Insomnia

Insomnia is a common sleep disorder involving persistent difficulty falling asleep, staying asleep, or getting restful sleep, despite having adequate opportunity to sleep. It can be short-term, often linked to stress or a specific event, or chronic, lasting three months or longer.

• Difficulty falling asleep at night
• Waking up frequently during the night or waking too early and being unable to get back to sleep
• Daytime tiredness, low energy, or sleepiness
• Difficulty concentrating, irritability, or low mood related to poor sleep
• Worry or frustration about sleep itself, which can make the problem worse

• Often related to stress, anxiety, or a significant life change or event, particularly in short-term insomnia.
• Poor sleep habits, such as irregular sleep schedules, excessive screen use before bed, or an uncomfortable sleep environment, can contribute.
• Caffeine, alcohol, nicotine, and certain medicines can disrupt sleep.
• Underlying medical or mental health conditions, such as chronic pain, depression, or other sleep disorders, can also cause or worsen insomnia.

• Diagnosed based on a detailed history of sleep patterns, daytime symptoms, and duration, often supported by a sleep diary kept over one to two weeks.
• Assessment for contributing factors, such as stress, caffeine or alcohol use, medicines, and underlying medical or mental health conditions, is an important part of evaluation.
• Further sleep studies are occasionally used, where available, if another underlying sleep disorder is suspected.

Cognitive behavioural therapy for insomnia (CBT-I), which addresses unhelpful sleep habits and thought patterns, is considered the most effective long-term treatment and is generally recommended before medicine.

Good sleep habits — a consistent sleep schedule, a comfortable and quiet sleep environment, limiting screens before bed, and avoiding caffeine and alcohol close to bedtime — form an important foundation of management.

Short-term use of a sleep medicine may occasionally be considered for brief, severe insomnia under medical guidance, but is generally not recommended for long-term use due to risk of dependence and side effects.

Any underlying medical or mental health condition contributing to insomnia is identified and treated, as this often improves sleep.

• Keep a consistent sleep and wake schedule, even on weekends.
• Create a comfortable, quiet, and dark sleep environment.
• Limit caffeine, especially in the afternoon and evening, and avoid alcohol close to bedtime.
• Reduce screen time and bright light exposure in the hour or so before bed.
• Engage in regular physical activity, but avoid vigorous exercise close to bedtime.