Insomnia

1) What it is

Insomnia is ongoing difficulty with:

• falling asleep
• staying asleep
• waking too early
• or waking feeling unrefreshed

When poor sleep starts affecting daily life, it becomes a health issue. A GP may look for causes and often offers CBT (cognitive behavioural therapy) for insomnia.

2) What it feels like

“I’m exhausted but I can’t switch off.”

“My brain starts racing at night.”

“I dread bedtime.”

“I feel broken and anxious the next day.”

“I’m tired all day but wide awake at night.”

3) Common signs & symptoms

• taking a long time to fall asleep
• waking often during the night
• waking too early
• irritability and low mood
• poor concentration / “brain fog”
• headaches or tension
• anxiety about sleep
• daytime fatigue and crashes

4) What causes it / risk factors

• stress, anxiety, depression
• trauma or hypervigilance
• shift work or irregular routine
• caffeine/alcohol rebound
• chronic pain
• menopause changes
• overthinking / rumination
• sleep environment issues

A GP will try to find out what’s causing it so you get the right support.

5) Triggers

• spending too long in bed awake
• watching the clock
• naps that are too long/late
• screens late at night
• alcohol (worsens sleep quality)
• high stress and overworking
• fear of not sleeping (“sleep anxiety loop”)

6) What helps right now

If you can’t sleep and you’re getting anxious:

• get up and go to a different room
• do something calm (reading/music)
• return to bed when sleepy (about 20 minutes)

Other quick tools:

• long-exhale breathing (in 4, out 6–8)
• “brain dump” page: write worries down
• relax muscles (jaw/shoulders/hands)

7) Longer-term self-help strategies

• consistent wake-up time (even after a bad night)
• reduce naps or keep them short
• sunlight in the morning
• stop caffeine after midday
• wind-down routine (same steps nightly)
• bed only for sleep (not scrolling/worrying)
• “worry time” earlier in the day

8) Treatment options

NHS: insomnia is often treated with CBT (in person or online) to change thoughts/behaviours keeping you awake.

Other options:

• sleep clinic referral (if another sleep disorder suspected)
• treating underlying anxiety/depression
• lifestyle changes and sleep hygiene support

9) Medication overview

Sleeping tablets may sometimes be used short-term, but the best long-term treatment is usually CBT for insomnia.

10) Work, relationships & daily life tips

• keep plans lighter after poor sleep
• don’t “punish yourself” with overworking
• ask for flexibility if sleep is chronic
• reduce driving risk when severely fatigued
• prioritise routine and recovery

11) When to seek urgent help

Urgent help if:

• you haven’t slept properly for multiple nights and feel unsafe
• insomnia is paired with suicidal thoughts
• severe agitation, paranoia, or hallucinations appear
• risk of accidents due to exhaustion

12) Trusted help & resources

NHS: Insomnia

NHS Every Mind Matters: Sleep problems

Samaritans 116 123 (24/7)

Shout: text SHOUT to 85258

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