I think I have insomnia: what should I know?

Insomnia means persistent difficulty falling asleep, staying asleep or getting refreshing sleep, and it can affect daytime functioning. A few poor nights do not by themselves confirm a condition; patterns, triggers and their effect on your day matter.

You may lie awake for a long time, wake repeatedly, or wake earlier than planned and be unable to return to sleep. Common daytime effects include Daytime Sleepiness, Difficulty Concentrating and irritability. Stress, Burnout, low mood, Generalised Anxiety Disorder, travel across time zones and changes in routine can all disturb sleep. Insomnia can also occur alongside another sleep or health problem, so the pattern deserves a proper assessment.

Keep a simple sleep diary for several days: record bedtime, estimated time to sleep, awakenings, final waking time, naps, caffeine, alcohol and medicines. Keep wake-up time steady, use the bed mainly for sleep, and dim bright screens before bed. If you are awake and alert for a while, move to a quiet low-light activity and return when sleepy. Avoid driving when drowsy. A GP can review medicines, mood, breathing symptoms and routines, then discuss a suitable plan.

Arrange a GP appointment when sleep difficulty keeps returning, affects work or safety, or leaves you struggling with daytime sleepiness or concentration. Seek prompt help if you have severe low mood, thoughts of self-harm, or unusual periods of very little sleep with racing thoughts and risky behaviour. Do not start sleeping tablets or combine sedating medicines with alcohol without medical advice.

What pattern does my sleep diary suggest? Could a medicine, mood change, pain or breathing problem be contributing? Which non-medicine treatment fits my situation? What should I do if I feel sleepy while driving or working?