Complex symptoms & the autonomic nervous system

Inner restlessness and exhaustion: Tired but not calm

Tino Both · 25 Jun 2026 · 7 min read

Briefly explained: Being exhausted and being able to settle are different things. Inner restlessness with sleep problems can arise from various physical, psychological and everyday factors. In my work, I am therefore interested in how your system responds to the specific task, as well as whether you try to relax.

Are you tired — and even relaxation feels like work?During the free initial telephone consultation, you can describe when restlessness begins, what makes it worse and what has already been assessed. Together, we explore whether support with Applied Neurofunction in Vilshofen fits usefully with your previous steps.

Discuss your restlessness and exhaustion →

The day is over. Your body keeps going anyway.

You only want to sit or lie down. At the same time, becoming still is difficult. Thoughts keep jumping, your chest feels tense or you constantly check whether relaxation has begun. Perhaps you eventually think, 'Apparently I cannot even rest properly.'

This is not a helpful judgement about yourself. Physical exhaustion, sleepiness and internal activation can diverge. Low energy does not automatically mean falling asleep easily. And feeling tense does not mean one single 'blockage' has to be found.

Why 'You just need to wind down' falls short

Too little opportunity to sleep, ongoing demands, pain, medication or caffeine may contribute. Worries, distressing experiences and mental health conditions also deserve attention. Physical and psychological aspects are not opposing explanations.

In Applied Neurofunction, I look more closely at the conditions: Does restlessness begin after visual demands? Does it increase when consciously controlling breathing? Is a particular situation decisive? These lead to different assessment routes, rather than the same calming exercise for everyone.

An illuminating example: Slow breathing can still mean too much breathing

A common recommendation is to breathe slowly and deeply. This combines two different quantities: How often you breathe and how much air you move per breath. Fewer breaths do not automatically mean less breathing overall.

Breathing rate and depth are different thingsMaking every breath especially large can move more air than the body currently needs — even without breathing hurriedly. Excessive breathing can change carbon dioxide levels and contribute to light-headedness or tingling, for example. This is one possible reason a well-intentioned breathing exercise becomes uncomfortable.

This does not mean every instance of restlessness is a breathing problem. It leads to a more specific question: Does the exercise, as you actually perform it, suit you? If it makes symptoms worse, you do not need to practise more consistently, more deeply or for longer.

How I might break this situation down with you

A possible example of how I work — not a breathing guide for self-testing.

1. Describe the starting pointYou sit comfortably and initially breathe without deliberate changes. We note how your chest, head and inner restlessness currently feel. A brief assessment is enough; you should not monitor every breath.

2. Understand the previous strategyYou describe what you do during 'deep breathing'. Do you lift your shoulders? Fill your lungs as much as possible each time? Hold your breath to meet a prescribed number of seconds? We do not need to provoke an exercise already known to be unpleasant again.

3. Compare another conditionInstead of controlling breathing more strictly, an initial comparison might involve directing attention to a calm external reference point or noticing comfortable contact with the floor — while breathing naturally and without effort. We consider whether this changes the original tension. The useful reference is chosen individually.

4. Take away only a tolerable approachIf a comparison is comfortable and helps in an understandable way, we agree on a small application that fits everyday life. The later response also matters: Greater calm, no change or additional exhaustion? One briefly comfortable minute alone does not determine the suitable dose.

The distinction from a general relaxation guide lies in the decision between steps. I want to know what demand you are currently creating and how you respond to it. If breathing control adds effort, 'control it even better' is not automatically the next step.

More than movement: Experience and mental systems are involved too

My work goes beyond visible movement. Distressing experiences, expectations and a sense of safety can matter to the present situation. We therefore also discuss whether certain contexts trigger restlessness and what you experience as comfortable or overwhelming.

You do not have to share anything against your wishes or deliberately bring up distressing memories. Pace, consent and stability are part of the approach. If psychotherapeutic support is indicated or already taking place, functional support should fit alongside it.

Why sleep cannot be forced

Going to bed tired and then checking whether the body is finally calm can lead to a demanding monitoring mode. Sleep becomes a performance test. Extra exercises, measurements and strict rules can unintentionally add to the demands of this situation.

For longer-standing sleep difficulties, targeted assessment is more useful than an ever-growing list of personal experiments. Cognitive behavioural therapy for insomnia, CBT-I, is a first-line treatment for chronic insomnia. For everyday conditions, the 24-hour sleep toolkit offers a separate, practical overview.

What you can observe without additional pressure to control

For a few days, choose just one question: 'In which situation does restlessness begin?' If needed, note a keyword, such as after a long period at the screen, after late coffee or when beginning a breathing exercise. A second helpful observation is what feels comfortable of its own accord.

You do not need to derive a diagnosis from this. The observations help avoid changing everything indiscriminately. If even note-taking increases pressure, a spoken description during the conversation is enough.

When medical support is important

New, increasing or persistent exhaustion and sleep difficulties should be assessed medically. This applies particularly to marked daytime sleepiness, observed pauses in breathing or a clear deterioration in capacity for activity. Acute severe breathlessness, chest pain or fainting call for immediate medical help rather than a breathing experiment; in an emergency, call 112.

If symptoms increase markedly only hours after minor exertion, this pattern should also be mentioned explicitly. A general increase in training is then not a good starting strategy.

Frequently asked questions

Can you be exhausted and tense at the same time?Yes. Exhaustion describes a lack of energy; tension or alertness are other aspects. The factors coming together need to be considered in the particular situation.

Should I continue breathing exercises if I become dizzy?Stop an exercise that worsens symptoms and return to effortless breathing. New or recurring symptoms should be assessed. Persevering is not a sign of quality here.

Is this always an overactive sympathetic nervous system?That cannot be inferred from the feeling alone. Inner restlessness is not a measurement of one part of the autonomic nervous system. Specific triggers, progression and findings are more helpful than a broad label.