Understanding sleep problems
Short-term poor sleep is normal during stress, illness or disruption. It becomes chronic insomnia when it persists three nights a week for three months or more, and starts affecting daytime functioning.
The trap is understandable. After a few bad nights you go to bed earlier, lie in longer, nap, and try harder to sleep. Each of these weakens the association between bed and sleep, and effort is incompatible with sleep — you cannot force it the way you can force exercise.
The most effective treatment, CBT for insomnia, is more effective than sleeping tablets in the long run and works by rebuilding sleep pressure and the bed–sleep association. It is uncomfortable for a week or two, then usually decisive.
Signs to look for
Everyone experiences some of these sometimes. What matters is how many, how long, and how much they interfere with your life.
At night
- Taking more than 30 minutes to fall asleep
- Waking repeatedly, or lying awake in the early hours
- Waking far earlier than intended and unable to return to sleep
- Dreading bedtime; clock-watching
In the day
- Fatigue that sleep does not resolve
- Poor concentration and short-term memory lapses
- Irritability and low frustration tolerance
- Relying on caffeine to function, and on alcohol to wind down
When to seek help
You do not need to be in crisis to deserve support. Consider speaking to someone if:
- It has been more than three months
- You are using alcohol or unprescribed medication to sleep
- Daytime functioning or driving safety is affected
- Your partner reports loud snoring or pauses in breathing — that needs a medical assessment for sleep apnoea
What helps
CBT for insomnia
The first-line treatment. It combines restricting time in bed to rebuild sleep drive, reserving the bed for sleep, and addressing the beliefs that keep you anxious about sleeping. Typically four to eight sessions.
A fixed wake time
One anchor matters more than the rest: get up at the same time daily regardless of how you slept. Lying in to catch up is the single most common thing that keeps insomnia going.
Getting out of bed
If you are awake and frustrated for more than about twenty minutes, leave the bed and do something dull in low light until sleepy. This rebuilds the association between bed and sleep rather than bed and struggle.
Treating what is underneath
Insomnia frequently travels with anxiety, depression or pain. Where a racing mind is the barrier, treating the anxiety often does more for sleep than any amount of sleep hygiene.
Common questions
How much sleep do I actually need?
Most adults need seven to nine hours, but there is real individual variation. A more useful measure than hours is whether you function well during the day.
Are sleeping tablets a bad idea?
They can help short-term in specific circumstances, and that is a decision for a doctor. For chronic insomnia the evidence favours CBT-I, because it addresses the mechanism rather than suppressing the symptom, and the benefit persists after treatment ends.
Does BetterSpace track my sleep?
The app can read sleep data from Apple Health or Google Health Connect if you allow it, and show trends alongside your mood. You can also book a consultation with a sleep coach.
Is lying with my eyes closed as good as sleeping?
No, and treating it as a substitute tends to prolong insomnia by extending time in bed without sleep.