What Causes Insomnia and How to Sleep Better

Kerri Masutto, MD
November 19, 2018

We’ve helped hundreds of our patients at Parsley Health answer the question, “Why can’t I sleep?” But the answer is usually more complex than people think. Here’s what’s keeping you up at night and what you can do about it.

If you suffer from insomnia (myself and about 60 million other Americans included), reading another suggestion to turn your phone off two hours before bed and wake up at the same time every day as the solution to all of your sleep woes can be downright infuriating.

While those habits can certainly help a lot of people improve their sleep quality, if you truly suffer from insomnia, it’s usually not that simple. After yet another restless (or worse, completely sleepless) night, you’re probably already worried about what tonight has in store for your sleep.

I think that’s the worst part about insomnia: the lack of control you have over it. You feel very much at the mercy of your mind, body, and some other unseen force that seems to decide on a whim whether or not you’ll sleep that night.

In this article, I hope to help you gain some knowledge to feel empowered to tackle your sleep issues, both on your own and with the help of a qualified medical practitioner. Let’s dive into what really causes insomnia and how you can start taking back control of your sleep.

What causes insomnia?

The truth is, insomnia is a complex disorder caused by a lot of different physical and mental components that play together in a few different ways . I like to break these factors down into what’s keeping you up in the first place, what’s triggering poor nights of sleep, and how your insomnia can turn from occasional to chronic. Looking at your sleep (or lack thereof) in this way can be very empowering because you can often find what those initial sleep-disturbing factors were and how you may have perpetuated the problem.

What’s keeping you up in the first place

There are a few things that can make it easier to disrupt your sleep and circadian rhythm. These are issues that need to addressed as a root cause of disrupted sleep. If one of these issues has kept you from sleeping well, then they will continue to keep you from sleeping well in the future:

  • Prescription and over-the-counter medications, alcohol, and caffeine
  • Physical illness or injury
  • Mental illness
  • Lifestyle factors like shift work or jet lag

How to fight back

Oftentimes sleep disturbances cause by predisposing factors go away when the underlying factor is fixed. These usually need to be addressed through major lifestyle changes, as well as working with a medical professional who can help you diagnose and treat any underlying conditions, both obvious and hidden. At Parsley Health, we do a thorough examination and use advanced testing to look for hormonal imbalances, vitamin and mineral deficiencies, an imbalanced gut microbiome, and other things that may be contributing.

What triggers a night of poor sleep

Certain things can prompt sleep disturbance events, especially when stacked on top of the factors above:

  • Stress related to work, family or health challenges
  • Negative life events such as divorce, death, or job-loss
  • Positive life events such as an upcoming wedding or birth of a child

How to fight back

You may need the help of a mental health professional to resolve the underlying stress that may be manifesting as anxiety , depression, or even PTSD. Learning the skills needed to deal with the ups and downs of life are so critical for a lot of different reasons, not just sleep.

How your insomnia turns from occasional to chronic

Often, the things that are keeping us up or triggering a night of poor sleep lead us to do things to compensate for the sleep disruption. This can end up making insomnia worse and can turn it from a short-term nuisance into a chronic, debilitating condition. Some commons things I see include:

  • Developing anxiety and worry about not being able to sleep
  • Spending a lot of time in bed when you can’t sleep (this includes laying in bed awake, watching TV, or reading)
  • Napping or sleeping too much outside of normal sleep times
  • Turning to medications, caffeine, and alcohol to try to combat daytime sleepiness and then to help you fall asleep
  • Trying to “force” yourself to sleep (yeah, that never works)

How to fight back

These are the factors that are most in your control and there are a number of things you can do to sleep better.

How to sleep better

You can learn to control some of the major factors that impact your sleep, starting with your body, mind, and bed. Here’s how:


Reduce physical symptoms of medical conditions that are making it hard to sleep by working with your doctor.

Get moving first thing in the morning and use your body throughout the day. Our bodies are designed to sleep when they’ve been used! I didn’t go camping until I was 34 because I was always worried I’d never be able to sleep (since I often couldn’t sleep in even the most ideal of circumstances.) Turns out if you hike 12 miles with a 30lb backpack at 10,000 feet of elevation, you sleep no matter how uncomfortable the bed (or lack thereof) you’re in.

While that’s obviously not useful for every day, it was a big wake-up call (no pun intended) to me that my body needs to be used in order to be physically tired at the end of the day.

Monitor how caffeine and alcohol effects you. Everyone has differing levels of sensitivity to caffeine and alcohol. Figure out yours. For some people, one cup of coffee in the morning can be enough to keep you up. Others can down an espresso right before bed. Alcohol pretty much universally screws up your sleep cycles, so pay attention to how much you’re imbibing before bed. Often even hours before bed and in small doses can still have an impact.


Practice sleep hygiene. Minimizing electronics and bright light before bed, waking up at the same time every morning, and keeping your bedroom dark and quiet are all important – but as you probably already know, they don’t work by themselves.

Quiet your mind. Reason #1,928,134 to meditate… In all seriousness, a patient told me the other day, “I started meditating and my insomnia got 90 percent better—it’s amazing!” Find a meditation practice that works for you and get started today.

Re-frame your relationship to insomnia by no longer thinking of yourself as a victim. That means stop saying “I’m an insomniac.” Instead, you’re someone who is currently dealing with some issues that have manifested as insomnia in your life. That doesn’t mean you’ll always have insomnia. It doesn’t mean it’s incurable. Focus on the facts and view each day as an observable experiment.

Slept poorly last night? Think about the factors that could be contributing. It’s amazing how much this shift can change your relationship from an anxiety-producing illness, to merely a symptom that you’re working on figuring out how to deal with.


Make your bedroom feel like a sanctuary. Your sleep environment actually makes a big difference in the quality of your sleep. It should be a space that makes you feel nothing but joyful when you walk into it. That means no piles of clothes or dust-covered nightstands.

I resisted this for a long time in my own life, telling myself that “You don’t see your bedroom when you sleep so how much of a difference can it make?!” Boooooy was I wrong.

Clear the clutter and leave only beautiful items sitting out that bring you joy. Soft, ambient lighting (I use Himalayan salt lamps) and live plants can totally shift the energy of the room.

Invest in a good mattress, pillows, and bedding. I used to balk at the idea of spending more than $40 for a set of sheets. But it makes a huge difference. When your bed feels like a luxury getaway and your space feels light and warm, you go to bed with a smile and a feeling of peace. That goes a long way.

The takeaway on treating your insomnia

Sleep is still one of the most complex and least understood functions of the human body. And yet it’s also one of the most foundational. If anything, I hope you can start to see insomnia not through the lens of frustration and despair, but instead with curiosity and hope. There is so much you can do on your own to help get better sleep . But if that’s not enough, please know that you are not alone in needing support around this issue. I still struggle with this on a regular basis, but have found immense relief in improving my sleep after nearly 2 decades of suffering. Find a qualified doctor that will really listen to your story, dig deep into finding the root cause of your issue and partner with you to create a plan that works for you in your real life.

Kerri Masutto, MD

Dr. Kerri Masutto is an Internal Medicine primary care physician with an integrative, whole-person approach to medicine who graduated from The College of Medicine at University of Illinois. With training in primary care, plus ongoing education through the Institute for Functional Medicine she creates a unique healing experience for anyone looking to improve their health and their life.

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