Why Can't I Sleep? Common Causes and Solutions

Insomnia — the persistent difficulty falling or staying asleep despite adequate opportunity — is one of the most common health complaints in the UK, affecting around a third of the population at any time. But insomnia is not a single condition; it is a symptom with many possible underlying causes. Identifying which cause is driving your sleep difficulty is the first step toward addressing it effectively.

Anxiety and stress are the most common psychological causes of sleep disruption. The aroused nervous system that stress and anxiety produce is physiologically incompatible with sleep — the brain is in alert mode when it needs to be in rest mode. If your mind races at bedtime or you wake in the night with thoughts and worries, anxiety and stress are likely significant contributors.

Sleep anxiety — the fear of not sleeping — is a particularly common and self-maintaining cause. Once a person has experienced enough nights of poor sleep, the anticipation of lying awake itself becomes anxiety-provoking, which then activates the stress response and makes sleep even harder. This cycle can maintain insomnia long after the original precipitating cause has resolved.

Lifestyle factors are often underestimated. Irregular sleep and wake times disrupt the circadian rhythm. Evening screen use delays melatonin release. Excessive alcohol intake impairs sleep architecture. Insufficient physical activity reduces sleep pressure. Shift work and jet lag create direct circadian disruption. These factors are often addressable without professional help.

Medical causes of insomnia include sleep apnoea (pauses in breathing during sleep, often associated with snoring and daytime fatigue), restless legs syndrome, chronic pain, thyroid disorders, and the side effects of certain medications. These require medical assessment and, where identified, medical management. If your insomnia is accompanied by loud snoring, witnessed breathing pauses, or significant daytime sleepiness, see your GP.

Depression commonly disrupts sleep, typically producing early morning waking — waking hours before you wish to and being unable to return to sleep. If this pattern is accompanied by persistent low mood, loss of interest, and other depressive symptoms, professional support for the depression is the priority.

For the majority of people with ongoing insomnia — particularly anxiety-driven insomnia and the insomnia that perpetuates itself through sleep anxiety — hypnotherapy offers a highly effective and durable solution. It addresses both the psychological drivers of insomnia and the nervous system's learned relationship with sleep.