Why Can’t I Sleep? 4 Areas to Check Before Trying Another Sleep Tip
If you’ve ever Googled “Why can’t I sleep?”, you’ll know there is no shortage of answers.
Stop using your phone.
Take magnesium.
Go to bed earlier.
Have a hot bath.
Make your bedroom colder.
Try white noise.
Get eight hours.
And if it’s your child who won’t sleep? There’s another enormous list of bedtime routines, sleep schedules and things you’re apparently supposed to be doing.
But there’s a problem with all of this.
You’re being given solutions before anyone has worked out what the problem actually is.
Whether you’re struggling to fall asleep, waking up in the night, waking too early, feeling exhausted despite sleeping, or trying to understand why your child or teenager can’t sleep, I’d start somewhere completely different.
I’d look at four areas.
Why am I not sleeping properly?
Poor sleep isn’t one problem.
Two people can both say “I can’t sleep” and have completely different things going on underneath.
One person might have plenty of opportunity to sleep but not enough sleep pressure.
Another might be tired but trying to sleep at a time their body clock isn't ready for.
Someone else may be experiencing insomnia, where sleep itself has become associated with worry and alertness.
And sometimes symptoms such as snoring, restless legs, breathing changes during sleep or excessive daytime sleepiness can indicate that something medical needs investigating.
The same is true when we're looking at sleep problems in children and teenagers.
So before changing your bedtime routine or trying another sleep hack, these are the four areas I want you to think about.
1. Medical conditions and sleep disorders
This always comes first.
Because sometimes poor sleep isn't really a “sleep hygiene” problem at all.
Conditions such as obstructive sleep apnoea and restless legs syndrome can significantly disrupt sleep. Pain, medication, hormonal changes including menopause, and other health conditions can affect sleep too.
For children, regular snoring, mouth breathing, unusual breathing during sleep, very restless sleep or excessive tiredness during the day are things I would want to know about.
And this is important:
You cannot sleep-hygiene your way out of an untreated medical problem.
If something doesn't feel right, it deserves proper investigation rather than another bedtime tip.
My free Four-Area Sleep Check includes medical questions and links to recognised screening tools, including STOP-Bang where appropriate, to help you understand whether further investigation may be worthwhile.
The guide doesn't diagnose a sleep disorder. It helps you know what to look for and when it might be worth speaking to your GP or another appropriate healthcare professional.
2. Sleep pressure: are you actually ready to sleep?
This is one of the most overlooked parts of sleep.
Your body has a natural drive for sleep known as sleep pressure.
From the time you wake up, that pressure gradually builds. Generally, the longer you've been awake, the greater your drive for sleep becomes.
Which is why being tired and being ready to sleep aren't always quite the same thing.
After a bad night, it's completely understandable to try to compensate.
You might go to bed earlier.
Have a nap.
Lie in.
Spend longer in bed because you desperately need more sleep.
But those behaviours can change the amount of sleep pressure you've built by bedtime.
Sleep pressure matters for children too, although age and development are really important here. Naps are biologically appropriate for younger children, for example, but the timing and duration of sleep across the day can influence when they're ready to sleep again.
So if you're asking:
“Why can't I sleep even though I'm tired?”
Or:
“Why is my child taking so long to fall asleep?”
Sleep pressure is one of the things worth looking at.
3. Circadian rhythm: what time does your body think it is?
The next area is your circadian rhythm, often called your body clock.
Your circadian rhythm helps regulate when you feel alert and when you feel sleepy across roughly 24 hours.
And your brain needs signals to keep that clock synchronised.
One of the most important is light.
Morning and daytime light help tell the brain:
It's daytime. Be awake.
As light reduces later in the day, your biology receives a very different signal.
This distinction between day and night helps your sleep system know when to promote alertness and when to promote sleep.
This is one reason I talk so much about getting daylight during the day, rather than simply frightening everyone about blue light at night.
Circadian rhythm is particularly important when we're talking about teenage sleep.
During adolescence, sleep timing naturally tends to shift later. A teenager who doesn't feel sleepy particularly early in the evening isn't necessarily being difficult or refusing to sleep.
Their body clock may genuinely be telling them something different.
Body-clock timing can also be particularly relevant for shift workers, people with irregular schedules and anyone who finds themselves wide awake at night but desperately sleepy in the morning.
Sometimes the question isn't simply:
“How can I sleep more?”
It's:
“Am I trying to sleep when my biology is actually expecting sleep?”
4. Your nervous system: are you tired but wired?
You can have plenty of sleep pressure.
Your body clock can be beautifully aligned.
And you can still get into bed and suddenly feel...
wide awake.
This is the classic “I'm exhausted but I can't sleep” experience.
Your head hits the pillow and your brain starts:
What time is it?
How long have I got left?
Why am I not asleep yet?
I'm going to be shattered tomorrow.
Maybe I should try that breathing thing.
Is it working?
Perhaps I'll check the time again...
This is where the nervous system becomes really important.
Sleep is an automatic biological process. We can't force ourselves to sleep.
And sometimes the harder we try, the more alert we become.
For adults with insomnia, this relationship between bed, sleep, worry and alertness can become particularly important.
But children can experience their own version too.
Bedtime anxiety, separation, fear, sensory needs, big emotions and difficulties transitioning from the activity of the day can all affect a child's ability to settle.
For neurodivergent children, including children with ADHD or autism, I'd also want to understand their individual sensory and regulation needs rather than simply imposing a generic bedtime routine.
Again, the question isn't:
“What's the perfect bedtime routine?”
It's:
“What's keeping this particular brain and body awake?”
What is actually causing your sleep problem?
This is where sleep becomes much easier to understand.
Rather than asking:
“What should I do to sleep better?”
Start by asking:
“Where is my sleep getting stuck?”
Is there something medical that needs ruling out?
Have you built enough sleep pressure?
Is your circadian rhythm working with the sleep schedule you're trying to keep?
Or is your nervous system remaining alert when you want it to switch off?
It might be one area.
It might be several.
And that's why the sleep tip that completely transforms one person's sleep can do absolutely nothing for somebody else.
Start with the free Four-Area Sleep Check
I've created a free downloadable Four-Area Sleep Check to help you work through exactly this.
It's designed for adults, children and teenagers and takes you through the four areas I look at when trying to understand a sleep problem:
Medical factors and sleep disorders: Sleep pressure, Circadian rhythm and body clock, Nervous system and regulation.
It also points you towards appropriate established screening tools where symptoms suggest something may need further investigation.
You don't need to try every sleep tip on the internet.
First, understand the sleep problem you're actually trying to solve.
Find the driver. Then choose the lever.
Kerry Davies — The Sleep Fixer,
Sleep specialist and CBT-I therapist helping adults, children and families understand what's getting in the way of sleep.
The Four-Area Sleep Check is an educational resource and does not diagnose sleep disorders or medical conditions. If you are concerned about your own or your child's health, breathing during sleep, excessive daytime sleepiness or other symptoms, speak to your GP or an appropriate healthcare professional.
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