Why can't I sleep even though I'm tired?

If you are exhausted but still cannot sleep, the problem is rarely your bedtime routine. Chronic insomnia is usually kept going by two things sleep hygiene never touches: a nervous system that has learned to stay alert in bed, and the sleep systems that are built during your day, not at night. That is also where the fix lives.

Kate Blyth, Sleep Coach at Autonomy.

Most of the people I work with are not sleeping badly for lack of trying. By the time we speak, they have usually worked hard at trying to problem solve their way out of it. They have often focused on improving their ‘sleep hygiene’: things that have become commonly accepted as important for sleep, such as a consistent bedtime, cutting out caffeine, and avoiding screens before bed, along with a wind-down routine they have refined down to the last detail. They have often tried everything that mainstream advice touts as a solution, and yet they are still lying awake, increasingly convinced that the fault must sit with them, that perhaps their sleep chemistry is broken.

But what if I told you that you cannot lose your ability to sleep, that you do not need the perfect wind-down routine, that your bedtime does not need to be exactly the same every night, that screen light from your phone has less of an influence than it has been made out to be, and that when we try to micromanage sleep, it usually backfires?

Sleep advice is everywhere now, and it is talked about more in the wellness space than ever before. In one sense, the increased attention is a good thing: sleep is finally being understood and prioritised for the vital repair work it does. But it has also created a lot of noise and misinformation. It’s common for a weak research study to get flattened into a headline, amplified across media, and quickly become accepted as mainstream fact. Before long, a product often launches to profit from the claim, such as blue light blocking glasses.

When sleep feels difficult, it is natural to reach for a promising quick fix, and that wellness industry has a significant influence on the sleep advice most people end up hearing. We are drowning in information about sleep, and I suspect it is making our sleep worse, not better. A 2025 survey by the American Academy of Sleep Medicine supports this, finding that 76 percent of adults have lost sleep simply from worrying about their sleep.

So why is it possible to try all the ‘top sleep tips’ and still struggle?

Does sleep hygiene actually work for insomnia?

Sleep hygiene supports sleep, but it does not treat chronic insomnia. A cool, dark room and skipping a coffee before bed are genuinely helpful, but they are not the solution for chronic insomnia, much like good dental hygiene helps prevent a cavity, but we do not then assume we can treat the cavity by flossing harder.

Part of the reason the advice keeps missing the mark is that the research on what actually resolves chronic insomnia is often misinterpreted by mainstream media, and sensational headlines and more marketable advice tend to spread faster. Sleep hygiene advice has evolved from a general list of behaviours that a researcher identified in the 1970s as broadly supportive of sleep into a one-size-fits-all rule book that it was never intended to be.

With sleep, what matters is targeting the behaviours that directly support our biological sleep systems, namely sleep drive and circadian rhythm, while also addressing the nervous system activation that can override our ability to sleep during times of stress.

These habits are rarely as appealing as a quick fix, which may be one reason they do not receive the attention they deserve. A well-branded sleepy hot chocolate can be a more appealing solution than the foundational daily practices of building consistent behaviour change over time, yet the importance of seemingly small, targeted habits, repeated consistently, is hard to overstate.

Why does insomnia continue after the stress has passed?

Because what triggers insomnia is not what keeps it going. The original stressor often resolves, and the sleep problem stays, maintained by an entirely different set of factors.

For many people, persistent sleep difficulties often start with a stressful period, such as illness, job loss, grief, divorce, menopause or simply a demanding stretch of life, and any of these can trigger a period of poor sleep. It is a normal nervous system response for sleep to become unsettled during a difficult time. Our biology has evolved to keep us more vigilant when there is a predator or danger nearby, and these days, work stress or other pressures can still trigger that same response. For many people, sleep settles again once life stabilises, but often the sleep difficulty becomes a perpetuating cycle.

During a period of poor sleep, it is natural to try to solve the problem, as life can be incredibly challenging when running on little sleep. So when it lingers it is natural to start researching sleep advice, adjusting routines, experimenting with supplements, and generally paying closer attention to how you sleep. This response is completely logical, and in most other areas of life, careful problem-solving leads to improvement (effort usually equals reward), whether that is working hard to earn a promotion or building muscle at the gym. The problem is not that people are not trying hard enough, it is that insomnia is one of the few problems where trying harder often becomes part of the problem. Gradually, and often without realising it, the mind begins monitoring sleep more closely: “I can’t have another bad night,” or “How will I function tomorrow if I don’t fall asleep soon?”

