Insomnia

Written by Dr Claudia Pastides, 13th March 2019

Insomnia is a lack of good-quality sleep, occasionally due to difficulty falling asleep or staying asleep, other times the sleep is of poor quality despite having time and opportunity to sleep.


Causes

There are two types of insomnia: primary and secondary.

Primary insomnia accounts for up to 20% of all insomnias. The cause of it isn’t clear, but is often triggered by stressful life events.

Secondary insomnia can be caused by a wide variety of factors such as physical and mental health conditions, drugs (both medicinal and recreational) and other sleep disorders.


Risk factors

  • Poor sleep hygiene
  • Caffeinated drinks
  • Alcohol
  • Recreational drugs
  • Chronic pain
  • Chronic medical conditions


Typical Symptoms

  • Difficulty falling asleep
  • Waking multiple times during the night
  • Feeling tired during the day
  • Irritability
  • Low concentration
  • Needing to nap during the daytime


Common Treatment

Treatment often focuses on lifestyle and self-help measures, such as:

  • Reducing caffeinated drinks, alcohol or other stimulants
  • Improving sleep hygiene (see below for tips)
  • Relaxation techniques
  • Cognitive behavioural therapy (CBT)

In some circumstances, a GP will prescribe medication.


Sleep hygiene tips

  • Aim to go to bed at the same time every night and wake at the same time every morning (avoiding the temptation to sleep in late) This will help your internal body clock adapt to a routine.
  • Try to get between 6 and 9 hours of sleep every night.
  • Take time to prepare for bed. Try setting up a bedtime routine for yourself by having a bath, reading a book, doing some relaxation exercises, listening to a relaxing song or using a meditation app.
  • Keep your bedroom a calm, quiet place that is a good temperature and dark.
  • Try to keep caffeine intake to a minimum and avoid it altogether in the evenings.
  • Keep screens out of the bedroom if possible.


When to speak to a doctor

Insomnia can often be initially managed via a digital consultation.

It is particularly important to speak to a doctor if you are:

  • Persistently waking early in the morning
  • Have headaches
  • Experience unexplained weight loss
  • Have any worries about your mental health


Prevention

Insomnia can sometimes be managed and prevented by following the sleep hygiene tips above, taking regular exercise and avoiding stimulating substances such as caffeine, alcohol and other recreational drugs.



More information

NHS information on Insomnia