What should you know about AAFP insomnia?

Clinical care focuses on the sleep pattern, daytime effects, possible triggers, medicines and health conditions. For ongoing insomnia, cognitive behavioural therapy for insomnia is generally the main treatment approach; sleeping medicines may have a limited role after an individual review.

Insomnia can involve a long wait for sleep, repeated waking, waking earlier than intended, or sleep that feels unrefreshing. It may lead to daytime tiredness, irritability, reduced concentration or worry about bedtime. A clinician distinguishes it from simply choosing too little time for sleep.

Stress, changing schedules, pain, caffeine, alcohol, some medicines, anxiety, depression and other sleep disorders can maintain the problem. Identifying a contributor matters because treatment can then address both the sleep difficulty and its driver.

Keep a consistent rising time, reserve the bed for sleep, and leave the bed for a quiet activity if wakefulness becomes frustrating. Return when sleepy. Limit late caffeine and nicotine, avoid using alcohol as a sleep aid, and keep naps from undermining nighttime sleep. A sleep diary can reveal links between timing, substances and symptoms.

Ask about cognitive behavioural therapy for insomnia, which combines practical sleep scheduling with techniques that reduce unhelpful thoughts and habits. Do not stop a prescribed sedative suddenly; a clinician can plan changes safely and check for interactions or rebound symptoms.

Arrange a medical assessment when poor sleep persists, interferes with work or driving, or comes with loud snoring, choking during sleep, uncomfortable leg sensations, marked mood change or medication concerns. Seek urgent help for thoughts of self-harm, severe confusion, or dangerous sleepiness while driving; stop driving and move to a safe place.

Ask whether a sleep diary would help, whether your medicines or another condition could be disturbing sleep, and where you can access cognitive behavioural therapy for insomnia. If medication is proposed, clarify its purpose, likely side effects, safe duration and how it should be reduced or stopped.