Tired but can't sleep
In conversation, we tend to use 'tired' and 'sleepy' interchangeably but in reality they signal very different things and it is important to be able to tell the difference between them.
A person might feel extremely fatigued but, in fact, not be ready for sleep. As you may have experienced, feeling tired does not necessarily make sleep inevitable!
Feeling sleepy, on the other hand, is what is called a 'discriminative stimulus' for sleep; it predicts sleep is about to occur. So how can you tell if you really are sleepy-tired? Look out for signs such as: itchy eyes, a lack of energy, aching muscles, yawning and a tendency to “nod off”.
Heading to bed without having experienced any of these signs may make it less likely that you'll get to sleep quickly, and more likely that you'll find yourself lying awake, thinking about not sleeping.
An active mind
The 'racing mind', as it is known, is very common in poor sleepers. In fact, respondents to the Great British Sleep Survey revealed it to be the most frequent cause of their sleeplessness.
Whether you find yourself thinking about past or future events, or even trivial things that hold little importance, persistent thoughts can be enough to keep a very tired person from feeling sleepy.
The more your thoughts race, the more alert you become, even if you feel extremely tired.
It isn't just your thoughts that can prevent you from falling asleep – exercising shortly before going to bed or ingesting stimulants too late in the day can also deter sleepiness from setting in.
Whilst exercise has been shown to correlate with better sleep, intense aerobic exercise too close to bedtime may actually boost your energy, making it more difficult to get to sleep.
Similar effects can be caused by stimulants such as caffeine and nicotine. As stimulant drugs they can make it more difficult to reduce arousal and initiate sleep. Caffeine consumption, in particular, has been shown to result in a longer time to fall asleep.
What should you do when you are tired but cannot sleep?
The key is to stick to activities and habits that you find relaxing and help to reduce over-arousal, allowing sleep to overcome wakefulness.
People with sleep problems often have difficulty relaxing and 'letting-go'. It is really important therefore that you learn to let it happen and do not try to force it.
Different people find different activities relaxing so experiment to find what works best for you!
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, or 'CBT', works by addressing both the mental (cognitive) and behavioral factors that can prevent you from getting to sleep.
CBT trains you to use techniques that help overcome the negative emotions that accompany the experience of being unable to sleep. Alongside this, CBT can help you to establish a healthy sleep pattern and achieve a strong connection between bed and successful sleep, meaning that falling asleep becomes more automatic and natural.
The Sleepio course, a CBT-based sleep intervention, has also been shown to help people get to sleep faster and stay asleep through the night. In fact, participants in the clinical trial of the program, saw an average reduction in time to get to sleep of approximately 50% (Espie et al., 2012).
Espie, C.A., Kyle, S., Williams, C., Ong, J.C., Douglas, N.J., Hames, P., Brown, J.S.L. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.