Sleep Problems and Insomnia

A bad night now and then is normal. Weeks of them are not, and they wear down mood, patience, memory and the will to do anything at all. NHS inform says insomnia is thought to affect around a third of people in the UK.

Insomnia is treatable. The NHS names cognitive behavioural therapy as a treatment, and says sleeping pills are rarely prescribed. This page explains what insomnia is, when to see a GP and what a professional can do.

Sources: NHS inform: insomnia, NHS: insomnia

What insomnia is

You may have insomnia if you regularly find it hard to fall asleep, stay asleep or wake too early. Most adults need around seven to nine hours a night. What counts is how you feel in the day, not the exact number.

The NHS lists the signs:

• Finding it hard to go to sleep
• Waking several times during the night
• Lying awake at night
• Waking early and not being able to go back to sleep
• Still feeling tired after waking up
• Feeling tired and irritable during the day
• Finding it hard to concentrate because you are tired

The NHS calls insomnia short-term when it lasts less than 3 months. After 3 months it counts as long-term.

Sources: NHS: sleep problems, NHS: insomnia

Where it comes from

The NHS names stress, anxiety and depression as the most common causes. A mind that will not stop at midnight is usually carrying something from the day. Our anxiety page covers the worry that keeps many people awake.

It also names causes outside your mind: noise, a room that is too hot or cold, an uncomfortable bed. Alcohol, caffeine, nicotine, jet lag and shift work are on the list too. Some medicines, some health conditions and menopause can disturb sleep too.

Source: NHS: insomnia

When to see a GP

See a GP if better habits have not helped, if it has lasted months or if it affects daily life. A GP can check for a medical cause. If they suspect another sleep disorder, they can refer you to a sleep clinic.

Sleeping pills, where they are prescribed at all, are for a short time in severe cases. A professional found here does not prescribe anything. If you think a medicine is disturbing your sleep, ask your GP or pharmacist.

Sources: NHS: insomnia, NHS: sleep problems

What you can try first

The NHS lists habits that help many people:

• Go to bed and get up at the same time every day
• Wind down before bed, and keep the bedroom dark and quiet
• Exercise regularly, but not within 4 hours of bedtime
• Avoid caffeine, alcohol and smoking for 6 hours before bed
• Avoid big meals late in the evening
• Avoid screens before bed
• Do not nap during the day

If you have tried these for a few weeks and nothing has moved, the problem is probably not your habits. That is when a professional can look at what else is keeping you awake.

Source: NHS: insomnia

What talking therapy can do

The NHS names cognitive behavioural therapy as a treatment for insomnia. NHS inform names a version built for sleep, often called CBT-I. It works on the thoughts and habits that keep the night going, such as watching the clock or dreading bed.

Cognitive behavioural therapy is structured and practical, and it usually involves keeping a sleep diary. If your nights are ruled by worry or low mood, a professional may work on that first.

Sources: NHS: insomnia, NHS inform: insomnia

Who to look for

Look for a professional who names sleep or insomnia in their profile. Ask whether they use CBT-I. Ask what happens between sessions, because much of the work is done at home.

Online sessions suit many people, since travelling somewhere tired is another thing to dread.

If work has run you down rather than kept you awake, our burnout at work page may fit better.

Many people put up with bad nights for years, because everyone is tired. Tell us what your nights are like, and we will find someone who can help.