Trouble going to sleep and staying asleep

Some people lie awake before sleep, then wake repeatedly or too early. Anticipating another poor night can increase alertness, while checking the clock makes the night feel longer. Noise, temperature, screens, caffeine, nicotine, alcohol, pain, itching, reflux, or needing the toilet can interrupt sleep. Stress, burnout, anxiety, depression, thyroid overactivity, travel, and sleep apnoea are other possibilities. Insomnia is considered when sleep difficulty is persistent and affects how you feel or function during the day; this symptom alone does not identify a cause.

Set a consistent wake time and let bedtime follow genuine sleepiness where possible. Get outdoor light and physical activity during the day, while avoiding vigorous exercise close to bed if it makes you alert. Keep the bedroom quiet, dark, and comfortable. Use a predictable wind-down routine and keep phones out of reach. If wakefulness becomes frustrating, leave the bed for a quiet, dimly lit activity and return when drowsy. Avoid using alcohol as a sleep aid and check medicines or supplements with a professional. A diary of sleep, naps, substances, symptoms, and daytime effects can guide the review.

Arrange an appointment if this pattern continues, affects mood or concentration, or creates risk while driving or working. Tell the clinician about loud snoring, witnessed pauses, gasping, restless legs, reflux, pain, or a change in mood. Seek urgent help for severe breathlessness, chest pain, confusion, or thoughts of self-harm. Assessment may include consideration of [Insomnia](/conditions/insomnia/) and [Obstructive Sleep Apnoea](/conditions/obstructive-sleep-apnoea/), alongside medical and emotional factors.

Ask what pattern your sleep diary suggests, whether a medicine or symptom is interrupting sleep, and which behavioural treatment is suitable. Ask whether reflux, mood symptoms, thyroid symptoms, or breathing changes warrant further checks.