What causes insomnia?

Worry can keep the mind alert at bedtime, and Generalised Anxiety Disorder may make this pattern persistent. Depression can change sleep timing, early waking or the ability to feel rested. Jet Lag temporarily shifts the body clock after crossing time zones. Pain, itching, hot flushes, breathing problems, caffeine, nicotine, alcohol and some medicines can also disturb sleep.

A few poor nights can create concern about sleep, which increases alertness the next night. Insomnia may involve difficulty falling asleep, repeated waking or waking too early. The effect on daytime concentration, mood and safety matters as much as the time spent in bed.

Keep a regular wake time, use the bed mainly for sleep, and make the room dark, quiet and comfortable. Limit caffeine later in the day, avoid nicotine and alcohol near bedtime, and reduce bright screens while winding down. If you are awake and frustrated, get up briefly for a calm activity and return when sleepy.

Keep a sleep diary showing bedtime, waking, naps, substances and daytime effects. A clinician can look for anxiety, depression, medicines, breathing symptoms or another condition. Persistent insomnia may benefit from structured behavioural treatment rather than relying on sleeping tablets.

Seek urgent help if lack of sleep is accompanied by thoughts of self-harm, severe confusion, unsafe behaviour or extreme agitation. Arrange a clinical review when insomnia persists, affects driving or work, or occurs with loud snoring, choking during sleep, persistent low mood or overwhelming worry.

Ask whether a medicine or health condition is disturbing sleep, whether anxiety or depression should be assessed, and which behavioural sleep programme is suitable. Discuss travel, shift work, naps and any snoring or breathing pauses.