Insomnia guide: symptoms, causes & treatments

Believed to affect a third of Brits at some point,¹ insomnia makes it difficult for sufferers to fall or stay asleep. Read on to find out more about this common sleep disorder.

What is insomnia?

The word insomnia comes from the Latin words for no ‘in’ and sleep ‘somnus’, insomnus.²

People with insomnia struggle to fall asleep or stay sleeping for long enough.

Insomnia is also when people wake up frequently throughout the night and have trouble getting back to sleep. It is more common in people who are:

• Elderly
• Divorced / separated / widowed
• Female
• White
• People with other physical / mental illnesses

Those with insomnia often wake up feeling tired even if they’ve had enough time to sleep.

How does insomnia affect everyday life?

Most of us are familiar with feeling drowsy and irritable after a night without enough good quality sleep. Similarly, long-term insomnia has a huge impact on our mood and energy during the day.

Summary:

• Insomnia is a common sleep disorder that can leave people feeling tired and in a bad mood during the day

9 insomnia symptoms

Some of the most common symptoms of insomnia include:

1. Feeling tired
2. Feeling short-tempered
3. Lacking in concentration
4. Difficulty falling asleep
5. Lying awake at night
6. Waking up multiple times in the night
7. Waking early and not being able to sleep again
8. Feeling tired after waking up
9. Not being able to nap, even though you’re tired

These symptoms can go on to affect relationships with friends and family as well as performance at work or school.

Are there different types of insomnia?

Many people may experience insomnia at different points in their lives, but it can affect some people for months or years. Here are the 4 main types of insomnia and what you can expect from each.

4 different types of insomnia

Finding out which type of insomnia you have can be very helpful in tackling it; here are 4 of the most common types of insomnia:

1. Acute insomnia

Short-term episodes of disturbed sleep are known as acute insomnia, often lasting from one night to several weeks.

It’s the most common type of insomnia and often includes difficulty falling and staying asleep, waking up too early and feeling ‘unrefreshed’ the following day. This can cause people to feel sleepy, fatigued or irritable.

Those with acute insomnia could also find it difficult to concentrate, think and regulate mood.

It’s sometimes also called ‘adjustment insomnia’. Adjustment insomnia is usually caused by stressful events or a change in environment.

Here are some common acute insomnia causes:

• Jet lag
• Hot or cold nights
• Bright lights
• Loud noise
• Uncomfortable / unfamiliar bedding
• New school / job
• Moving to a new house
• Work deadlines
• Death of family or friend
• Relationship difficulties
• Pain / physical discomfort
• Allergies
• Some medications

2. Chronic insomnia

Extended periods of insomnia are referred to as chronic insomnia. This is when someone has insomnia at least three nights a week for over a month.

It is considered a more complex condition than acute insomnia. This is because is usually comes with cognitive problems the next day (memory, concentration, focus, etc), and/or impaired performance.

In order to be considered chronic insomnia, this will not only be affecting the individual, but also their friends, caretakers and coworkers.³

People with insomnia are more likely to / are more at risk of:⁴

• Visiting doctors and hospitals
• Being absent from work
• Making mistakes or have accidents at work
• Being involved in fatal road accidents
• Having depression
• Having anxiety
• Abusing substances
• Committing suicide

3. Behavioural insomnia of childhood

There isn’t a set definition of behavioural insomnia of childhood (BIC), but problems like struggling to fall asleep independently or waking up frequently in the night are common.

These sleep problems tend to come from the child having negative feelings towards sleep, which can contribute to their struggle to fall asleep and waking at night.

Examples of this are young children who rely on rocking / nursing to settle into sleep, and older children who get to fall asleep with their parent’s presence / the lure of the TV!

The most common treatments are behavioural interventions, e.g. establishing routines, teaching relaxation / self-soothing skills and positive associations with sleep.⁵

4. Maintenance insomnia

Do you wake up and see the clock flash 4.am and desperately try to fall back to sleep but fail due to flashbacks of yesterdays, anxiety for the coming day or ‘to-do’ list ideas. You may be experiencing maintenance insomnia.

It involves not getting enough sleep quality or quantity and waking up feeling unrefreshed. Women experience maintenance insomnia more than men.

What are the effects of insomnia?

