Sleep onset insomnia: what to know

You may lie awake while feeling tired, become alert when bedtime arrives, or start worrying about not sleeping. The pattern can be short-lived after a stressful event or continue as Insomnia. Burnout, Depression, and Generalised Anxiety Disorder can affect sleep, while Jet Lag can shift the body clock after travel.

Difficulty Sleeping may be the main complaint, while Daytime Sleepiness or Difficulty Concentrating can show how poor sleep is affecting the day. These symptoms do not identify one cause by themselves.

Keep a consistent wake time and use the bed mainly for sleep. Dim bright light before bed, avoid stimulating work in the bedroom, and write down worries earlier in the evening. If you remain awake and frustrated, move briefly to a quiet activity in low light, then return when sleepy.

Record bedtime, estimated time to sleep, awakenings, naps, caffeine, alcohol, medicines, and daytime alertness. Bring this diary to a GP. Treatment may focus on sleep habits, a structured behavioural approach, or a contributing condition; do not start or combine sleep medicines without advice.

Arrange a GP appointment when difficulty falling asleep keeps recurring, limits concentration or daytime functioning, or leaves you reliant on sedating products. Seek urgent help if sleeplessness comes with thoughts of self-harm, severe agitation, or feeling detached from reality. Ask for prompt review when a new medicine or substance may be affecting sleep.

Could anxiety, low mood, burnout, travel, pain, or a medicine be affecting my sleep onset? Would a sleep diary or behavioural sleep treatment help? What should I do if daytime sleepiness makes driving or work unsafe?