Bandai Choi
Clinical Psychologist | Board-approved supervisor
Breathe-n-Smile Psychology, Essendon North, Footscray and telehealth across Australia
I am exhausted. Why does trying harder to sleep seem to keep me awake?
When sleep becomes a task to complete, clock-watching, checking whether you are relaxed and fearing tomorrow's exhaustion can maintain alertness. These forms of “sleep effort” contribute to some insomnia patterns. Assessment can explore what first disrupted sleep and what now keeps the difficulty going, then identify suitable support.[1]
TL;DR
- Sleep effort and worry about wakefulness may help maintain alertness.[1]
- Assessment considers nights, daytime effects, health, medicines and daily circumstances.[1][3]
- Australian guidance recommends multi-component cognitive behavioural therapy for insomnia (CBT-I) as first-line care.[1]
- Bring a brief account of the pattern to a suitable professional rather than designing a strict sleep schedule yourself.[2]
Bedtime starts to feel like a test
Consider a hypothetical example. You have a meeting tomorrow and go to bed early to secure enough rest. When sleep does not come, you check the time, calculate the hours remaining and monitor your heartbeat and breathing. Each attempt is followed by another check: “Did that work?” Even relaxing becomes a task to perform correctly.
Australia's 2026 adult insomnia position statement describes how thoughts, rituals and behaviours intended to produce sleep can become counterproductive.[1] The useful question is what a particular habit does in your pattern.
Notice whether you are enjoying a wind-down activity or repeatedly testing whether you should be asleep yet. That distinction can be discussed in an appointment.
Why can sleep remain difficult after the original problem changes?
Stress, health problems, medication changes, shift work or another disruption may begin the difficulty. Worries and habits can then help maintain it. The Sleep Health Foundation describes how the bed can become associated with being awake and alert, known as conditioned arousal.[2]
For example, checking how tired you are whenever you lie down may turn bed into a place for assessing tomorrow's performance. Therapy can explore how that pattern developed and discuss different responses.
Sleep also depends on timing and actual circumstances. Caring, shift work, pain or noise may reduce the opportunity to sleep. These need attention alongside psychological patterns.[1]
What would assessment explore?
Bring approximate bed and waking times, difficulties falling or staying asleep, daytime effects and how long this has continued. A doctor or suitable sleep professional may also review physical health, pain, mood, medicines, caffeine and work arrangements.[1][3]
Tell your doctor about loud snoring, observed breathing pauses, uncomfortable legs or unintentionally falling asleep during the day. These details may indicate a need to assess other sleep problems.[3]
A brief morning sleep diary can help. Rough estimates are useful; you do not need to watch the clock all night. The record should help understanding rather than become another task to perform perfectly.[1][2]
What does CBT-I involve?
CBT-I combines sleep education with cognitive and behavioural work to address factors maintaining insomnia. Australia's 2026 joint statement recommends multi-component CBT-I as first-line treatment and says sleep-hygiene advice alone is insufficient for chronic insomnia.[1]
Work can explore more than caffeine or a relaxing bedtime routine. It may include predictions about a poor night, attempts to control sleep and their effects overnight and during the day. The approach should fit assessment and circumstances.[2]
Some methods change time-in-bed arrangements and need to consider health history, daytime sleepiness, work safety, shifts and caring responsibilities with a suitable professional.[1] Treatment also involves practice and review. One night's immediate result does not capture the whole process.
What should I ask a psychologist?
Describe the main problem, such as getting to sleep, worry after waking or spending the day fearing the next night. Psychological assessment can explore sleep alongside anxiety, mood and daily responses. If seeking CBT-I, ask about relevant training, whether the clinician provides it and whether medical or other sleep assessment is needed.[2][3]
Options may include CBT-I from trained clinicians or other evidence-supported formats suited to the person. Ask what is actually provided, how it fits your life and how progress will be reviewed.[1]
Our anxiety and stress page explains support for ongoing worry. Our starting therapy guide describes an initial psychological conversation.
Make the first discussion manageable
Bring one or two recent evenings. When did “I must sleep well tonight” begin? What happened next? Which part of the following day was hardest? These details can help without a perfect set of sleep rules.
Include real work, household and caring demands. If a proposed approach cannot fit your circumstances, tell the clinician so it can be adjusted. If sleepiness affects driving or other safety-sensitive activities, avoid doing them while unsafe and discuss this with your doctor.[1]
Persistent sleep difficulty that affects life is worth assessing. Ask what information is needed next, who will address each part and when the approach will be reviewed.
Four useful starting points
- Briefly record approximate sleep patterns and daytime effects each morning, without tracking minutes all night.
- Notice one repeated check or test of sleepiness to discuss in therapy.
- Tell your doctor about health, medicines, shifts, caring duties and unusual sleep symptoms.
- Ask about training, the proposed method and how health and safety needs will be considered.
You may also be interested in
- Anxiety and stress support: when worry starts to affect the whole day.
- Sudden anxiety during perimenopause: when sleep changes overlap with that transition and emotional difficulties.
- Starting therapy: preparing for an initial appointment.
Common questions
Can I discuss CBT-I without an anxiety diagnosis?
Yes. CBT-I targets insomnia and does not require an anxiety diagnosis. Suitability depends on the sleep pattern, health context and assessment.[1]
Does psychological treatment mean stopping sleeping tablets immediately?
Do not stop or change medicines yourself. Medical care and CBT-I can work together where appropriate; discuss medication arrangements with the prescribing doctor.[1]
Get in touch
Breathe-n-Smile Psychology offers clinical psychology support for adults and adolescents.
Appointments are offered in Essendon North and Footscray, with telehealth across Australia.
To enquire or book, call 0431 828 769, email reception@breathe-n-smile.com, or use our online enquiry form.