Lights out but no sleep: four stories
Imagine Solomiia: all day she longs for rest, but in bed she goes over every unfinished task. The more often she looks at the clock, the tenser she becomes.
Or Vadym, who goes to bed earlier at weekends after late shifts but still falls asleep at his usual late time. His difficulty is mainly about his schedule.
Or Nestor, who opens the news in bed “just for a minute”. An hour later he is still scrolling, and when he finally puts the phone down, thoughts about what he has read keep him awake.
Or Lada, who falls asleep on the sofa watching a series, but when she moves to bed, sleep is gone. She lies there tired but cannot fall asleep again.
Solomiia is kept awake by thoughts about tasks, Vadym by a shifted schedule, Nestor by the news before bed, and Lada by the fact that her sleep started outside her bed. The section “Why does tiredness not always lead to sleep?” explains why tiredness does not always lead to sleep.
If at least one of these stories resembles yours, note what happens for you after the lights go out. If none of them fits, the questions in the section “What happens after the lights go out?” can help you describe it.
What happens after the lights go out?
Difficulty falling asleep is a state in which it takes noticeably longer than usual to fall asleep after going to bed. Think about last evening and answer these questions:
- How much time passed from the moment you went to bed until you fell asleep?
- Did you feel sleepy when you went to bed?
- What kept you awake: anxiety, inner tension, a stream of thoughts or your phone?
- How long has falling asleep been difficult, and how many nights a week does it happen?
- Do you also wake during the night or too early in the morning?
- The next day, do you feel tired, sleepy, irritable or less able to concentrate?
If you do not yet feel sleepy when you go to bed, your bedtime may be the issue. If you feel sleepy but thoughts or tension keep you awake, start with the section “Taking pressure out of falling asleep”.
If falling asleep has been hard for several weeks, a doctor can help you understand what is getting in the way and find the right help.
Consultation booking form.Who to talk to about difficulty falling asleep
For new or persistent physical symptoms, start with a family doctor. Further investigations depend on your symptoms and examination, not a standard checklist. If anxiety or mood changes keep you from falling asleep, you can discuss this with a psychiatrist.
If you decide to book, the initial psychiatric consultation page lets you find out in advance how it goes. The profiles on the clinic’s doctors page can help you choose a specialist.
Taking pressure out of falling asleep
You cannot force yourself to sleep, but you can remove what gets in the way:
- Keep a fairly consistent wake-up time and go to bed when you really feel sleepy.
- If sleep does not come for a long time, get up briefly, go to another quiet place and do something inactive in dim light. Go back to bed when you feel sleepy again.
- Do not keep checking the time. Limit caffeine and other stimulants in the afternoon.
- If, like Nestor in our example, you read the news in bed, close the feed before you lie down.
For persistent difficulty falling asleep, one of the most studied non-drug approaches is cognitive behavioural therapy for insomnia (CBT-I).
Falling asleep or another sleep difficulty?
Difficulty falling asleep often comes alongside other sleep problems. Compare which is closer to your experience.
- Insomnia. It is hard not only to fall asleep but also to sleep without waking or long enough. See the page on insomnia.
- Frequent waking. You manage to fall asleep, but your sleep is interrupted during the night. Read more on the page about frequent night awakenings.
- Early waking. You fall asleep normally but wake long before the alarm. Compare with the description of early morning awakening.
- Anxiety. Before sleep your thoughts circle around worrying topics, as with Solomiia in our example, and they do not let go during the day. If anxiety persists together with low mood, see the page on anxiety with depression.
These difficulties often occur together, and one of them on its own decides nothing. If you recognised yourself in several points, tell your doctor.
Why does tiredness not always lead to sleep?
Tiredness and sleepiness do not always come at the same time. Falling asleep can be disrupted by tension, caffeine, late shifts or a bedtime that does not suit your rhythm, as with Vadym in our example. That is why it is important to discuss your schedule and how you feel, not just the minutes in bed.
If low mood and loss of interest in life persist along with difficulty falling asleep, a doctor may also assess for depression. Difficulty falling asleep on its own does not yet mean that you have this disorder.
Taking long to fall asleep: where to go from here
- If your need for sleep has suddenly decreased and you are experiencing unusually high energy, increased activity, faster speech or thinking, impulsivity or noticeable changes in behaviour, you should be evaluated by a professional.
- If sleep problems come with unpleasant sensations in the legs, loud snoring or pauses in breathing during sleep, a consultation is especially important: tell your doctor about these signs too.
- If difficulty falling asleep comes with marked anxiety, low mood or chronic pain, a consultation is also especially important.
- If the difficulty lasts several weeks, occurs regularly or leads to marked daytime tiredness, sleepiness, irritability or reduced performance, see a doctor.
- If falling asleep is hard only on some evenings, try the steps in the section “Taking pressure out of falling asleep”. If the difficulty goes beyond falling asleep, compare your state with the descriptions in the section “Falling asleep or another sleep difficulty?”.
If point 3 or 4 is closer to you, book a consultation. You can start by describing what happens after the lights go out.
Consultation booking form.Common questions
No: putting pressure on yourself can increase tension. If the problem repeats, discuss your evening routine, sleep timing and anxiety in bed.