When to seek care for insomnia

Overview

Insomnia is a sleep problem where you have trouble falling asleep, staying asleep, or waking up too early and not being able to get back to sleep. Even if you have time to sleep, you may feel tired during the day.

Yes, insomnia is very common. About 1 in 3 adults have some symptoms, and about 1 in 10 have chronic (long-term) insomnia.

Insomnia can affect people of all ages, but it is more common in women and older adults. It can also affect children and teenagers.

Symptoms

Common symptoms

• Difficulty falling asleep at night
• Waking up often during the night
• Waking up too early and not being able to go back to sleep
• Feeling tired or not rested after a night's sleep
• Daytime sleepiness, low energy, or irritability
• Trouble concentrating or remembering things

Symptoms in children

• Trouble settling down at bedtime
• Waking up frequently during the night
• Complaints of being tired during the day
• Mood swings or behavioral problems

Symptoms in older adults

• Changes in sleep patterns (e.g., waking earlier)
• More time spent in bed but less deep sleep
• Increased daytime napping
• Confusion or memory problems linked to poor sleep

Causes

Main causes

• Stress from work, school, health, or family
• Poor sleep habits (like irregular bedtimes, using screens before bed, or napping too much)
• Medical conditions such as pain, asthma, or thyroid problems
• Mental health conditions like depression or anxiety
• Medications that interfere with sleep (talk to your doctor)
• Caffeine, nicotine, or alcohol use, especially close to bedtime

Risk factors

• Being older
• Being female (hormonal changes may play a role)
• Shift work or frequent travel across time zones
• Having a mental health condition
• Long-term illness or chronic pain

When to see a doctor

See a doctor urgently if:

• If you have severe anxiety, panic, or thoughts of harming yourself
• If you have chest pain or trouble breathing when trying to sleep

Book a routine appointment if:

• If your sleep troubles have lasted more than a few weeks and affect your daily life
• If you have other symptoms like snoring, gasping, or leg movements that wake you
• If you want help finding the best way to manage insomnia

Diagnosis

Your doctor will ask about your sleep habits, lifestyle, and overall health. They may ask you to keep a sleep diary for a week or two.

Tests that may be done

• Sleep diary (recording when you go to bed, wake up, and how you feel)
• Questionnaires about sleep quality and daytime tiredness
• If needed, a sleep study (polysomnography) to check for other sleep disorders like sleep apnea

What to expect at your appointment

The doctor will listen to your concerns and work with you to find possible causes. They may suggest changes in your routine or refer you to a sleep specialist. You will not be judged – insomnia is a medical problem, not a personal failure.

Treatment

Treatment focuses on improving your sleep habits and addressing any underlying causes. The first step is often cognitive behavioral therapy for insomnia (CBT-I), a talking therapy that helps change negative thoughts and behaviors around sleep.

Self-care at home

• Keep a regular sleep schedule – go to bed and wake up at the same time every day
• Create a relaxing bedtime routine (e.g., reading, gentle stretching)
• Make your bedroom dark, quiet, and cool
• Avoid screens (phones, tablets, TV) for at least an hour before bed
• Limit caffeine and avoid large meals or alcohol close to bedtime
• Get regular physical activity, but not too close to bedtime

Medical treatments

If self-care and therapy are not enough, a doctor may recommend a short course of medication to help you sleep. These are usually prescribed for a limited time. Always follow your doctor's advice – do not use over-the-counter sleep aids for long periods without checking with your healthcare provider.

When is surgery considered?

Surgery is not used to treat insomnia itself, but may be needed if insomnia is caused by an underlying condition (e.g., surgery for sleep apnea). Your doctor will explain if this applies to you.

Living with this condition

Living with insomnia can be tiring, but small changes can make a big difference. Be patient with yourself – improving sleep takes time. Try to keep a consistent routine and avoid naps if they interfere with night sleep.

Lifestyle tips

• Exercise regularly, but avoid intense activity within 2 hours of bedtime
• Manage stress with relaxation techniques like deep breathing or meditation
• Limit alcohol – it may help you fall asleep but often causes worse sleep later

Diet and exercise

Eat a balanced diet and avoid heavy or spicy meals before bed. Regular exercise (like walking or swimming) helps many people sleep better. Try not to eat a large meal within 2–3 hours of bedtime.

Mental health and emotional wellbeing

Insomnia can increase the risk of depression, anxiety, and irritability. It can also make existing mental health conditions worse. If you feel down or worried, talk to your doctor or a mental health professional. Improving sleep often helps your mood.

Prevention

Not all insomnia can be prevented, but you can lower your risk by practicing good sleep hygiene. That means having a regular bedtime, avoiding caffeine late in the day, and managing stress. If you have a stressful event coming up, try to prepare by keeping a calm routine.

Screening programmes

There is no routine screening test for insomnia. Your doctor may ask about sleep during check-ups, especially if you have risk factors like shift work or chronic illness.

Complications

If left untreated

• Increased risk of depression and anxiety
• Poor concentration and memory problems
• Higher chance of accidents (including car accidents)
• Weakened immune system
• Long-term health issues like high blood pressure or heart disease

Long-term outlook

Most people with insomnia improve with the right support. Treatment – especially cognitive behavioral therapy – is very effective. Even chronic insomnia can often be managed well. You do not have to live with poor sleep forever. Help is available.

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