Common Causes Of Trouble Sleeping And Strategies To Improve Sleep And Mental Health

Medically reviewed by Melissa Guarnaccia, LCSW
Updated March 21st, 2025 by BetterHelp Editorial Team

According to the Center for Disease Control and Prevention’s National Health Interview Survey (NHIS), in 2020, 14.5% of adults reported experiencing trouble sleeping every day or most days over the previous month. Persistent difficulty getting enough high-quality rest can result in a number of potential health challenges, from an increased risk of dementia, heart disease, depression, and certain cancers to trouble functioning and a higher likelihood of accidents. That said, there are a number of strategies that may help improve both the quality and the quantity of a person’s sleep, which can support physical and mental health in turn. Keep reading to learn more about some common causes of trouble sleeping and a few key tips for improving sleep patterns. 

An older woman sits on a couch, her face resting on her hand, looking worried.
Getty/fizkes
Are you having trouble sleeping?

Defining trouble sleeping (insomnia)

Insomnia refers to difficulty falling asleep or staying asleep long enough to get high-quality rest. Research suggests that approximately 10–15% adults experience chronic insomnia. A person with insomnia will typically experience one of these three types:

  • Initial insomnia, which typically causes difficulty falling asleep
  • Late insomnia, which refers to a tendency to wake up too early in the morning and not be able to fall back asleep
  • Middle insomnia, which refers to a tendency to wake up in the middle of the night and have trouble falling back asleep

If you’re experiencing symptoms of a sleep disorder like insomnia or others, it’s generally recommended that you meet with your doctor for evaluation and a diagnosis, if applicable.

How sleep apnea can affect the quality of your rest

Sleep apnea is another sleep-related condition that could make it hard for a person to regularly feel rested. The term comes from the Greek term “apnoia,” which means “without breath.”

The most common form of sleep apnea is obstructive sleep apnea. It’s typically caused by a collapse of the upper airway tissues, cutting off airflow, which often leads a person to suddenly awaken and begin breathing again. Some people are prescribed a special machine called a continuous positive airway pressure (CPAP) to help reduce the impacts of sleep apnea on their rest. These machines deliver constant air pressure into a person’s airway to keep it open during sleep. 

Other sleep disorders a person may experience

Another category of sleep disorders that can cause sleep disruption is shift work disorders. These tend to occur in people who work night shifts or rotating shifts. Working different shifts can disrupt a person’s circadian rhythm, or sleep-wake cycle, which can make it difficult to fall asleep when it’s time to rest.

Sleep quality can also be disrupted by sleep-related movement disorders. These disorders may cause some people to move their legs involuntarily during sleep. Or, a person may experience sleepwalking or a REM behavior disorder. During the latter, a person may not lose control of their limbs as most people do during a REM cycle, which may lead them to act out their dreams.  

A man sits on a couch, gazing into the distance with a pensive expression.
Getty/RealPeopleGroup

How insufficient sleep can affect mental health and overall well-being

According to the National Institutes of Health (NIH), getting sufficient sleep can be important for a number of critical mental and physical processes. The NIH reports that good sleep can be important for things like brain function, decision-making, emotional regulation, attention, and creativity. 

In contrast, a lack of quality sleep over time could increase the risk of health challenges like:

  • Obesity
  • Type 2 diabetes
  • Cardiovascular conditions
  • Certain types of cancer
  • Depression
  • Anxiety
  • Psychosis, paranoia, and hallucinations
  • Chronic pain

In other words, poor sleep can not only affect mental health but also physical well-being and many other facets of life. That’s why improving sleep hygiene and health is a common mental health topic.

Tips for improving sleep

Various strategies may help a person improve both the quantity and quality of their sleep. Those who experience poor sleep may benefit from implementing a sleep hygiene plan, which refers to positive sleeping habits. For example, those who work a typical day shift may benefit from setting an evening bedtime and keeping to it as much as possible. Sleep hygiene can also involve getting exercise at least four times per week, but not within three hours of bedtime, as exercise before bedtime may make it difficult to fall asleep. Sleeping in a cool, dark, quiet environment and limiting caffeine may be helpful as well.

Another component of hygiene that may help is to avoid screen time at least two to three hours before bedtime. According to Harvard Medical School, blue light from screens may affect a person’s circadian rhythm or sleep cycle, making it more difficult to fall asleep. 

Stress reduction and its role in getting quality rest

Another strategy that may help with trouble sleeping is to implement stress reduction techniques. For example, some people may find that they sleep better if they practice deep breathing exercises on a regular basis. Examples include techniques like box breathing, pursed lip breathing, and diaphragmatic breathing. 

Getting mental health support for trouble falling asleep

Individuals who experience difficulty sleeping may also benefit from speaking with a licensed mental health professional. A therapist may be able to uncover sources of stress and address any mental health conditions that might be interfering with a person’s rest. Therapists can also offer stress reduction strategies that might increase relaxation and reduce the time it takes to fall asleep. 

A woman sits at a table, focused as she types on her laptop.
Getty/d3sign
Are you having trouble sleeping?

How online therapy may help those who can’t fall asleep 

Some people who experience trouble sleeping may have difficulty attending traditional in-person therapy sessions. For example, they may work long hours and/or sleep during the day to make up for lost sleep. In these cases, they might find it convenient to seek support through online therapy instead. 

Online therapy allows people to connect with a therapist from home or anywhere with an internet connection at a time that suits their schedule, often even in the evenings and on weekends. Online therapy also can be more affordable than in-person therapy without insurance. 

In addition to offering flexibility, research suggests that online therapy can be effective for treating a number of disorders, including insomnia. For instance, one study published in the journal Sleep suggests that cognitive behavioral therapy for insomnia (CBT-i) can be just as effective when delivered online as when delivered in person. 

Takeaway

Trouble sleeping can be related to a variety of factors, including sleep disorders and chronic stress. People experiencing difficulty sleeping may benefit from seeing a specialist to get any sleep disorders diagnosed in addition to implementing a comprehensive sleep hygiene plan. Working with a therapist may also be helpful.
Learn the impacts of sleep deprivation
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started