Trouble going to sleep: what to know

Sleep can be delayed when bedtime changes often, daytime naps reduce sleepiness, or bright light and stimulating activities continue late into the evening. Caffeine, nicotine, some medicines, pain, itching, reflux, or a busy mind may also interfere. Shift work and travel can move the body clock away from the time you want to sleep. Persistent difficulty with sleep and daytime tiredness may fit insomnia, while anxiety, depression, thyroid overactivity, or breathing problems may need separate assessment.

Choose a regular wake time, even after a poor night, and use daylight and movement during the day. Make the final hour before bed quieter: lower the lights, put screens aside, and choose reading, breathing exercises, or another relaxing routine. Keep the bed for sleep rather than work. If you are awake and frustrated, sit somewhere dim and return when drowsy. Avoid late caffeine, nicotine, heavy meals, and alcohol. Record bedtime, wake time, naps, substances, and symptoms for a week or two to discuss with a clinician.

Seek a medical review when difficulty starting sleep is persistent, causes daytime sleepiness, or makes driving and work unsafe. Mention snoring, choking sounds, restless legs, reflux, persistent worry, low mood, or a pounding heartbeat. Urgent help is needed for severe breathing difficulty, chest pain, confusion, or thoughts of self-harm. A clinician may consider [Insomnia](/conditions/insomnia/), [Jet Lag](/conditions/jet-lag/), [Depression](/conditions/depression/), or another contributor.

Ask which factors might be delaying sleep, whether any medicine should be changed, and whether a structured sleep treatment could help. You can also ask how to check for [Generalised Anxiety Disorder](/conditions/generalised-anxiety-disorder/) or [Obstructive Sleep Apnoea](/conditions/obstructive-sleep-apnoea/) if your symptoms point that way.