What does insomnia feel like?
Insomnia is less about the number of hours and more about sleep that does not restore you. You might lie awake for a long time, wake several times in the night, or wake far too early and not get back to sleep. The next day you feel tired, irritable and find it hard to concentrate.
Commonly reported experiences include:
- Taking a long time to fall asleep
- Waking several times during the night
- Waking early and not being able to get back to sleep
- Still feeling tired after waking
- Daytime irritability and poor concentration
How does poor sleep affect daily life?
Ongoing poor sleep shows up in the day: tiredness, a shorter temper, and trouble focusing at work, in class or while driving. The NHS lists these daytime effects as part of insomnia itself, which is why it is worth taking seriously even if you are "only" losing a little sleep.
The NHS calls insomnia short-term when it lasts less than three months and long-term when it lasts longer, and says it usually gets better by changing sleep habits. If it does not, or it has gone on for months, that is the time to get help.
What causes sleep problems?
Sleep problems usually have more than one cause. The NHS lists stress, anxiety and depression; a noisy, hot or cold bedroom; caffeine, alcohol and nicotine; shift work; and some physical health conditions, such as an overactive thyroid or the menopause. Many medicines can also affect sleep.
Loud snoring, gasping or choking at night, or breathing that stops and starts, can be signs of sleep apnoea, a medical condition a doctor should assess.
Do sleep hygiene tips actually work?
Good sleep habits help, but on their own they are rarely enough for long-term insomnia. The NHS recommends habits such as a regular wake-up time and a wind-down hour. The American Academy of Sleep Medicine advises clinicians not to use sleep hygiene as the only treatment for chronic insomnia, but to include it within fuller therapy.
Habits the NHS suggests:
- Go to bed only when you feel sleepy, and get up at the same time every day
- Wind down for an hour before bed, and keep the room dark and quiet
- Avoid tea, coffee, smoking and alcohol for at least six hours before bed
- Avoid screens just before bed, heavy late meals and daytime naps
- Be active during the day, but not within four hours of bedtime
What kinds of support help with insomnia?
The treatment with the strongest evidence is cognitive behavioural therapy for insomnia (CBT-I). It is the only treatment given a strong recommendation in the American Academy of Sleep Medicine guideline for chronic insomnia in adults. The NHS also offers CBT for insomnia, face to face or as online self-help. It helps you change the thoughts and habits that keep you awake.
If anxiety, low mood or stress is keeping you up, working on that with a therapist can help your sleep too. Medicines for sleep are a matter for a doctor who has assessed you. The NHS notes that GPs now rarely prescribe sleeping pills for insomnia.
What are common misconceptions about sleep problems?
Poor sleep is not a personal failing or a lack of discipline. CBT for insomnia has strong evidence behind it. If simple changes have not worked, that is a reason to get help, not a sign that nothing will.
When to seek professional support
- See a doctor if changing your sleep habits has not helped, or you have had trouble sleeping for months.
- See a doctor if poor sleep is making daily life, work or study hard to manage.
- See a doctor if you snore loudly, gasp or choke in your sleep, or someone has noticed your breathing stop and start, as these can be signs of sleep apnoea.
- Talk to a therapist if worry, stress or low mood is keeping you awake.
- If you are thinking about harming yourself, call Rescue 1122 or Taskeen on 0316-8275336 now.
