Insomnia is the most common sleep disorder in the UK, affecting around a third of the population at any given time. It is characterised by difficulty falling asleep, staying asleep, or waking too early — leaving you feeling unrefreshed and impacting your ability to function during the day. While most people experience occasional poor sleep, chronic insomnia (lasting more than three months) requires treatment.
Types of Insomnia
Short-term (acute) insomnia lasts less than three months and is usually triggered by a specific event such as stress, illness, grief, or disruption to routine. It typically resolves once the underlying cause is addressed. Long-term (chronic) insomnia persists for three months or more, occurring at least three nights per week, and often takes on a life of its own independent of the original trigger. Chronic insomnia is most effectively treated with psychological therapy.
Insomnia Symptoms
Common symptoms include difficulty falling asleep despite being tired, waking repeatedly during the night, waking very early and being unable to return to sleep, feeling unrefreshed after sleep, daytime fatigue and low energy, difficulty concentrating and poor memory, irritability, low mood and anxiety, and reduced performance at work or school. Early morning waking is particularly associated with depression.
What Causes Insomnia?
Insomnia has many potential causes. Common causes include stress and anxiety (work pressures, financial worries, health anxiety), depression and other mental health conditions, poor sleep habits such as irregular sleep times or screen use before bed, shift work and jet lag, physical health conditions including chronic pain, restless legs syndrome, and menopause, alcohol and caffeine use, and certain medications including some antidepressants and corticosteroids.
How Much Sleep Do Adults Need?
Most adults need 7–9 hours of sleep per night. However, sleep needs vary individually — what matters most is how you feel during the day. If you feel alert and able to function well, you are likely getting enough sleep. Persistent tiredness despite adequate time in bed is a key signal that sleep quality is poor.
NHS Treatment: CBT-I (Recommended First-Line)
Cognitive Behavioural Therapy for Insomnia (CBT-I) is recommended by NICE as the first-line treatment for chronic insomnia. It is more effective than sleeping tablets for long-term outcomes and produces lasting benefits without dependence. CBT-I is typically delivered over 6–8 sessions and addresses thoughts, behaviours, and habits that perpetuate insomnia. Core components include sleep restriction therapy (temporarily reducing time in bed to consolidate sleep), stimulus control (re-associating the bed with sleepiness), cognitive restructuring (challenging unhelpful sleep beliefs), and relaxation techniques.
In England, CBT-I is available through NHS Talking Therapies (self-refer at nhs.uk). The NHS-recommended digital CBT-I programme Sleepio is available free to some NHS patients. Daylight and Sleepstation are other evidence-based digital options.
Sleeping Pills: What the NHS Says
The NHS recommends sleeping pills only as a short-term measure (typically no more than two to four weeks) due to risks of tolerance, dependence, and side effects. Prescribed options include zopiclone (a Z-drug), benzodiazepines such as temazepam, and melatonin (licensed for adults over 55). Over-the-counter antihistamine-based sleep aids (diphenhydramine, promethazine) lose effectiveness quickly and should only be used occasionally. None of these address the underlying causes of insomnia.
Sleep Hygiene: Evidence-Based Tips
Good sleep hygiene supports better sleep quality. Key recommendations include keeping a consistent sleep and wake time every day; only going to bed when sleepy (not just tired); getting out of bed if you cannot sleep after 20 minutes and returning only when sleepy; keeping the bedroom cool, dark, and quiet; avoiding screens for 30–60 minutes before bed; avoiding caffeine after midday; avoiding alcohol within three hours of bedtime; getting regular daylight exposure, especially in the morning; and establishing a relaxing pre-sleep wind-down routine.
Sleep Apnoea: Are You at Risk?
Sleep apnoea is a common and often undiagnosed sleep disorder in the UK involving repeated pauses in breathing during sleep. Key signs include loud snoring, gasping or choking during sleep (often reported by a partner), excessive daytime sleepiness despite adequate sleep time, morning headaches, and difficulty concentrating. Sleep apnoea significantly increases the risk of cardiovascular disease, type 2 diabetes, and depression. If you suspect sleep apnoea, see your GP — it is treatable with CPAP (Continuous Positive Airway Pressure) therapy, which is highly effective.
Restless Legs Syndrome
Restless legs syndrome (RLS) affects around 5–10% of people in the UK and is a significant but often unrecognised cause of insomnia. It causes an irresistible urge to move the legs, typically accompanied by uncomfortable sensations described as crawling, tingling, or aching — worst at rest and in the evening. RLS can be primary (with a genetic component) or secondary to iron deficiency, kidney disease, or pregnancy. Treatment includes iron supplementation (if deficient), lifestyle changes, and in more severe cases, dopamine agonist medications.
Important: If poor sleep is significantly affecting your daily life, please speak to your GP. Chronic insomnia is a medical condition and effective treatments are available — it should not simply be accepted as inevitable.
Related Health Guides on YourHealthXpert
Explore these related NHS-aligned health guides on conditions connected to this topic:
- Anxiety and Depression — anxiety is the leading cause of insomnia; treating the underlying anxiety often resolves sleep problems
- Sleep Apnoea — obstructive sleep apnoea causes fragmented, unrefreshing sleep often mistaken for insomnia
- ADHD — sleep difficulties are extremely common in adults with ADHD
- Menopause — night sweats and hormonal changes cause significant sleep disruption
- Vitamin D Deficiency — low vitamin D is associated with sleep disturbance