preventing sleep

Overview

Sleep difficulties, often called insomnia, mean that you regularly find it hard to fall asleep, stay asleep, or get enough restful sleep. This can happen even when you have the time and a good opportunity to sleep.

Yes. At least one in three adults has brief bouts of insomnia, and about one in ten has long-term (chronic) sleep problems.

Anyone can experience sleep difficulties. They are more common in women, in people over 60, and in those with mental health conditions such as anxiety or depression.

Symptoms

Common symptoms

• Trouble falling asleep at night
• Waking up frequently during the night
• Waking up too early and not being able to get back to sleep
• Feeling tired during the day
• Irritability, low mood, or poor concentration

Symptoms in children

• Difficulty settling at bedtime
• Waking up repeatedly in the night
• Needing a parent to stay until sleep
• Daytime sleepiness or behaviour problems

Symptoms in older adults

• Lighter sleep with more awakenings
• Waking up very early
• Longer time in bed but less deep sleep
• Daytime fatigue and memory complaints

Causes

Main causes

• Stress or worry about work, school, health, or family
• Poor sleep habits, like irregular schedules or using screens before bed
• Mental health conditions such as anxiety, depression, or post-traumatic stress
• Certain medical conditions, pain, or medications
• Caffeine, nicotine, alcohol, or heavy meals close to bedtime

Risk factors

• Shift work or frequent time zone changes
• Being a woman – hormonal changes can affect sleep
• Age over 60
• A history of mental health problems
• A sedentary lifestyle

When to see a doctor

See a doctor urgently if:

• If you have been unable to sleep for several nights in a row and it is affecting your ability to function
• If you have thoughts of harming yourself or others
• If you have trouble breathing or severe chest pain with sleep difficulties

Book a routine appointment if:

• If sleep problems happen more than three nights a week for more than three months
• If daytime fatigue makes it hard to work, study, or drive
• If you want support with improving your sleep

Diagnosis

A doctor will usually ask about your sleep patterns, daily habits, and how you feel during the day. They may ask you to keep a sleep diary for a week or two.

Tests that may be done

• Sleep diary
• Questionnaires about sleepiness and sleep quality
• Sometimes a sleep study (polysomnography) to check for conditions like sleep apnoea

What to expect at your appointment

Your doctor will want to rule out other causes, such as depression or an underactive thyroid. They will work with you to find practical steps that can help, without jumping to medication.

Treatment

The most effective treatment for long-term insomnia is a non-drug programme called cognitive behavioural therapy for insomnia (CBT-I). It helps you change unhelpful thoughts and habits that stop you sleeping.

Self-care at home

• Go to bed and get up at the same times, even at weekends
• Keep your bedroom dark, quiet, and cool
• Avoid caffeine after lunch and alcohol before bed
• If you cannot sleep after 20 minutes, get up and do something calm until you feel sleepy
• Use a wind-down routine: read, listen to soft music, or take a warm bath

Medical treatments

Medications are not usually the first choice. In some cases, a doctor may consider a short course of a sleeping tablet, but these can have side effects and are only for short-term use. Always discuss the risks and benefits with your healthcare provider.

When is surgery considered?

Surgery is not used for treating sleep difficulties.

Living with this condition

Try to keep a regular rhythm to your day. Get natural light in the morning, stay active, and limit naps to 20–30 minutes early in the afternoon.

Lifestyle tips

• Regular physical activity, but not within two hours of bedtime
• A light snack before bed if you are hungry, but avoid heavy meals
• Limit caffeine and alcohol
• Avoid using your phone or tablet in bed

Diet and exercise

Eat a balanced diet and exercise regularly. Gentle walking, yoga, or stretching in the late afternoon can promote drowsiness later. Avoid large, spicy, or high-sugar meals in the evening.

Mental health and emotional wellbeing

Sleeplessness can make you feel tense, frustrated, or low. It is common to worry about not sleeping, which makes it even harder to drift off. If sleep problems persist, talk to a mental health professional – treating anxiety or depression often improves sleep.

Prevention

Not all sleep problems can be prevented, but good sleep habits can reduce your risk. Keeping a consistent sleep schedule, managing stress, and having a relaxing bedtime routine are the most important steps.

Vaccines

There is no vaccine for sleep difficulties.

Screening programmes

There is no routine screening test for sleep problems. Your doctor may ask about sleep during regular check-ups, especially if you have symptoms such as heavy snoring or daytime sleepiness.

Complications

If left untreated

• Worse mental health – sleep loss can increase symptoms of anxiety and depression
• A weaker immune system, making you more prone to colds and infections
• Higher risk of accidents because of daytime sleepiness
• Difficulty concentrating, remembering, or making decisions

Long-term outlook

With the right support, most people can improve their sleep. It may take time, but simple changes to your routine and, if needed, non-drug treatments, can make a real difference. Be patient and kind to yourself.

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