Maintenance insomnia

You may wake repeatedly, lie awake for long periods or wake earlier than intended. The result can be daytime sleepiness, irritability, low energy or difficulty concentrating. Causes include stress, an uncomfortable sleep environment, pain, reflux, breathing problems, alcohol, caffeine, medicines and changes in sleep timing. Burnout, depression, generalised anxiety and jet lag can also disturb sleep, but night waking alone does not identify one cause. Note the time you go to bed, awakenings, naps, substances and daytime effects for a clearer assessment.

Keep a regular wake time, use the bed for sleep, and keep the room dark, quiet and comfortably cool. If you are awake and alert, leave the bed briefly for a calm activity in dim light, then return when sleepy. Limit late caffeine, nicotine, alcohol and heavy meals, and avoid checking the clock repeatedly. Seek an assessment if sleep disruption continues or affects work, driving, mood or relationships. Learn more about [Insomnia](/conditions/insomnia/) and [Difficulty Sleeping](/symptoms/difficulty-sleeping/).

Arrange prompt medical help if sleeplessness comes with severe depression, thoughts of self-harm, unusual confusion, dangerous daytime sleepiness or symptoms suggesting a breathing problem during sleep. Do not drive or operate machinery when you feel too sleepy to stay alert. A clinician can review mental health, medicines and physical symptoms, including [Daytime Sleepiness](/symptoms/daytime-sleepiness/) and [Difficulty Concentrating](/symptoms/difficulty-concentrating/).

Ask what may be waking you, whether a sleep diary would help, and which behavioural treatment is suitable. Discuss medicines, mood, snoring, restless sensations and a plan for returning to sleep without relying on alcohol or unprescribed sedatives.