Insomnia

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Dr Tom Micklewright

Medically reviewed by:

Dr Tom Micklewright - Medical Officer

Updated: Aug 18, 2021
Next review: Aug 18, 2022
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Dr Sarah Marshall

Medically reviewed by:

Dr Sarah Marshall - Medical Officer

Updated: Aug 18, 2021
Next review: Aug 18, 2022
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Insomnia is a disorder that means a person has difficulty getting to sleep or staying asleep. Some people have trouble with both.

While everyone has a bad night every now and then, if you’re having trouble sleeping on a regular basis, it’s best to see a doctor.

Our online doctors will discuss your symptoms with you, identify the underlying cause for your insomnia and recommend the most effective treatment.

While most people think of insomnia as not being able to sleep, the symptoms can be more complicated than that. The following symptoms can all be a warning sign of insomnia:

  • Trouble falling asleep
  • Waking up frequently and not being able to get back to sleep
  • Waking up much earlier than you need to
  • Not feeling refreshed when you wake up
  • Feeling irritable during the day
  • Not being able to concentrate

These symptoms can be acute (short term) or chronic (long term). If left untreated, both can lead to:

  • Arguments with family or friends
  • Poor performance at work
  • Lack of a social life
  • Near constant bad mood

Your tiredness can also have an impact on others. For example, your risk of accidents while driving is increased. For that reason, it’s very important to see a doctor about your symptoms as soon as possible if you’re unable to get the recommended 7-9 hours of a sleep a night.

Find out more about insomnia symptoms.

 

Insomnia has a wide variety of possible causes. Identifying what’s causing your sleep problems is an essential step towards finding the most effective treatment for you. Dealing with the underlying cause is often the best way to make insomnia go away.

Here are some of the possible causes of insomnia:

Mental health

Mental health issues are a common cause of both short and long term insomnia. Not being able to sleep is just one of the symptoms of these conditions, so it’s really important to get the help you need if you're experiencing:

In rare cases, insomnia can be an early sign of Alzheimer’s or Parkinson’s disease.

Sleep issues

While insomnia is a sleep disorder in itself, it can sometimes be triggered by other problems with your sleep, such as:

  • Snoring - this can be a sign of a serious sleep disorder known as sleep apnoea.
  • Other sleep disorders such as nightmares, sleepwalking or narcolepsy.
  • A poor sleep environment - too much light or noise, your room being too hot or cold, using electronic devices in bed, allowing pets to share your room or sleeping in an uncomfortable bed can all make it difficult to sleep.

Lifestyle choices

Certain factors that you might not think are linked to sleep can increase your likelihood of insomnia, including:

  • Smoking
  • Drinking alcohol
  • Drinking caffeine close to bedtime
  • Eating too much before going to bed
  • Exercising too close to bedtime

Physical health

Sometimes a problem with your physical health can have an impact on your ability to sleep properly.

  • Heart problems can make it hard to breathe when you lie down.
  • Respiratory problems and allergies such as asthma can be worse at night.
  • Needing to pee a lot.
  • Joint pain, such as arthritis or a back injury.

Work

If you have to travel abroad a lot for work, moving between time zones all the time can mess with your sleeping pattern and lead to insomnia. The same thing can happen if you work irregular shift patterns.

Get even more information about the potential causes of insomnia here.

While there’s no single test for insomnia, our doctors can ask you a series of questions to help diagnose your sleep problems.

They will want to know about your sleep habits and will likely ask a range of questions about your lifestyle, too. Everything you share with our doctors is confidential and no recording of your consultation is kept. You might be asked:

  • What time you usually go to bed
  • What time you usually get up (note that for many insomniacs, this may be different to the time that you wake up)
  • Whether there is anything that could distract you from sleep, such as street noise, bright lights, your room being too hot or too cold
  • Whether you’re currently experiencing stress or anxiety
  • Whether you smoke
  • Whether you drink alcohol (and if so, how much)
  • How often you exercise, and when
  • Whether you’re taking any medication

To help our doctors confirm your diagnosis, they might ask you to keep a sleep diary for a week or two. This would involve recording:

  • What time you go to bed
  • What time you fall asleep (roughly)
  • What time you wake up
  • How often you wake up during the night

Find out more about how our doctors diagnose insomnia.

Insomnia can affect anyone at any time, but it’s thought to be more common in older people.

As we’ve seen, insomnia has many possible causes. Identifying this cause will influence the treatment our doctors suggest. They might decide that a simple lifestyle change will help with your symptoms, while they can also prescribe medication or refer you to a specialist where necessary.

Our doctors can:

  • Treat mental health conditions using CBT or medication.
  • Provide advice that will help you correct issues that are disrupting your sleep, such as suggesting an eye mask to block out light or changing your mattress to make your bed more comfortable.
  • Treat sleep disorders such as sleep apnoea, sleepwalking, nightmares or narcolepsy.
  • Suggest changes to your lifestyle, such as giving up smoking, cutting down on alcohol and avoiding caffeine too close to bedtime.
  • Treat physical health problems such as joint pain, allergies or heart and respiratory problems. This could be anything from medication to referring you for specialist treatment. 

Our doctors will always have your best interest in mind and recommend the treatment that they think is the most suitable.

Please note that they can’t prescribe zopiclone or sleeping tablets.

During pregnancy, your body undergoes a lot of changes. Some of these can make it harder to get to sleep at night. Insomnia in pregnancy can be caused by:

  • Hormonal changes - especially during the first trimester.
  • Having to get up in the night due to morning sickness, or needing to go to the toilet.
  • Difficulty getting comfortable, particularly as your baby grows.
  • Anxiety about delivery, the health of your baby and your upcoming parenthood.

Our doctors can help you manage these symptoms and provide effective treatment that’s safe for you and your baby. 

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