Overcoming insomnia

Insomnia may mean difficulty falling asleep, repeated waking, waking too early, or sleep that leaves you unrefreshed. Daytime sleepiness and difficulty concentrating can follow, even when you have spent enough time in bed.

Stress, burnout, low mood, anxiety, jet lag, pain, medicines, caffeine, alcohol, and an irregular schedule may all disturb sleep. The pattern and its effect during the day help a clinician decide whether insomnia is the main problem or a sign of another condition.

Keep a regular wake time, including after a poor night, and use the bed mainly for sleep. Dim bright light in the evening, reduce stimulating activities near bedtime, and keep the bedroom quiet, comfortable, and dark. Avoid late caffeine and alcohol because they can fragment sleep even when they make you drowsy at first.

If you remain awake and frustrated, leave the bed for a calm activity in low light and return when sleepy. A sleep diary can reveal links between schedule, naps, substances, and symptoms. If insomnia persists, ask about cognitive behavioural treatment for insomnia; do not start or stop sleep medicines without advice.

Arrange an appointment when sleep difficulty repeatedly affects concentration, mood, work, or driving. Seek prompt help for severe daytime sleepiness that makes driving unsafe, unusual periods of very little sleep with high energy or risky behaviour, or thoughts of self-harm. A clinician can review mental health, medicines, breathing-related sleep symptoms, and physical causes.

Ask: What may be keeping me awake? Would structured insomnia therapy suit me? Do my medicines or symptoms suggest another sleep disorder? How should I manage daytime sleepiness while treatment starts?