Insomnia

What is insomnia? 

Insomnia is a common sleep disorder which makes it hard for you to fall or stay asleep. Some people with insomnia may wake up too early and struggle to fall back to sleep. People with insomnia will often feel tired when they wake up in the morning. 

You can sometimes manage insomnia with lifestyle changes like avoiding caffeine or creating a relaxing bedtime routine. However, the recommended gold-standard treatment for chronic insomnia is cognitive behavioural therapy for insomnia (CBTi). 

Our sleep specialists at Royal Brompton and Harefield hospitals are internationally renowned and are experts in treating insomnia. We are one of the few private providers of CBTi treatment.

Types of insomnia

The main types of insomnia are short-term and chronic. Short-term insomnia is where your condition lasts for less than 3 months. Chronic insomnia is where the sleep disturbance lasts for more than 3 months.

Insomnia symptoms

Getting enough sleep can be challenging but, for some people, it can turn into insomnia. Disrupted sleep, or lack of it, can affect your general wellbeing and daily life. 

On average, adults need between 7 and 9 hours of sleep each night. Not getting the amount of sleep you need regularly may cause you to experience problems when you’re awake. 

The main symptom of insomnia is being unable to fall or stay asleep, but you might not realise the links between other symptoms and insomnia.  

These symptoms can include:   

• finding it difficult to stay asleep 
• waking up during the night 
• waking up too early 
• feeling tired during the day 
• experiencing anxiety or an irritable mood during the day 
• not being able to nap during the day despite being tired 
• struggling to concentrate in the daytime 

If you’re constantly tired during the day, you’re most likely not getting enough sleep and insomnia may be the cause.  

Most adults will experience insomnia at times in their lives, even for a short period. However, this usually resolves itself once they find the stressor or cause of the insomnia. But for some people, insomnia can be a chronic condition and last for 3 months or more.  

If you are experiencing symptoms of insomnia and would like to speak to one of our sleep specialists, contact our team to arrange an appointment.

What causes insomnia?

Many things can cause insomnia, even a combination of different factors.  

The most common causes of insomnia are:  

• stress, anxiety and depression – your emotional health can affect your sleep, so trying to minimise stress and getting treatment for mental health conditions can help
• sleeping in a room that’s too hot or cold – it’s challenging for your body to relax and rest if the room is too hot or cold at night, so try adjusting the room’s temperature to between 16°C and 18°C
• drinking caffeine or alcohol – these stimulants can keep you awake longer than you should be, so avoiding them before bed is crucial when battling insomnia
• an uncomfortable bed – if your bed isn’t comfy, your body will struggle to fall asleep as it’ll be more focused on how uncomfortable you are 
• sleep apnoea – this sleep-related condition occurs when you temporarily stop breathing during the night. It can disrupt your sleep, especially if it’s undiagnosed
• jet lag or shift work – this can disrupt your circadian rhythm (internal body clock), which means your sleep-wake cycle doesn’t work as it should, potentially leading to insomnia

Who is at risk of insomnia? 

Insomnia can occur in anyone and at any time, but it may be more common if you’re:  

• over 60 
• a woman 
• stressed 
• jet lagged 
• a shift worker 

It may also be a risk for someone with a mental or physical health condition.

Complications of insomnia 

Sleep is vital for your health, so not getting enough can cause problems. For instance, having insomnia could lead to:  

• a decreased performance at school or work 
• slower reaction times, which can be dangerous while driving 
• mental health conditions, such as anxiety and depression 
• a higher risk of long-term health conditions like high blood pressure and coronary heart disease  

If you are concerned about insomnia and would like to speak to one of our consultants, contact our team to arrange an appointment.  

Diagnosing insomnia 

Diagnosing insomnia may require a multi-stage approach. First, our sleep specialists may perform a physical examination to check for signs of other problems caused by insomnia. We may perform blood tests to rule out thyroid problems or other health conditions that could be affecting your sleep.  

Our consultant may ask about your sleep and suggest you keep a sleep diary for a few weeks, where you write down how much sleep you get and how often you wake.  

If your insomnia isn’t apparent or you have signs of another potential sleep disorder, you may need to undergo a sleep study. During the study, you’ll stay at our sleep disorder clinic overnight and we’ll monitor your brain waves, heart rate and eye and body movements.    

If you are looking for a fast and accurate diagnosis for insomnia, our sleep experts can help. Contact our team to arrange an appointment at a time that suits you.

Insomnia treatment 

You can sometimes manage insomnia with lifestyle changes, such as:  

• avoiding caffeine and alcohol, especially before bed 
• staying active during the day to encourage healthy sleep 
• avoiding large meals before bed 
• making your bedroom comfortable 
• not watching TV or using screens before bed 
• creating a relaxing bedtime routine 
• using ear plugs or an eye mask if noise or light interrupts your sleep  
• trying not to nap during the day to help create a healthy sleep pattern 

Over-the-counter sleeping aids may help you temporarily, but you shouldn’t take them long-term to manage insomnia. If at-home management isn’t helping your insomnia, then treatment from your doctor may be necessary.

Cognitive behavioural therapy for insomnia 

At Royal Brompton and Harefield hospitals, we offer cognitive behavioural therapy for insomnia (CBTi). Our 8-week programme aims to improve sleep disturbances and address sleep-related anxiety.  

CBTi is considered the gold-standard treatment for insomnia and is recommended by The National Institute for Health and Care Excellence (NICE). Our CBTi consists of 6 to 8 weekly sessions lasting between 20 and 40 minutes each. We also offer these sessions as video calls and in-person.  

We take 2 approaches. The cognitive approach provides strategies that help to reduce sleep-related anxiety and support relaxation. We also offer tips on relaxing your muscles in bed so you can feel mentally and physically relaxed.    

The behavioural approach examines different behaviours that you can introduce to help minimise insomnia. For example, reducing the amount of time you spend in bed so that you’re not awake for hours while struggling to sleep.  

We will also consider stimulus control therapy. During this treatment, you will try to create an association of sleep when going to bed. Examples include setting a regular sleeping schedule where you go to bed and wake up at the same time every day and avoiding napping during the day. 

Insomnia can be a challenging condition to manage but, over time – and by implementing strategies that work for you – your symptoms should improve. With our support, you’ll finally be able to get the sleep you need. Get in touch with our team to book an appointment with one of our consultants.