On top of this, once insomnia has become a long-term pattern, it is often being maintained by factors that are different from the ones that triggered it. One of the most common is a conditioned response, where the brain itself begins to associate being in bed with hypervigilance rather than sleep. There may also be physiological factors at play, such as circadian misalignment, while in some cases an underlying sleep disorder may be presenting as insomnia but have a different root cause altogether, such as sleep apnea.

How do you build better sleep during the day?

Sleep is built during the day, not at bedtime. It is not switched on by command at night, and better sleep starts long before you get into bed.

When people try to solve sleep by focusing on what they do right before bed, they are often missing this more fundamental principle. There are two biological systems running in the background that control far more of this than people realise: sleep pressure, the drive your body builds throughout the day, and circadian rhythm, the clock that tells your body when to do what. Sleep does not happen simply because you lie down at bedtime. It is regulated by these two systems, which determine when sleep is possible and how restorative it will be once it arrives. Understanding this shifts the real question from ‘What do I do at bedtime?’ to ‘How am I using my day to support sleep?’

These sleep systems are intangible, which is also why I think they often do not get the weighting they deserve. You cannot feel adenosine, the molecule behind sleep pressure, building through the day. You cannot see that the lighting in your office is, biologically speaking, closer to dusk than daylight, even though your body reads it that way. The link between a flattened or misaligned circadian rhythm and poor sleep quality, reduced mood and alertness, and overall cellular and hormonal incoherence is often not linked back to the upstream signalling of a weakened circadian rhythm. I try to help people address those upstream signals, so that every other aspect of health Autonomy is helping you achieve is supported by the right signals for optimal cellular functioning. So I often find that the things that actually move the needle rarely get the credit and prioritisation they deserve.

What actually treats chronic insomnia?

The gold standard treatment for chronic insomnia is cognitive behavioural therapy for insomnia (CBT-I). It is recommended by every major sleep and medical association worldwide, and it is the first-line treatment for long-term insomnia, despite sleeping tablets still being more routinely prescribed.

My approach is evidence-based and grounded in CBT-I. Alongside this, I integrate elements of acceptance and commitment therapy and applied chronobiology.

I think of this as practical sleep recalibration: an approach that works with both behavioural patterns and underlying biology, addressing root causes rather than band-aid solutions.

I have also lived through the fog of chronic insomnia myself, and I know first-hand how life-changing it is to get back the clarity and energy that comes with improved sleep. That experience is what fuels my motivation to help others break the cycle.

I aim to help people take the stress out of sleep and build their own toolkit for establishing a stronger sleep baseline and greater resilience during challenging periods. Part of this is helping people trust their body’s innate ability to sleep, because when the right conditions are in place across the day and the nervous system feels safe enough to let go, sleep arrives more easily.

What we do at Autonomy

Chronic insomnia is unique to each individual and requires a thorough assessment of both psychological and physiological drivers. The team at Autonomy work collaboratively to investigate the root drivers for each person. This integrative approach encompasses cognitive, behavioural and physiological factors. The team assess whether something physiological is present alongside the behavioural drivers that can maintain persistent insomnia, such as: a disrupted cortisol rhythm, a thyroid issue, low iron, unstable overnight glucose, or undiagnosed sleep apnea.

That is why we do both. I work with people using CBT-I, acceptance and commitment therapy, and applied chronobiology to rebuild the behavioural and circadian foundations of sleep. Alongside that, the Autonomy clinical team can investigate whether something physiological is adding to the picture – measuring rather than guessing – so that nothing is missed and both sides of the problem are addressed at the same time.

Most people start with a Discovery Consultation. It is 30 minutes, and its purpose is not to sell you a programme. It is to work out what is actually driving your sleep problem, and to tell you honestly what would help – including if that is something we do not offer.

Kate Blyth

Sleep Coach

Medically reviewed by Dr Ula Heywood. Published 16 July 2026.

 Book a Discovery Consultation today!

BOOK NOW

American Academy of Sleep Medicine. (2025). Worried and wired: What’s keeping America awake. https://aasm.org/worried-and-wired-whats-keeping-america-awake/

Bauducco, S., Pillion, M., Bartel, K., Reynolds, C., Kahn, M., & Gradisar, M. (2024). A bidirectional model of sleep and technology use: A theoretical review of how much, for whom, and which mechanisms. Sleep Medicine Reviews, 76, 101933. https://doi.org/10.1016/j.smrv.2024.101933

Ellis, J. G., Perlis, M. L., Espie, C. A., Grandner, M. A., Bastien, C. H., Barclay, N. L., Altena, E., & Gardani, M. (2021). The natural history of insomnia: Predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia. Sleep, 44(9), zsab095. https://doi.org/10.1093/sleep/zsab095

Hauri, P. (1977). Current Concepts: The Sleep Disorders. Upjohn Company.

Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10(4), 541–553.