Does a general practice perform insomnia management?

The clinician may ask how long sleep has been difficult, whether you struggle to fall asleep or stay asleep, and how daytime concentration, mood, and energy are affected. They may explore stress, pain, reflux, breathing symptoms, restless legs, caffeine, alcohol, shift work, and medicines. A sleep diary can reveal patterns that are hard to remember during a short appointment. Management often starts with a consistent routine and behavioural strategies; cognitive behavioural therapy for insomnia may be discussed. Sleeping tablets are not suitable for everyone and should be reviewed carefully.

Keep a simple sleep diary, noting bedtime, waking periods, final waking time, naps, and daytime sleepiness. Keep a regular wake time, use the bed for sleep rather than prolonged wakefulness, and reduce late caffeine, alcohol, and bright-screen exposure. Do not stop prescribed medicines without guidance, even if you suspect they disturb sleep. Tell the clinician about snoring, gasping, unusual movements, low mood, anxiety, pain, and any non-prescription sleep products.

Seek prompt medical advice if sleeplessness is accompanied by severe depression, thoughts of self-harm, confusion, extreme agitation, or unsafe daytime sleepiness. Do not drive or operate machinery when you are struggling to stay awake. Loud snoring with gasping, persistent breathing pauses, or sudden changes in behaviour also warrant assessment. Emergency help is needed for immediate danger or thoughts of acting on self-harm.

Ask what may be maintaining the insomnia, whether another condition or medicine needs review, which behavioural strategy to try first, and whether a sleep diary or referral would help. If medicine is discussed, ask about its purpose, side effects, duration of use, and a follow-up plan.