Why does exercise seem to worsen my insomnia?

Question

Hello doctor,

I am 28 years old and have been dealing with insomnia for almost two years. Everyone keeps telling me that exercising more will help me sleep better. I tried going to the gym four times a week for three months, but my sleep actually got worse instead of better. I am now averaging only three to four broken hours of sleep each night. A cortisol test I took came back at 22 mcg/dL in the evening, which my GP said is higher than expected.

I have been prescribed Zopiclone for short-term use, but I am worried about becoming dependent on it. My psychiatrist mentioned that I might have hyperarousal-type insomnia, where my nervous system remains overly activated. Exercise tends to make my heart race at bedtime, even when I work out in the morning.

I also have mild anxiety, which I am treating with Escitalopram at a dose of 10 mg. Why does exercise seem to worsen insomnia for some people, and what approaches could actually help someone like me, who is 28 and struggling with this type of sleep disorder?

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and would like to help you with your problem.

Your symptoms align with a condition known as hyperarousal insomnia, where the brain and nervous system remain excessively alert, leaving you feeling wired but tired. In this situation, exercise may sometimes worsen sleep rather than improve it because it can increase adrenaline, cortisol, heart rate, and overall body activation.

Your elevated evening cortisol levels, racing heart at bedtime, broken sleep, and anxiety further support this possibility. Chronic insomnia can also lead to increased cortisol levels, creating a cycle of stress and sleeplessness.

For some individuals, intense workouts or heavy gym routines can overstimulate the nervous system. Gentler activities, such as walking, yoga, stretching, tai chi, or light exercise, are often better tolerated.

Typically, the most effective long-term treatment for chronic insomnia is Cognitive behavioral therapy for insomnia (CBT-I), rather than mainly relying on sleeping pills. CBT-I helps retrain the brain and reduce sleep-related hypervigilance and anxiety.

While Zopiclone can provide short-term relief, prolonged use may lead to tolerance, dependence, and rebound insomnia.

Escitalopram can sometimes contribute to insomnia or restlessness in certain individuals, so it is important to discuss medication timing and effects with your doctor.

The primary issue may not be a lack of tiredness, but rather that your nervous system remains too activated to allow for normal sleep.

I hope I have addressed all of your queries and concerns. Please follow up whenever needed.

Take care and have a nice day.