Why do people get insomnia even though they are exhausted?
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One of the more common reasons involves day/night (circadian) rhythms. Your brain tracks not only how long you’ve been awake and how much sleep you’ve gotten recently, but also roughly what sun time it is. If all is well, you don’t make melatonin until sundown, and your sleep and night signals line up. However, if you’ve recently flown a couple thousand miles east or west, or work weird shifts, you’re not synced with the sun. If you stay up using a computer or phone, or being under bright lights, you suppress melatonin production. The result of all of these is a mismatch between the part of your brain saying “we need sleep” and the part saying “it’s daytime, we need to wait.”
People with chronic insomnia also tend to have a lot of counterproductive habits. Bed goes from being a calming sleepy place to an irritating/anxious place associated with tossing and turning, where they check the clock to see how bad their sleep is (but actually get less and less accurate at estimating sleep timing.) The fear of insomnia becomes a vicious cycle of trying too hard and being keyed up at night, enough to overcome the brain’s sleep drive.
Circadian rhythm problems are treated with careful management of bright light, darkness, and sometimes added melatonin. Other insomnia responds well to a brief course of specialized therapy that helps counter the thoughts and habits messing with sleep.
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