that regular exercise can improve the quality and length of your sleep. Just don’t get your workout in right before bedtime. 

7. Avoid heavy meals before bed. If you’re hungry before you go to sleep, snack on something light and healthy. Eating a heavy or spicy meal too close to bedtime may upset your stomach and keep you from sleeping.

8. Say no to joe. Limit your consumption of caffeinated beverages, like coffee, to earlier in the day. Caffeine is a stimulant that can stay in your body for over 6 hours.

9. Nix the nightcaps. Alcohol may make you feel sleepy at first, but over time it hinders how well you snooze and raises daytime sleepiness. 

10. Take a warm shower or bath. Jump in a warm shower or bath about 45 minutes before you head to bed. Your body will register the dip in temperature when you step out as a signal to sleep.

11. Wait 20 minutes. If you’re unable to fall asleep after 20 minutes of being in bed, get up and do a relaxing activity that doesn’t involve a lot of light. Go back to bed when you feel sleepy.

12. Try sleep meditation. You can find calming, guided meditations online or through a sleep app. Research suggests meditation can lower your stress and may help people with chronic insomnia see improvement in their symptoms.

13. Practice progressive muscle relaxation. During progressive muscle relaxation, you’ll tense and then relax each muscle in your body, which may help you fall asleep. 

14. Use your imagination. Think about calm, peaceful scenes or imagine falling asleep and getting a good night’s rest to settle your mind.

15. Focus on your breathing. Deep breathing may help your body relax, lower your blood pressure, and produce feelings of well-being that may calm you enough to fall asleep. 

What else can I do if I can’t sleep?

Even if you make your sleep space feel like a soothing spa and try all of the tips mentioned above, you may still not get enough shut-eye. If that’s the case, it may be time to call in a professional. But who exactly should you talk to? Below, we review a few options. 

Primary care provider

Your primary care provider may be able to help you in a number of ways. First, if your sleep problems are caused by a medical condition or a medication, your provider can work with you to address the underlying issue. 

Or, after looking through your medical history, your primary care provider may ask you to keep a sleep diary to track your sleep and bedtime habits. They may also recommend that you get a sleep study. Or, depending on your symptoms and how severe the issue is, your provider may recommend medications for sleep, counseling, or a combination of both. 

Sleep specialist

Sleep disorder specialists are healthcare providers who have extra training in sleep medicine. They often work with a team that may include a behavioral sleep specialist, a physician assistant, and a sleep technologist. This type of team can perform your sleep study, interpret the results, and go over treatment options with you. 

Telemedicine provider

Providers can also treat sleep disorders over telemedicine. A telemedicine provider can: 

• Order a home study for sleep apnea

• Help you adjust your CPAP therapy device

• Manage your medications

• Help you find a behavioral counselor if needed

More get-to-sleep resources

There are several organizations that post tips for sleeping better and keep up with the latest sleep research. You can learn more about getting better sleep by visiting these organizations’ websites. Here are a few good places to start: 

• American Academy of Sleep Medicine

• American Sleep Association

• American Sleep Apnea Association

• National Heart, Lung, and Blood Institute

Why trust our experts?

Written by:

Ana Gascon

Ana Gascon has over 15 years of writing and editing experience, with 8 years in health and medical content work. She is a versatile health and medical content creator who writes about acute conditions, chronic diseases, mental health challenges, and health equity.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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