I can't sleep

Persistent trouble falling or staying asleep can stem from stress, anxiety, restless legs, or untreated sleep apnea. An online visit can rule out common causes and start the right treatment.

Also called: trouble sleeping · can't fall asleep · wake up at night

Medically reviewed by Dr. Ikechukwu Ogbu, MD
MD · Board-Certified, Internal Medicine · Last reviewed

Seek urgent care or the ER if you have:

  • Symptoms that are sudden, severe, or rapidly worsening
  • High fever (over 103°F / 39.4°C) that doesn't respond to treatment
  • Chest pain, trouble breathing, fainting, or confusion
  • Signs of dehydration — dizziness, dark urine, unable to keep fluids down
  • Symptoms in someone who is pregnant, immunocompromised, or over 65

What i can't sleep could be

The most common causes a clinician considers. This isn't a diagnosis — it's the differential a provider works through with you.

Insomnia

Insomnia is one of the more common causes of i can't sleep. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Anxiety

Anxiety is one of the more common causes of i can't sleep. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Restless legs syndrome

Restless legs syndrome is one of the more common causes of i can't sleep. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Typical workup

What a clinician usually orders or asks about when someone presents with i can't sleep.

  • Focused history: timing, triggers, severity, and prior treatments related to "i can't sleep"
  • Targeted physical exam of the involved system
  • Rule-in / rule-out workup for the most likely causes: Insomnia, Anxiety, Restless legs syndrome
  • Labs, imaging, or referral only when the answer will change management

When to see a clinician

  • Symptoms have lasted more than a few days without improving, or keep coming back
  • You're not sure if this needs antibiotics, prescription treatment, or watchful waiting
  • You have a chronic condition (diabetes, heart disease, immunocompromised) that raises the stakes
  • You want a same-day plan without a trip to urgent care

Common questions