Difficulty falling asleep

A busy mind, anxiety, low mood, shift work, travel across time zones, late caffeine or irregular sleep times can delay sleep. Pain, reflux, hot flushes, an overactive thyroid and some medicines may also interfere. Insomnia describes a pattern of difficulty starting or maintaining sleep with consequences during the day; one restless night does not define it.

Keep track of bedtime, estimated time to sleep, awakenings, naps, caffeine, alcohol, medicines and how alert you feel the next day. Snoring, gasping or morning headaches can point toward obstructive sleep apnoea and deserve medical discussion.

Keep a consistent wake time, get daylight and movement during the day, and use the bed mainly for sleep. Wind down with quiet activities; dim bright screens and avoid caffeine close to bedtime. If you remain awake and frustrated, leave the bed briefly for a calm activity and return when sleepy. Do not drive when very drowsy. If the pattern continues, a clinician can assess causes and discuss behavioural sleep treatment rather than relying on self-selected sedatives.

Arrange a medical appointment if sleep difficulty is recurring, causing impaired concentration, mood changes or unsafe drowsiness, or began after a new medicine. Seek urgent help for thoughts of self-harm, severe agitation, confusion, or several nights with almost no sleep alongside unusually elevated energy or risky behaviour.

Could a medicine, mood problem, reflux, thyroid problem or sleep disorder be contributing? Would a sleep diary or assessment help? What treatment is suitable for my situation, and how should I manage daytime drowsiness?