12119 Insomnia

Overview

Insomnia is when you have trouble falling asleep, staying asleep, or waking up too early and not being able to go back to sleep. It may last for a short time or continue for months. It can affect your energy, mood, and health.

Yes. Around one in three people in the UK has short-term insomnia at some point. Long-term insomnia affects about one in ten people.

It can happen at any age. It becomes more common as you get older, and it affects women more often than men. People who are stressed, have a mental health condition, or have other health problems are also more likely to experience it.

Symptoms

Common symptoms

• Difficulty falling asleep at night
• Waking up in the middle of the night
• Waking up too early and not being able to go back to sleep
• Feeling tired after a night's sleep
• Daytime sleepiness or fatigue
• Irritability, low mood, or difficulty concentrating

Symptoms in children

• Trouble settling down at bedtime
• Waking up often during the night
• Needing a parent or carer to stay until they fall asleep
• Sleepiness in the daytime and difficulty paying attention at school

Symptoms in older adults

• Lighter sleep and more broken sleep
• Waking up very early in the morning
• Needing more time to fall asleep
• Napping during the day, which can make night sleep harder

Causes

Main causes

• Stress, worries, or major life changes
• Anxiety or depression
• Poor sleep habits, such as using screens late at night
• Caffeine, alcohol, or heavy meals close to bedtime
• Pain, breathing problems, or other health conditions
• Certain medicines that affect sleep
• Shift work, jet lag, or irregular sleep times

Risk factors

• Being female
• Being older
• Having a job that involves shifts or travel
• Living with a long-term health problem, such as heart disease, diabetes, or chronic pain
• Struggling with stress, anxiety, or low mood
• Using stimulants like caffeine, especially in the afternoon or evening

When to see a doctor

See a doctor urgently if:

• You are feeling so tired that you fall asleep while driving or doing something dangerous
• You have thoughts of harming yourself
• You have sudden chest pain, trouble breathing, or a very severe headache

Book a routine appointment if:

• Sleep problems last for more than a few weeks
• Insomnia affects your work, school, or relationships
• You want to find the cause and explore treatments

Diagnosis

A doctor will ask you about your sleep patterns, your routine, how you feel during the day, and any medicines you take. There is no single lab test for insomnia. The doctor will often suggest you keep a sleep diary for a week or two.

Tests that may be done

• A sleep diary – you write down when you go to bed, when you wake, and how well you slept
• Blood tests – to check for conditions like an underactive thyroid or low iron
• A sleep study – sometimes, if a sleep disorder like sleep apnoea is suspected, you may be asked to stay overnight in a sleep clinic

What to expect at your appointment

The doctor may talk to you about what might be causing your insomnia and discuss simple changes to try at home. If the problem continues, they may offer to support you with a talking therapy program or ask more questions about your sleep cycle.

Treatment

Treatment for insomnia usually starts with changes to your daily habits and finding out what is causing the problem. Talking therapy – especially a type called cognitive behavioural therapy for insomnia (CBT-I) – is often recommended as the first choice. Medicines are used only for a short time and after discussing risks and benefits with a doctor.

Self-care at home

• Go to bed and get up at the same time every day, including weekends
• Make your bedroom quiet, dark, and cool
• Switch off screens (phones, tablets, TV) at least 30 minutes before bed
• Avoid caffeine, energy drinks, and alcohol in the evening
• Get regular physical activity, but not vigorous exercise close to bedtime
• Create a relaxing wind-down routine, like reading or gentle stretching
• If you can't sleep after about 20 minutes, get up and do something calm, then return to bed when you feel sleepy

Medical treatments

Doctors may recommend a talking therapy called cognitive behavioural therapy for insomnia (CBT-I), which is proven to be effective. In some cases, a doctor may prescribe a short course of a sleep medicine, but this is not the first option and should never be started without professional advice. Your doctor can also check if a health condition or a medicine is affecting your sleep and help with that.

Living with this condition

Living with insomnia means creating a steady routine that makes sleep easier. Some nights will still be difficult. Try not to watch the clock and be kind to yourself. Tell a friend or family member if you are struggling, and remember that seeking help is a positive step.

Lifestyle tips

• Keep a regular wake-up time, even after a bad night
• Get natural daylight early in the day
• Incorporate daily exercise that you enjoy
• Reserve the bedroom for sleep, not work or screens
• Use relaxation techniques such as deep breathing or mindfulness before bed
• Avoid naps in the late afternoon or evening

Diet and exercise

A healthy, balanced diet can support good sleep. Avoid large, heavy meals and plenty of caffeine in the few hours before bed. Regular exercise helps most people sleep better, but it is best to finish physical activity a few hours before you plan to go to sleep.

Mental health and emotional wellbeing

Insomnia and mental health are closely linked. Anxiety, worry, or low mood can make sleep worse, and poor sleep can make those feelings stronger. It is important to talk to a doctor if you find this happening. If you ever have thoughts of self-harm or suicide, contact your local crisis helpline or emergency services right away.

Prevention

Insomnia cannot always be prevented, but the chances of it get smaller if you keep steady sleep habits and find healthy ways to handle stress. Taking care of your overall health is the best way to lower the risk.

Complications

If left untreated

• Daytime tiredness and difficulty concentrating at work or school
• Mood problems such as irritability, anxiety, or depression
• Weaker immune system, so you catch more infections
• Higher blood pressure and increased risk of heart disease over a long period
• More chance of accidents from falling asleep at the wheel or making mistakes

Long-term outlook

The outlook for insomnia is generally very positive. Most people notice a big improvement once they understand what is causing their sleep problem and find the right combination of healthy habits, support, and, if needed, professional treatment. Even long-standing insomnia can become manageable with help.

Find support

Local organisations

• NHS Sleep and tiredness ↗ · United Kingdom

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