If you feel exhausted all day yet can’t sleep at night, the reason is that tiredness and sleepiness are not the same thing. Tiredness is a lack of energy; sleepiness is the biological signal that it is actually time to sleep. In insomnia the body is tired but the nervous system stays switched on — so the cure is not to force sleep, but to restore the body’s ability to feel sleepy at the right time.

Why am I shattered all day but wide awake at night?

It is one of the questions I hear most often: “How does it make sense that I’m wiped out all day — and then at night I can’t sleep?” It is frustrating, confusing and very common. Many people assume that being tired should automatically bring sleep. But in sleep there is a big difference between tiredness and sleepiness.

Tiredness is a lack of energy. Sleepiness is a clear biological signal: now is the time to sleep. In insomnia, something else happens — the body is tired, but the nervous system is on high alert.

What keeps the system switched on?

Several common factors weaken the natural drive to sleep:

  • Ongoing stress
  • Worry about sleep itself
  • Spending too long in bed
  • Trying to “make up” for lost sleep with daytime naps

Each of these chips away at sleep pressure — the build-up that should make you sleepy at bedtime — and keeps you in a state of alert just when you most want to wind down.

How does treatment help?

Cognitive behavioural therapy for insomnia (CBT-I) does not try to “knock you out”. It restores the body’s ability to feel sleepy at the right time — by rebuilding sleep pressure, calming evening arousal and breaking the habits that undermine the system. When that happens, falling asleep becomes natural again. CBT-I is the treatment recommended by NICE and the NHS as the first-line approach for chronic insomnia.

If you are tired all the time but sleep keeps slipping away, you can change it. Take a short insomnia self-assessment or book a consultation with Dr Jonathan Kushnir, clinical psychologist (HCPC PYL042430).

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