Sleep problems are extremely serious from a societal point of view. A substantial portion of the population in many countries suffers from sleep problems. Sleep problems may directly or indirectly cause health problems. They may have harmful consequences in terms of accidents and reduced productivity. The economic costs in society are immense. However, the causal background to sleep problems is often complex. Various determinants contribute and interact. This does not exclude that some determinants are more crucial than others in particular cases. In some cases sleep problems are caused by distinct medical disorders. In other cases they have psychosocial causes related to, for example, personal economic problems or stress at work. A special category of social determinants consists of societal activities that disturb people’s normal sleep rhythms such as shift work. In these cases there is a discrepancy between an individual’s body clock (a biological determinant) and the social clock (a social determinant). Given this plurality of determinants of sleep problems, a plurality of potential remedies emerges. However, what is considered to be a key determinant may vary from one case to another, and this suggests in turn that the key remedy may also vary from one case to another. In my philosophical discussion of these issues I make three proposals. First, I propose an explanatory pluralism. Different explanations are adequate in different contexts given the epistemic interests in those particular contexts. No explanation of sleep problems is the most adequate in every context. Second, I propose a kind of interactionism that recognizes that biological determinants sometimes limit social malleability. The variation in sleep patterns among different cultures and within particular societies indicates the existence of some malleability in how and when we meet our sleep needs, but the existence and function of body clocks indicate that there are certain limits to malleability. Third, I propose that in searching for ethically acceptable remedies for sleep problems we should take this explanatory pluralism and this kind of interactionism seriously.