What should you know about having difficulty sleeping at night?

Trouble falling asleep, waking often or waking too early can be connected with stress, burnout, depression or generalised anxiety disorder. Acid reflux, an overactive thyroid and obstructive sleep apnoea can also disturb nights. Jet lag, shift work, late caffeine, alcohol, screens or an irregular schedule may keep the body clock out of step. Snoring, witnessed pauses in breathing, morning headaches or marked daytime sleepiness are useful clues to share with a clinician.

Keep a consistent wake time and allow a calm wind-down before bed. Use the bed for sleep rather than prolonged worrying or scrolling; if you remain awake, try a quiet activity in dim light and return when sleepy. Keep the room comfortable, limit caffeine later in the day, and avoid using alcohol as a sleep aid. A sleep diary can show links between bedtime, naps, medicines, symptoms and next-day alertness. Seek help if self-care is not enough.

Arrange a medical review when poor sleep affects concentration, mood, work or safety, or keeps returning. Ask promptly about loud snoring, breathing pauses, restless legs, reflux or symptoms of depression and anxiety. Do not drive when very sleepy. Seek emergency help for thoughts of harming yourself, severe confusion, or a dramatic reduction in sleep with unusually high energy or risky behaviour.

Could a medicine or health condition be disturbing my sleep? Do my snoring or breathing symptoms suggest obstructive sleep apnoea? Would a sleep diary or talking therapy help? Which sleep treatments are suitable and for how long?