Why Can’t I Sleep?

Why Can’t I Sleep?

woman with insomnia on bed in Chicago, thinking about CBT-I

You may find yourself struggling with getting to sleep. Perhaps it’s only been for a couple of weeks, or maybe it’s been for years. When we struggle with sleep, it can feel like we’re struggling with everything else in our lives. But insomnia is a common sleep disorder that affects millions of people worldwide. 

Insomnia is characterized by difficulty falling asleep, staying asleep, or both, despite having adequate opportunity to sleep. Insomnia can have a significant impact on someone’s quality of life, as it can lead to daytime fatigue, irritability, and difficulty concentrating. But what causes insomnia, what does it really look like, and how can you cope with not getting enough sleep and learn to sleep better? 


What are the causes of insomnia?


There are many different factors that can contribute to the development of insomnia. Some of the most common causes of insomnia include:


Stress and Anxiety

Stress and anxiety are two of the most common causes of insomnia. When you’re stressed or anxious, your body releases stress hormones such as cortisol, which can make it difficult to fall asleep or stay asleep. A lack of sleep, lower quality sleep, and nightmares or night terrors can also contribute to an increase in stress and anxiety, which then turns into a feedback loop. 


Environmental Factors 

Environmental factors such as noise, light, and temperature can also contribute to insomnia. For example, if your bedroom is too hot or too cold, or if there’s too much noise or light, it can be difficult to get a good night’s sleep.

But this can also include things like a tense living situation, a stressful job, or a difficult relationship. 


Medical Conditions

Medical conditions such as depression, chronic pain, sleep apnea and restless leg syndrome can also contribute to insomnia. These conditions can make it difficult to fall asleep or stay asleep, create discomfort while sleeping, and even compound the night for sleep. This can lead to daytime fatigue and an increase in symptoms which then exacerbate sleep even more.


Lifestyle Factors

Lifestyle factors including caffeine consumption, alcohol use, and irregular sleep schedules can also contribute to insomnia. If you consume caffeine or alcohol close to bedtime, or if you don’t have a consistent sleep schedule, it can make it difficult to get a good night’s sleep.

Alcohol may help someone get to sleep, but the quality of sleep is actually decreased, and alcohol often leads to more waking up throughout the night. 


What Can I Do About Insomnia?


In order to improve your insomnia, you have to know what type of insomnia you’re dealing with, which is determined by the root cause of the issue.

There are two main types of insomnia: acute insomnia and chronic insomnia.


Acute Insomnia

Acute insomnia is a short-term sleep disorder that typically lasts for a few days to a few weeks. It can be caused by a stressful life event, such as a job loss or a relationship breakup, an illness or pain, and typically resolves on its own once the underlying stressor is resolved.


Chronic Insomnia

Chronic insomnia is a long-term sleep disorder that typically lasts for more than three months. At times, the strategies people use to cope with a bout of acute insomnia can actually perpetuate it where it develops into a chronic condition and may require treatment to resolve.

The treatment of insomnia depends on the severity and underlying cause of the condition. In some cases, simple lifestyle changes may be enough to improve sleep quality, while in others, intervention may be necessary. 


Treatments For Insomnia


Cognitive Behavioral Therapy for Insomnia (CBT-I): 

CBT-I is a form of therapy that helps individuals identify and modify negative thoughts and behaviors that contribute to insomnia. This therapy can be done individually or in a group setting and is considered the gold standard of non-drug treatments for insomnia.



There are several medications that can be used to treat insomnia, including over-the-counter and prescription medications. Over-the-counter medications, such as antihistamines, can help with occasional insomnia, while prescription medications, such as benzodiazepines and non-benzodiazepine sedative-hypnotics, can be used for short-term treatment of insomnia.  

However, these medications can have side effects and risks, including adverse cognitive effects (such as memory loss), psychomotor effects (such as falls, fractures, road traffic crashes), daytime sleepiness, and addiction. Additionally, research shows that these medications don’t truly help in the long term. Medications should only be used under the guidance of a healthcare provider and considered on a temporary basis until the root of the sleep issue can be addressed. 


Relaxation Techniques

Relaxation techniques, such as progressive muscle relaxation, deep breathing, and guided imagery, can help reduce stress and promote relaxation, which can improve sleep quality. Headspace is a great resource that offers breathing exercises, body scans, visualizations, and other tools that can help you relax and fall asleep easier. 


Sleep Hygiene

Sleep hygiene refers to the practices and habits that promote good sleep. This includes maintaining a regular sleep schedule, creating a comfortable sleep environment, avoiding stimulating activities before bed, limiting caffeine and alcohol intake, and avoiding naps during the day.


The Importance of Sleep 


Unfortunately in our increasingly busy lives, we often stop prioritizing sleep, particularly when one is experiencing insomnia as they might not even “feel” tired. 

When we are stressed, anxious, or depressed, we may instead focus on external tasks as the key to helping our mood and making it easier to sleep. And while stress does make it harder to sleep and stay asleep, not sleeping does lead to increased stress. Research has shown that not getting enough sleep impacts us heavily in terms of our mental health and our mood. 

It’s important to note that treatment for insomnia should be tailored to the individual and may require a combination of approaches. As a psychologist who has worked in sleep medicine, and treated insomnia for over a decade now, I’m a HUGE proponent of CBT-I. If you are struggling with persistent insomnia and are finally ready to start taking steps to sleeping better, reach out for a free consultation to see if CBT-I can help.

I offer individual online therapy for insomnia and am trained as a certified mindfulness-based stress reduction teacher. Mindfulness techniques can help you learn how to manage anxiety and stress through creating more of an understanding of the emotions within the body and can help you get more in touch with your values and needs, and less anxiety and less stress equates to more sleep. 

I am a Licensed Clinical Psychologist trained in CBT-I and I work with clients in the United Kingdom, United States, or elsewhere in the world. So, if you’re looking for a counselor in Chicago (or almost anywhere in the United States or the world) and are interested in learning more about how I could help you, please don’t hesitate to contact me