Why can’t I sleep and what can I do about it?

Written By: Tzvi Prochnik, LCSW

Picture this: you’re lying in bed at 2:00 AM, unable to sleep. Your mind is racing with everything you’re stressed about—bills, news, environmental disasters, or that embarrassing comment from a work meeting earlier that day. You try to distract yourself by scrolling on your phone, but it doesn't help. As the clock ticks down, you start worrying about whether you'll be able to function tomorrow. With only four hours left before your alarm goes off, you wonder: Is something wrong with me? Do other people struggle with sleep like this too?

The good news is that you’re not alone. Sleep disorders are remarkably common in modern society; estimates suggest that 33% to 45% of American adults will experience a sleep disorder at some point in their lives. Unfortunately, misinformation about sleep abounds—from myths about how much sleep we actually need, to confusing a single bad night with a chronic disorder, to ineffective fixes. While companies often push expensive cooling mattresses, supplements or sleep-tracking gadgets, this article covers the fundamentals of one of the most common sleep issues—insomnia—and offers practical, evidence-based ways to address it.

Insomnia is defined as difficulty falling asleep, staying asleep, or achieving restful sleep despite having adequate time and a suitable environment. It generally falls into two categories: acute insomnia, which lasts from a few days to a few weeks and is typically triggered by a short-term stressor or life event; and chronic insomnia, which occurs at least three nights a week for three months or longer. Both forms can stem from a combination of genetic, environmental, physical, and psychological factors.

One of the simplest places to begin tackling insomnia is with sleep hygiene—the foundational habits and environmental factors that support restful sleep. Key strategies include:

●     Consistent scheduling: Going to bed and waking up at the same time every day (even on weekends) helps train your internal body clock. Aim for 7 to 9 hours of uninterrupted sleep time, limit daytime naps to 45 minutes or fewer early in the day, and get natural sunlight first thing in the morning.

●     Optimizing your environment: Keep your bedroom cool (ideally 65–68°F), minimize light and noise, and reserve your bed strictly for sleep and intimacy.

●     Adjusting evening habits: Cut off caffeine by 2:00 PM, avoid heavy meals and alcohol close to bedtime, and reduce screen time before sleep.

●     Winding down: Establish a relaxing pre-bedtime routine—such as reading a book, listening to calm music, or watching a low-stimulation show—to help put your mind at ease.

If you are already practicing good sleep hygiene and still struggle with persistent sleep issues, structured therapeutic protocols can help. The gold standard treatment for chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). Under the guidance of a licensed professional, CBT-I helps retrain your mind and body to achieve sleep naturally through several core components:

●     Stimulus Control: Re-establishing the association between your bed and sleep by using the bedroom only for sleep and intimacy. If you lie awake for more than 20 minutes, you leave the bedroom and engage in a quiet, low-stimulation activity until you feel sleepy again.

●     Sleep Restriction: Temporarily limiting your time in bed to match the actual amount of time you spend asleep (for instance, 6 hours). This increases sleep efficiency so your brain learns to associate being in bed with continuous sleep.

●     Cognitive Restructuring: Identifying and challenging anxious beliefs about sleep—such as “If I don’t sleep eight hours tonight, I won’t be able to function tomorrow”—to reduce pre-bedtime anxiety.

●     Relaxation Training: Incorporating techniques like deep breathing and progressive muscle relaxation to lower physiological arousal before bed.

 

Although sleep restriction can be challenging at first, CBT-I is remarkably effective, boasting a success rate of 70% to 80% for resolving chronic insomnia. So, the next time you’re struggling with your sleep, try out some of these tips or reach out to a mental health provider trained in CBT-I. Good luck and good night!

  

**For additional reading material on this topic, I recommend:

●     Why We Sleep: Unlocking the Power of Sleep and Dreams by Matthew Walker, PHD.

●     For a self-help CBT-I protocol: Sleep through Insomnia by Brandon R. Peters, M.D.