Why You Can’t Sleep (and How to Fix It) | Dr. Michael Grandner

Sleep is a biological function that works best when you stop trying to force it; chronic sleeplessness is rarely a lack of skill, but rather the result of "conditioned arousal" where the brain associates the bed with stress. The most effective solutions involve behavioral retraining—specifically Cognitive Behavioral Therapy for Insomnia (CBT-I)—rather than relying on sedatives or supplements to "fix" the issue.

• Conditioned arousal — Chronic sleeplessness often stems from your brain associating the bed with anxiety and effort rather than rest [06:05].

• Stimulus control — To break negative associations, keep the bed strictly for sleep:

  • Get up if you cannot fall asleep after a short while [22:04].
  • Avoid staying in bed to scroll on your phone [19:13].
  • Sit or stand elsewhere until your body naturally feels tired [21:05].

• Sleep apnea prevalence — This condition is surprisingly common and often goes undiagnosed in fit individuals, leading to fragmented, shallow rest [39:24].

• Morning light — Exposure to outdoor light shortly after waking helps set your internal clock more effectively than rigid bedtimes [1:25:51].

• Melatonin usage — This is a signaling hormone for darkness, not a sedative; low doses [0.5mg] at the right time are often more effective than high doses [1:44:06].

• Wearable data — Metrics regarding sleep/wake times are generally reliable, but proprietary "sleep scores" are estimates that should be interpreted with caution [2:45:11].

• Injury prevention — Consistent sleep quality is a better predictor of athletic injury risk than simple sleep duration [3:22:50].

• How can I distinguish between a standard nighttime awakening and the signs of sleep apnea?

• What are the reliable methods for testing sleep apnea at home?