sleep at night

Overview

Sleep problems happen when you regularly struggle to fall asleep, stay asleep, or wake up feeling exhausted. Poor sleep can affect your mood, energy, and daily life.

Yes. Many people experience sleep difficulties at some point in their lives. Around 1 in 3 people have occasional sleeplessness, and about 1 in 10 have long-term sleep problems.

Sleep problems can affect people of all ages, but they are more common in adults, people under stress, shift workers, and those with anxiety or depression. They also become more frequent as we get older.

Symptoms

Common symptoms

• Difficulty falling asleep despite feeling tired
• Waking up repeatedly during the night
• Waking up too early and being unable to get back to sleep
• Feeling tired, irritable, or low in energy during the day
• Difficulty concentrating or remembering things

Symptoms in children

• Trouble settling at bedtime or resisting going to bed
• Waking up multiple times crying or calling out
• Nightmares or night terrors
• Daytime sleepiness, tantrums, or difficulty paying attention at school

Symptoms in older adults

• Lighter sleep and waking earlier in the morning
• More time spent in bed but less deep sleep
• Waking up several times at night to use the bathroom
• Feeling sleepy during the day or napping frequently

Causes

Main causes

• Stress and worry about work, family, health, or money
• Anxiety or depression, which can keep the mind racing at night
• Poor sleep habits, such as irregular bedtimes or using screens in bed
• Caffeine, nicotine, alcohol, or heavy meals close to bedtime
• Medical conditions like pain, breathing problems, or an overactive bladder

Risk factors

• Working night shifts or rotating shifts
• Irregular sleep schedule
• Having a family history of sleep problems
• Getting older
• Living with a long-term health condition

When to see a doctor

See a doctor urgently if:

• You fall asleep without meaning to during daily activities
• Your child has loud snoring, gasping, or pauses in breathing
• You have new and severe mood changes or thoughts of self-harm

Book a routine appointment if:

• Sleep problems last longer than 4 weeks and affect your daily life
• You depend on alcohol, sleep medications, or other substances to sleep
• Your partner notices you stop breathing or gasp during sleep
• You have persistent fatigue, memory problems, or low mood

Diagnosis

A doctor or nurse will ask about your sleep patterns, habits, mood, and overall health. They may ask you to keep a sleep diary for a week or two to track your bedtime, wake time, and how you feel during the day.

Tests that may be done

• Sleep diary
• Questionnaires about sleepiness and sleep quality
• Blood tests to check for conditions like thyroid problems
• A sleep study (polysomnography) if a sleep disorder like sleep apnea is suspected

What to expect at your appointment

The appointment is usually relaxed and begins with a conversation. You do not need to bring anything special, but a two-week sleep diary can be very helpful. Your doctor will work with you to find the most likely cause of your sleep trouble.

Treatment

Treatment depends on the cause of your sleep problem. In most cases, the first step is improving sleep habits and addressing any stress or mental health issues. If those are not enough, other approaches, like talking therapy or a temporary trial of medication, may be offered.

Self-care at home

• Keep a regular sleep schedule — go to bed and wake up at the same time every day, even on weekends
• Make your bedroom quiet, dark, and a little cool
• Use the bed only for sleep and intimacy, not for work or watching TV
• Switch off screens (phones, tablets, TVs) at least an hour before bed
• Get natural light during the day, especially in the morning
• Walk or do light exercise daily, but finish vigorous exercise a few hours before bed
• Write down worries before bed to clear your mind

Medical treatments

Your doctor may talk with you about behavioral therapy, such as cognitive behavioral therapy for insomnia (CBT-I), which helps change unhelpful thoughts and habits around sleep. Sometimes a doctor might prescribe a short course of sleep medication, but this is not a long-term solution and should be used only under medical supervision.

When is surgery considered?

Surgery is rarely needed for sleep problems. In some cases, breathing problems during sleep (like sleep apnea) may be treated with a breathing device, and very rarely surgery is considered for specific airway issues. These decisions are always made by a specialist.

Living with this condition

Living with a sleep problem can be frustrating, but small, consistent changes make a big difference. Even when you do not sleep perfectly, focus on doing a few helpful habits each day, and be kind to yourself.

Lifestyle tips

• Try to get up at the same time every morning, even after a bad night
• Keep naps short (under 30 minutes) and avoid napping late in the day
• Reduce caffeine after the afternoon and avoid alcohol before bed
• Use an hour before bed for relaxing activities like reading, listening to calm music, or gentle stretching
• Put your clock away or turn it so you cannot see the time at night

Diet and exercise

A light bedtime snack like warm milk or a banana is fine, but avoid heavy meals, spicy food, and large drinks close to bedtime. Regular exercise helps you fall asleep more easily and sleep more deeply, but try to finish exercise at least three hours before bed.

Mental health and emotional wellbeing

Sleep and mental health are closely connected. Poor sleep can make you feel more irritable, anxious, or low. If you notice that your sleep is affecting your mood, or that your mood makes it harder to sleep, talk to a doctor. Reaching out is a sign of strength.

Prevention

Many sleep problems can be prevented or reduced by keeping consistent sleep habits, managing stress, and staying active. While you cannot control everything, you can create conditions that make good sleep more likely.

Screening programmes

You do not need special screening for most sleep problems. If you have ongoing sleep trouble, your regular doctor can assess you and, if needed, refer you to a sleep specialist.

Complications

If left untreated

• Daytime exhaustion can raise your risk of accidents, including falls and car crashes
• Long-term poor sleep is linked to high blood pressure, heart disease, diabetes, and weakened immunity
• Chronic sleep problems can make anxiety and depression worse
• Ongoing sleep loss may affect memory, concentration, and work or school performance

Long-term outlook

The outlook is generally positive. With the right support and consistent changes, most people can improve their sleep quality. It may take a few weeks to notice a difference, but many people feel a real improvement in energy, mood, and overall health. You are not alone, and help is available.

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