Why Do I Feel "Tired but Wired"?
Exhausted all day but wide awake at night? You aren't crazy. Learn the science behind the "tired but wired" feeling, how anxiety medication plays a role, and how to reset your body's rhythm.
It is 10:00 PM. You have been dragging yourself through the day, drinking coffee just to function, dreaming of your pillow.
But the moment you lie down and turn off the lights? Ping. Your eyes pop open. Your heart beats a little faster. Your thoughts start racing like a ticker tape of worries.
You are exhausted, but you cannot sleep. You are "tired but wired."
At NBCG, this is one of the most common complaints we hear. Patients often think they just have "bad insomnia," but "tired but wired" is usually a sign of something deeper: a dysregulation of your body's stress system or a side effect of your medication.
Here is why your body is hitting the gas and the brake at the same time.
1. The Biological Cause: The HPA Axis and Cortisol
To understand this feeling, you have to understand the HPA Axis (Hypothalamic-Pituitary-Adrenal Axis). This is your body's central command for stress.
How it should work: Cortisol (the stress hormone) should be high in the morning to wake you up, and low at night to let you sleep.
The "Tired but Wired" Curve: Chronic stress flips this curve. If you are anxious all day, your body keeps pumping out cortisol. By nighttime, your cortisol is still elevated.
Your body is physically exhausted (tired) from the energy drain of the day, but your brain is chemically flooded with stress hormones (wired). It is biologically impossible to relax because your brain thinks there is a tiger in the room.
2. The Anxiety Connection: "High-Functioning" Anxiety
This symptom is a hallmark of Generalized Anxiety Disorder (GAD), specifically in high performers.
If you are someone who "powers through" stress during the day, you are suppressing your anxiety to get work done. When you finally stop moving at night, that suppression lifts, and the anxiety comes rushing back. The "wired" feeling is essentially your unprocessed stress catching up with you.
3. The Medication Factor: Is Your Rx Helping or Hurting?
Sometimes, the "tired but wired" feeling isn't the condition—it's the treatment. If you are currently taking medication, here are three possibilities to discuss with your provider:
The "Activation" Phase: When starting a new antidepressant (SSRI/SNRI), some patients experience "activation syndrome"—a temporary spike in jitteriness or energy before the therapeutic mood benefits kick in.
Timing Matters: If you take an energizing medication (like Wellbutrin or certain SNRIs) too late in the day, it can interfere with your sleep architecture.
The Stimulant Trap: Many adults are prescribed stimulants for ADHD. If your root issue is actually anxiety, stimulants can exacerbate the "wired" feeling, masking the exhaustion without solving the focus issue.
4. How to Reset the Rhythm
You cannot force yourself to sleep, but you can coax your cortisol down.
Morning Light is Key: The best way to fix your night is to fix your morning. Viewing sunlight within 30 minutes of waking anchors your circadian rhythm, telling your body to dump cortisol now so it isn't high later.
Adjust Your Schedule: If your bedtime seems too late, gradually adjust your sleep schedule by hour (or less) increments to give your brain time to acclimate to the new schedule. Stay consistent every day once you go to sleep and wake up at the desired times.
The "Worry Dump": 2 hours before bed, write down everything you are worried about and the next step for each. This tells your brain, "It's handled," so it doesn't need to review the list at 2:00 AM.
Caffeine Cut-off: Limit your caffeine and alcohol intake before bed. Both substances disrupt sleep, further influencing circadian rhythms
Establish an Evening Routine: Create a predictable sequence of relaxing activities, such as reading or a warm bath, to signal to your brain that the day is over. This consistent ritual helps lower your heart rate and prepares your nervous system for a transition into deep rest.
Power Down Blue Light: Disconnect from all screens—including phones, tablets, and computers—at least one hour before bed. Blue light suppresses melatonin production, tricking your brain into thinking it is still daytime and making it harder to fall into a natural sleep cycle.
When to Seek Help
If you have been feeling "tired but wired" for more than two weeks, and sleep hygiene isn't fixing it, it is time to look at your biology.
At NBCG, we don't just guess. We can look at your hormone levels, review your medication timing, and evaluate if your anxiety needs a different approach.
You deserve to rest. Let us help you find the "off" switch.
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References & Clinical Data
For those who want to review the clinical science behind stress and sleep, we recommend the following sources.
The Stress-Sleep Connection:
Harvard Health: Understanding the Stress Response A detailed overview of how the HPA axis functions and how chronic stress keeps the body in a state of high alert.
Cortisol & Insomnia:
Sleep Foundation: Cortisol and Sleep Explains the "cortisol curve" and how high evening cortisol levels physically prevent the onset of sleep.
Medication Side Effects:
NIH / PubMed: Antidepressant-Induced Activation Syndrome Clinical research on "activation syndrome," the jittery or restless feeling some patients experience when starting SSRIs.
Magnesium & Anxiety:
National Institutes of Health (NIH): Magnesium and Sleep A double-blind clinical trial reviewing how magnesium supplementation can lower cortisol and improve sleep efficiency.
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Additional Resources
Helpful tools and articles for managing your daily rhythm.
Anxiety & Depression Association of America (ADAA): Sleep Disorders A patient guide distinguishing between simple insomnia and anxiety-induced sleep disruption.
Huberman Lab: Toolkit for Sleep Science-based protocols for using light, temperature, and timing to regulate your circadian rhythm.
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Stop Running on Empty.
If you are stuck in the cycle of exhaustion and anxiety, our medication management and therapy teams are here to help you reset.
Call us to schedule a consultation: (801) 806-4799
Learn more about our anxiety services: www.neurobcg.com
