Difficulty going to sleep

Sleep can be delayed by worry, low mood, work strain, late caffeine, alcohol, phone use or an inconsistent wake time. Jet lag shifts the timing system. Acid reflux, pain, hot sensations and an overactive thyroid can create physical alertness. Obstructive sleep apnoea may fragment sleep through breathing obstruction, especially when snoring or gasping is noticed.

Consider what happens before bed and during the day: do you nap, feel sleepy at unusual times, or lie awake with repetitive thoughts? A simple diary can reveal patterns without requiring you to monitor every moment of sleep.

Anchor the morning with a steady wake time, daylight and gentle activity. Keep the bedroom comfortable, quiet and dark, and reserve the bed for sleep and intimacy. Have a calming routine, limit late stimulants, and avoid watching the clock. If wakefulness becomes frustrating, move to a dim, quiet space until drowsy. Discuss persistent symptoms with a clinician before using sleep medicines, supplements or antihistamines.

Arrange a review if sleep difficulty affects alertness, mood, memory or driving, or if it continues despite routine changes. Seek urgent help for suicidal thoughts, confusion, extreme agitation, or reduced sleep with unusually elevated mood and risky behaviour.

Could my symptoms or medicines be interfering with sleep? Should I be assessed for insomnia, reflux, anxiety, thyroid disease or sleep apnoea? What plan can improve sleep without causing next-day sedation?