The question of insomnia and fatigue is much like the question of the chicken and the egg. Which came first? Have you ever found yourself being just too tired to sleep? I have, but I don't think that it was really that I was too tired to sleep. I think it was more like I was too wound up to sleep.

Physical exhaustion is no guarantee that sleep will happen. Sleep isn't just a physical state. Sleep is actually a mental state that causes a physical state.

When we sleep, we become unconscious. There are many things that can cause people to become unconscious…a hard blow to the head, being given an anesthetic, or too much alcohol or drug consumption. Any of these things can cause us to become temporarily unconscious.

Sleep, however, must be voluntary. We have to be willing both physically as well as mentally to go to sleep. Nobody can force you to go to sleep unless they conk you on the head or slip you a Mickey.

There are physical disorders that can cause fatigue no matter how much or how little sleep the person gets. One such condition is called "Chronic Fatigue Syndrome," and when this condition is present, the person is physically exhausted all of the time but still unable to sleep regularly or long enough.

There are many treatments for Chronic Fatigue Syndrome (CFS). There are drugs, or course, as well as other treatments. Exercise has proven to be an effective treatment. Additionally, there are herbal treatments that some people say are very effective, and psychotherapy has proven to be helpful in some cases. Acupuncture and hypnosis are also recognized treatments for Chronic Fatigue Syndrome.

The bottom line is that if you are constantly exhausted but still unable to sleep, you really should see your doctor.