Insomnia Dr Rob Hicks Sleeping difficulties are most commonly caused by stress and worry.

In this article

What is insomnia? Causes and risk factors

Treatment and recovery Advice and support

Insomnia is repeated difficulty in getting to, staying or getting enough good quality sleep, despite adequate opportunity, which leads to some form of impairment of performance or wellbeing during the daytime. If it occurs regularly or over a long period of time, it's called chronic insomnia.

About one in three adults will have had some sort of problem with insomnia within the past 12 months. For most the problem is fairly short-lived but for as many as one in ten it becomes a chronic problem which significantly affects their life.

There are many different patterns of insomnia. For example, one in three people with insomnia have no problem getting off to sleep but then wake in the early hours and cannot get back to sleep.

A common trigger for sleeping difficulties is stress and worry. Some people are particularly vulnerable because they are more likely to show a more extreme response to stress, such as people who are depressed, chronically ill or struggling with other difficult issues such as relationship problems.

Other common causes include physical illness that causes pain, environmental noise, depression, shift work, caffeine or alcohol consumption, and medication side-effects. Insomnia is much more common in older people.

Once triggered, sleep problems may then be perpetuated by the individuals beliefs and behaviours – they often worry excessively about the effect that inadequate sleep will have on them and so strive excessively hard to get to sleep, take daytime naps or sleep in late which can disrupt the natural rhythm, or turn to medicines or alcohol in the belief that this will help (most just induce unnatural patterns of sleep). A vicious cycle of poor sleep and stress is quickly set up and persists after the initial trigger has passed.

Insomnia contributes to excessive daytime tiredness, which in turn may be responsible for accidents, recurrent infections (inadequate sleep has been show to suppress the immune system), poor concentration, irritability, work and relationship problems and a general inability to cope. In children it may be linked to poor growth.

Sleeping tablets may be prescribed for short-term use only, when the cause of insomnia has been identified as bereavement or jet lag, for example.

However, it's usually more important to address any underlying cause of the insomnia and attempt to restore a normal sleep pattern through changes in behaviour and lifestyle. For example make sure your bed is comfortable and your bedroom dark and quiet. Try to follow a set routine, going to sleep and getting up at the same time and avoiding daytime naps, and don’t work or watch TV in your bedroom.

You should also try avoiding stimulants such as caffeine, nicotine and alcohol. Getting more exercise during the day, having a warm milky drink before bed, and herbs such as valerian and camomile can also help.

Insomnia Helpline (Medical Advisory Service)
Tel: 020 8994 9874
Email: info@medicaladvisoryservice.org.uk

Help the Aged
Tel: 020 7278 1114 (England); 0845 833 0200 (Scotland); 029 2043 1555 (Wales); 02890 230 666 (Northern Ireland)
Email: info@helptheaged.org.uk
Website: www.helptheaged.org.uk

This article was last medically reviewed by Dr Trisha Macnair in March 2009.