What is insomnia?
Insomnia is difficulty sleeping that happens regularly and affects your daily life. It can mean trouble falling asleep, waking frequently during the night, waking too early and being unable to get back to sleep, or simply not feeling refreshed despite spending enough time in bed. Insomnia can be short-term, often triggered by stress or a change in circumstances, or long-term, lasting months or more.
Almost everyone has the occasional bad night, which is normal. Insomnia becomes worth addressing when poor sleep is frequent and starts to affect how you feel and function during the day.
Common causes
Insomnia often results from a mix of factors rather than a single cause. Common contributors include:
- •Stress, anxiety or worry
- •An irregular sleep schedule or shift work
- •An uncomfortable, noisy or bright sleep environment
- •Caffeine, nicotine or alcohol, especially later in the day
- •Using screens late at night
- •Low mood or depression
- •Certain medical conditions or medications
- •Daytime napping or lack of physical activity
How poor sleep affects you
Sleep is essential for physical and mental health, so ongoing insomnia can take a real toll. In the short term, poor sleep causes tiredness, irritability, difficulty concentrating and low mood, and can affect performance and safety, for example when driving. Over the longer term, persistent poor sleep is associated with a higher risk of health problems and can worsen conditions such as anxiety and depression.
The encouraging news is that sleep is highly responsive to changes in habits and environment, so many people see real improvement by addressing the factors above.
How to sleep better
Improving sleep usually starts with sleep hygiene — the habits and environment that support good sleep. Helpful steps include keeping a consistent sleep and wake time, even at weekends; making your bedroom dark, quiet, cool and comfortable; avoiding screens, caffeine, large meals and alcohol before bed; getting daylight and exercise during the day; and using the bed mainly for sleep.
If you cannot sleep, it is often better to get up and do something calming until you feel sleepy, rather than lying awake frustrated. For insomnia that persists despite these changes, a doctor can help — a structured approach called cognitive behavioural therapy for insomnia (CBT-I) is highly effective, and underlying causes can be identified and treated.
Sleep hygiene: building better habits
Sleep hygiene refers to the everyday habits and environment that support good sleep, and improving it is the foundation of overcoming insomnia. A consistent routine is one of the most powerful tools: going to bed and getting up at the same times every day, including weekends, helps regulate your body clock so that sleep comes more naturally. A relaxing wind-down routine in the hour before bed signals to your body that it is time to sleep.
Your sleep environment matters greatly. A bedroom that is dark, quiet, cool and comfortable promotes better sleep, while light, noise and heat disrupt it. Reserving the bed mainly for sleep, rather than working, scrolling or watching television, strengthens the mental association between bed and sleep. Screens are particularly disruptive, both because of their light and their stimulating content, so avoiding them in the lead-up to bed helps.
What you consume affects sleep too. Caffeine can linger in the body for many hours, so avoiding it in the afternoon and evening helps. Alcohol, although it can make you feel sleepy initially, disrupts sleep later in the night. Large meals close to bedtime can also interfere. Getting natural daylight and physical activity during the day further supports a healthy sleep-wake cycle.
When insomnia needs more than self-help
While good sleep habits resolve much insomnia, some cases need more, and knowing when to seek help is important. If sleep problems persist for several weeks despite improving your habits, or significantly affect your mood, concentration, work or daily life, it is worth seeing a doctor. Persistent insomnia is common and treatable, so there is no need to simply endure it.
The recommended first-line treatment for ongoing insomnia is a structured approach called cognitive behavioural therapy for insomnia (CBT-I). This addresses the thoughts and behaviours that perpetuate poor sleep and is highly effective, often more so than medication in the long term. It can be delivered in person, through programmes or apps, and a doctor can advise on access.
Sleeping medications may occasionally help in the short term but are generally not recommended for long-term use, as they can cause dependence and side effects. It is also worth seeing a doctor if insomnia comes with loud snoring and daytime sleepiness (which can suggest sleep apnoea) or with low mood or anxiety, as treating an underlying cause often resolves the sleep problem too.