Insomnia

You have insomnia if you regularly:

• find it hard to go to sleep
• wake up several times during the night
• lie awake at night
• wake up early and cannot go back to sleep
• still feel tired after waking up
• find it hard to nap during the day even though you're tired
• feel tired and irritable during the day
• find it difficult to concentrate during the day because you're tired

If you have insomnia for a short time (less than 3 months) it's called short-term insomnia. Insomnia that lasts 3 months or longer is called long-term insomnia.

The most common causes of insomnia are:

• stress, anxiety or depression
• noise
• a room that's too hot or cold
• uncomfortable beds
• alcohol, caffeine or nicotine
• illegal drugs like cocaine or ecstasy
• jet lag
• shift work

Conditions and medicines that can cause insomnia:

• mental health conditions, such as schizophrenia or bipolar disorder
• Alzheimer's disease or Parkinson's disease
• restless legs syndrome
• overactive thyroid
• menopause

Many medicines can also cause insomnia.

Things that keep you from getting a good night's sleep:

• long-term pain
• sleepwalking
• snoring or interrupted breathing while sleeping (sleep apnoea)
• suddenly falling asleep anywhere (narcolepsy)
• nightmares or night terrors (particularly in children)

Insomnia usually gets better by changing your sleeping habits.

• only go to bed when you're sleepy

• wake up and get out of bed at the same time every day

• relax at least 1 hour before bed – for example, take a bath or read a book

• make sure your bedroom is dark and quiet – use curtains, blinds, an eye mask or ear plugs if needed

• exercise regularly during the day

• make sure your mattress, pillows and covers are comfortable

• do not smoke or drink alcohol, tea or coffee at least 6 hours before going to bed

• do not eat a big meal late at night

• do not exercise at least 4 hours before bed

• do not watch television or use devices, like smartphones, right before going to bed, because the blue light makes you more awake

• do not nap during the day

• do not drive when you feel sleepy

• do not sleep in after a bad night's sleep – stick to your regular sleeping hours instead

• changing your sleeping habits has not helped your insomnia
• you've had trouble sleeping for months
• your insomnia is affecting your daily life in a way that makes it hard for you to cope

A GP will try to find out what's causing your insomnia so you get the right treatment.

Sometimes you'll be offered cognitive behavioural therapy (CBT). This may be face-to-face with a therapist, or through an online self-help programme.

This can help you change the thoughts and behaviours that keep you from sleeping.

You may be referred to a sleep clinic if you have symptoms of another sleep disorder such as sleep apnoea.

GPs now rarely prescribe sleeping pills to treat insomnia. Sleeping pills can have serious side effects and you can become dependent on them.

Sleeping pills are only prescribed for a few days, or weeks at the most, if:

• your insomnia is very bad
• other treatments have not worked

Symptoms of insomnia include finding it hard to fall asleep, waking up several times during the night and feeling tired during the day.

Common causes of insomnia include stress, anxiety, too much noise at night, your bedroom being too hot or cold and drinks containing caffeine.

You can help improve insomnia by making changes to your sleep habits, such as having a bedtime routine and not eating or drinking shortly before bed.

Insomnia is sometimes treated with cognitive behavioural therapy (CBT). Sleeping pills are rarely used.