Occasional episodes of insomnia are unlikely to have any long-lasting consequences. But over time, lack of sleep caused by persistent insomnia can affect overall health, energy levels, concentration, and mood.

Summary:

• There are 4 common types of insomnia, all with slightly different symptoms and causes
• Common symptoms include feeling tired, difficulty falling asleep, lying awake at night and waking up early and not being able to go back to sleep

Causes of insomnia

Insomnia can be caused by a wide range of triggers including stress, medication and various health conditions.

What causes insomnia?

Here are some of the most common causes of insomnia:

1. Anxiety, stress and insomnia

From work problems and emotional worries to financial issues and bereavement, many people find it difficult to fall asleep during or after stressful and traumatic events.

Lying awake thinking about getting to sleep can often cause frustration and anxiety.

Mental health problems can also contribute to insomnia. In particular, depression, anxiety or post-traumatic stress disorder can play a part disrupting sleep.

2. Sleeping routine and environment

People with insomnia may find that going to bed at irregular times makes the issue worse. Aiming to go to bed at a similar time every night may help to develop a regular sleep pattern.

Other factors, such as shift changes at work or jet lag from flying long-haul to a different time zone, may also cause difficulty sleeping.

In addition, making sure your bedroom is not too hot, too cold or too bright may help you on your way to a good night’s sleep.

3. Medical conditions

There are several medical issues or conditions that can contribute to insomnia. These include respiratory, neurological and heart conditions such as asthma, Alzheimer’s disease or angina.

People with joint or muscle problems or those suffering from long term pain may also regularly struggle to sleep.

Other sleep disorders such as sleep apnoea, night terrors and sleepwalking could also be to blame.

4. Certain medications

Various over-the-counter medications or prescriptions can cause insomnia. To be on the safe side, always check the leaflet that comes with medications to find out if insomnia is listed as a side effect.

Pay particular attention to steroid medications, some antidepressants, beta-blockers and other high blood pressure medications.

Summary:

• There are many different insomnia causes, including anxiety, sleeping environments, changes to routines and certain medications

Insomnia help

If you’re coping with long-term insomnia, we’ve rounded up some tips so you can help yourself, along with guidance on when to see your GP.

23 insomnia treatments

Lifestyle changes

Making changes to your lifestyle, habits and where you sleep can help to improve your chances of falling asleep. Here are some general sleep tips:

1. Avoid napping during the day

Short naps during the day are encouraged for some people to help them relax, feel alert and improve their mood, but it turns out napping isn’t for everyone.

Napping during the day when you have insomnia can further confuse your already-out-of-whack body clock and make it even harder to sleep at night. 

It’s best to fight the urge to nap and save all that tiredness for later, when you can hopefully enjoy a better night’s sleep.

2. Regular daily exercise

Exercising during the day is one of the best things someone with insomnia can do to help them sleep, especially if they don’t currently do any (or exercise at night).⁶

It can help to regulate your circadian rhythm (internal body clock), and relieve depression and anxiety symptoms, all of which can help you on your way to better sleep.

One study found that when participants with chronic insomnia began regular exercise, they fell asleep up to 13 minutes faster and stayed asleep 18 minutes longer than they did before they started exercising.⁷

However, if it’s got to bedtime and you still haven’t exercised, then it’s better to just try again tomorrow. When you exercise too close to bedtime, the endorphins your body releases can become yet another barrier to a good night’s sleep.

3. No smoking before bed

Do you have a cigarette before bed to help you relax? Well, that’s not going to work, unfortunately! Nicotine is a stimulant, so it can make it harder for you to fall and stay asleep.

Smoking should be avoided completely, or at the very least avoided for at least 2 hours before bed.⁸

4. No caffeine before bed

Caffeine is a mental and physical stimulant, so it must be avoided close to bed.

Its effect can take around an hour to peak in your body, and the effects stay around for 4-6 hours. However, your body needs a full 24 hours to completely eliminate caffeine from your body.⁹

5. No alcohol before bed

Do you sometimes drink a glass of wine or two in the evening to help you sleep? It might not be such a good idea.

While alcohol may make you feel sleepy and could help you fall asleep, it will disrupt your sleep later on.

In the second half of your sleep after drinking alcohol, you are much more likely to keep waking up, develop a headaches, sweat, and even have nightmares – what a nightmare indeed!

