What should you know about effects of sleeplessness?

After a poor night, people may feel irritable, foggy, forgetful or unsteady. Sleep loss can make driving, operating equipment and making decisions less safe. Ongoing sleeplessness may worsen anxiety or low mood, change appetite and reduce the ability to cope with pain and everyday demands.

Common contributors include stress, an irregular schedule, travel across time zones, reflux, medicines and an uncomfortable sleep environment. Insomnia, depression, generalised anxiety disorder, hyperthyroidism, burnout and obstructive sleep apnoea can also be associated with sleep difficulty. Loud snoring, gasping or witnessed pauses in breathing should be specifically mentioned to a clinician.

Keep a consistent wake time, use the bed for sleep, and dim bright screens and lights before bed. Avoid late caffeine, nicotine and heavy meals if they disturb sleep. A cool, dark, quiet room and a short wind-down routine can help the brain switch from alertness to rest.

Do not drive when very sleepy. Keep a sleep diary showing bedtimes, awakenings, naps, medicines, caffeine and daytime alertness. If the problem persists or affects work, mood or safety, arrange a medical review rather than repeatedly self-medicating with sleeping tablets.

Arrange an appointment for persistent sleeplessness, repeated early waking, daytime sleepiness, loud snoring, gasping, restless legs, or a major change in mood. Seek urgent help for thoughts of self-harm, severe confusion, or behaviour suggesting loss of contact with reality. Sleepiness that makes driving unsafe needs prompt attention.

Could a medicine, thyroid problem, reflux, anxiety or breathing problem be affecting my sleep? Would a sleep diary, mental-health review or sleep assessment help? What treatment is suitable for my pattern of sleeplessness?