At 25, what is causing my insomnia?

Question

Hello doctor,

I am 25 years old and have been suffering from insomnia for almost 8 months now. I barely sleep 3 to 4 hours at night, and by afternoon, I am completely drained. But the strangest and most frustrating thing is, why does a 25 year old with insomnia find they cannot nap even when exhausted? I lie down during the day, and my body just will not shut off, even though I am running on almost no energy.

My mind keeps racing even when I am physically tired. My physician ran some thyroid tests (TSH came back 3.2, which is normal) and ruled out sleep apnea. I am currently trying melatonin 5mg, but it is barely doing anything. No psychiatrist has been consulted yet, but I feel like this is affecting my concentration and work badly now. Please tell me, could this be hyperarousal of my nervous system or some anxiety-related issue?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

What you are describing is actually very common in chronic insomnia, especially in younger adults, and it can feel incredibly frustrating because your body feels exhausted while your brain refuses to switch into sleep mode.

In many people with long standing insomnia, the problem is not a lack of tiredness but a state called hyperarousal, where the nervous system remains excessively alert even when the body needs rest. This can happen with

Anxiety.
Chronic stress.
Excessive mental thinking.
Irregular sleep habits.
Sensitivity.
Sometimes, after months of poor sleep itself.

The fact that you cannot nap despite severe fatigue strongly supports this pattern because your brain is essentially stuck in a wakefulness state. People often describe racing thoughts, feeling wired but tired, being very aware of every sensation while trying to sleep, and becoming increasingly focused on whether they will sleep or not.

Over time, your brain can unintentionally associate the bed and daytime rest with frustration and alertness rather than relaxation.

Your thyroid-stimulating hormone (TSH) of 3.2 being normal and sleep apnea being ruled out are reassuring, although insomnia can still occur independently of physical disease. Melatonin sometimes helps mild circadian rhythm problems, but it is often not very effective for chronic hyperarousal insomnia, especially at higher doses, where it may even feel less useful for some people.

Anxiety does not always appear as obvious panic or worry, either. Sometimes it presents mainly as physical alertness, racing thoughts, muscle tension, inability to switch off, and nonrestorative sleep.

Since this has lasted 8 months and is now affecting concentration and work, it would be reasonable to discuss this with a psychiatrist or sleep specialist because chronic insomnia is very treatable, particularly with cognitive behavioral therapy for insomnia, which is considered one of the most effective long term treatments. They can also assess whether underlying anxiety, depression, burnout, or another sleep disorder is contributing.

In the meantime, try to avoid forcing naps, avoid clock watching at night, limit caffeine even earlier in the day than you think necessary, keep a consistent wake time every day, reduce screen exposure before bed, and use the bed only for sleep rather than lying there awake for long periods.

The inability to nap despite exhaustion does not mean your body is broken. It usually means your nervous system has become stuck in an overactivated, sleep resistant pattern that can improve with the right treatment and sleep retraining approach.

I hope this information helps you.

Feel free to ask further queries.

Thank you.