It’s recommended to stop drinking alcohol at least 4 hours before you go to bed. Binge drinking should also be limited as it can affect your melatonin levels for up to a week, the hormone that helps us sleep.¹⁰

6. Unwind with a warm bath

If you eat a big curry and hop straight into bed, your body is probably not going to feel ready for sleep. When it is still having to digest a big meal, your body may struggle to switch off.

Try to avoid eating so late that you are still digesting your food in bed, as this puts you more at risk of acid reflux. You should also avoid fatty and spicy foods late in the evenings.¹¹

7. Unwind with a warm bath

Enjoying a warm bath around 90 minutes before bed could help you to fall asleep faster. This is because one of the most important sleep cues is a drop in body temperature, which naturally comes on in the evening.

When you take a warm bath, it raises your body temperature then drops it again when we get out of the bathtub. This can help to enhance the natural circadian rhythm and help us feel sleepy.¹²

8. Gently stretch

Although it’s perhaps not a good idea to go for a run just before bed, stretching and exercising gently before bed can be incredibly relaxing and bring on feelings of sleepiness.

A 2016 systematic review on the effect of meditative movement on sleep quality found that exercises like tai chi and yoga have a high success rate of improving sleep quality.¹³

9. Listen to soothing music

Putting on some soothing music when you get into bed could help you drift off. This is because calming music can help lower the heart rate and help you relax.

One study found that people who listened to non-commercial music for 45 minutes at bedtime has significantly lower heart rates and reported a significantly better improved sleep quality than people who didn’t listen to music.¹⁴

10. Develop a routine

Going to bed and waking up around the same time every day may help you sleep better by regulating your body clock.

11. Write down your worries

As worries and stress can often cause insomnia, write down a list of your concerns before you go to bed. This will help you come up with solutions so you can forget about them and fall asleep easier.¹⁵

Does where I sleep make a difference?

Yes, it can do! A noisy, bright or uncomfortable sleeping environment can make insomnia symptoms worse.

Make your bedroom suitable for sleep by:

1. Removing any TVs, phones or other electronic devices
2. Blocking light with an eye mask, blinds or thick curtains
3. Wearing earplugs if there’s a chance of any noise disturbances
4. Choosing a comfortable mattress and suitable bedding
5. Making sure the room isn’t too hot or cold

Supplements for insomnia

Sometimes our diets can be lacking in vitamins and minerals that can help us sleep better, so supplementing could help. Here are some of the vitamins you should keep topped up on:

1. Vitamin D and insomnia

People who have vitamin D deficiencies are at higher risk of sleep disorders.¹⁶

2. Iron and insomnia

Iron deficiency can cause restless leg syndrome, which causes people to uncontrollably move their legs when they go to bed.

3. Calcium and insomnia

Calcium helps our bodies to use an amino acid called tryptophan to synthesize melatonin – a hormone that helps with sleep.

4. B vitamins and insomnia

All of the B vitamins can help your body to produce tryptophan too. Vitamin B6 in particular could also help people to relax. ^17,18

5. Magnesium and insomnia

Magnesium can have a relaxing effect on the body before bed.

6. Valerian and insomnia

Valerian is a traditional herbal remedy that is used to help with temporary relief of sleep disturbances caused by mild anxiety.¹⁹

Therapy for insomnia

22. CBT

GPs will sometimes refer patients with insomnia to a cognitive behavioural therapy (CBT) therapist.

This treatment is used for a number of mental health conditions, and when it comes to insomnia, it can help you change the thoughts and behaviours that keep you awake at night.²⁰

Medications for insomnia

23. Sleeping pills

GPs rarely prescribe sleeping pills for insomnia due to their highly addictive nature and serious potential side effects.

Medication to help you sleep is usually only prescribed for a few days or weeks if other treatments have not worked or your insomnia is very bad.²¹

When should I see my GP?

If you’re still having difficulty sleeping well after trying out these guidelines, book an appointment to see your doctor. They will try to diagnose what is causing your insomnia and offer ways to treat any underlying conditions.

Summary:

• There are many insomnia treatments – and hopefully some there to help you sleep better
• If things don’t improve after trying some of these tips, go and see your GP who can help get to the root of your sleep problems and recommend treatment

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Last updated: 13 August 2021