Health condition · Clinically reviewed
Insomnia, the guide that answers what to do next.
Sleeping tablets are not the answer for long-term insomnia - CBT-I is. Here is how insomnia is diagnosed, what actually works, and when a snore might mean something else.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
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Sourced from guidance
Every claim is checked against NICE and peer-reviewed sources you can see at the end.
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Current for 2026
Reflects UK guidance on CBT-I as first-line, and where sleep medication still fits.
Key facts
Insomnia at a glance.
The essentials, in plain English - what it is, how common it is, what actually works, and when to look for something else behind it.
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What it is
Difficulty falling asleep, staying asleep, or waking too early - with daytime effect on mood, energy or performance.
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Acute vs chronic
Acute: less than 3 months, usually stress-related. Chronic: 3+ nights a week for 3+ months.
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How common
Around 1 in 3 UK adults report symptoms; 1 in 10 have chronic insomnia disorder.
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First-line treatment
CBT for insomnia (CBT-I) - more effective than sleeping tablets, without side effects.
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Medication
Short-term only. Z-drugs and benzodiazepines lose effect quickly and carry dependency risk.
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When to look further
Loud snoring, apnoeas, restless legs or new insomnia in later life - rule out sleep apnoea and other causes.
Why this guide matters
Sleep is treatable - the wrong route makes it worse.
Most people are handed a prescription; most respond better to a structured programme. The three points below shape everything else on this page.
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CBT-I beats sleeping tablets long-term
Structured behavioural change outlasts any pill - and does not run out.
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A snore can mean apnoea, not insomnia
Loud snoring with pauses points to OSA, which needs a different pathway entirely.
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Sleep drives mood, and vice versa
Treating one lifts the other. Do not accept “just anxiety” as an answer.
How the diagnosis is made
From bad nights to a clear plan.
The steps a UK GP will normally follow, in order - so you know what to expect and why.
Phase 1 · Recognising
Pattern, sleep diary and OSA screen
Phase 2 · Confirming
Health, medication and lifestyle review
Phase 3 · Managing
CBT-I first, medication only if needed
- 01
Recognising
Pattern of poor sleep
Difficulty falling asleep, staying asleep or early waking - with a daytime cost.
- 02
Recognising
Two-week sleep diary
Log bedtime, wake time, night awakenings and daytime function. Reveals patterns better than a single conversation.
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Recognising
Screen for OSA
Loud snoring, witnessed pauses, morning headache, resistant hypertension - suggest sleep apnoea, not primary insomnia.
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Confirming
Physical & mental health check
Thyroid, pain, medication side effects, anxiety and depression all commonly disturb sleep.
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Confirming
Substance & schedule review
Alcohol, caffeine, nicotine, shift-work patterns and screen exposure all affect sleep.
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Managing
CBT-I as first-line
Sleep restriction, stimulus control and cognitive components - available via app (Sleepio), self-help or therapist.
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Managing
Medication if needed
Short courses only, alongside CBT-I, with a plan to stop.
Typical timeline: 4-8 weeks from first review to a settled plan.
Symptoms
What insomnia actually looks like.
Insomnia is more than the odd bad night. Here are the patterns that matter - and the ones that suggest a different diagnosis.
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Difficulty falling asleep
Taking 30+ minutes most nights to fall asleep.
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Waking through the night
Multiple awakenings or long stretches awake in the small hours.
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Early-morning waking
Waking hours before your alarm, unable to return to sleep - a classic depression pattern too.
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Non-restorative sleep
Sleeping long but never feeling rested - especially with snoring, points to sleep apnoea.
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Daytime tiredness
Persistent low energy, needing naps or coffee to function.
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Poor concentration
Memory lapses, mistakes at work, slower reactions.
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Low mood or irritability
Insomnia both causes and worsens low mood - treating one helps the other.
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When to escalate
Loud snoring with pauses, falling asleep driving, or new insomnia in later life with cognitive change - see the red-flags section.
Treatment
How insomnia is treated in the UK.
CBT-I first, medication where needed - what each option does, and where it belongs in the plan.
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CBT-I
Cognitive Behavioural Therapy for Insomnia - the most effective long-term treatment. Available via Sleepio (NHS-commissioned in many areas), self-help books, or a therapist.
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Sleep restriction
Temporarily limiting time in bed to build sleep drive - counter-intuitive but highly effective. A CBT-I component.
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Stimulus control
Bed only for sleep and sex; get out of bed if not asleep in 20 minutes; consistent wake time.
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Sleep hygiene
Cool, dark, quiet bedroom; limit caffeine and alcohol; wind-down routine. Not enough on its own.
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Melatonin (short-term)
Licensed short-term in over-55s; used off-label for jet lag or shift work. Modest effect, generally well tolerated.
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Z-drugs & benzodiazepines
Short courses only (2-4 weeks). Effective initially but tolerance and dependence develop quickly.
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Treat the driver
If anxiety, depression, pain, sleep apnoea or reflux is fuelling insomnia, treating that transforms sleep.
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Address alcohol & screens
Alcohol fragments sleep even when it seems to help; late-evening screens delay sleep onset. Small changes, big effect.
What this guide is based on
The sources behind every claim on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, ask about CBT-I.
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NICE. Insomnia: management (Clinical Knowledge Summary).
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NICE. Digital CBT-I (Sleepio) technology appraisal.
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British Sleep Society. Patient information on insomnia.
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NHS. Insomnia: overview and self-help.
Red flags
When insomnia points to something else.
Most insomnia is treatable at home. These are the situations where you should look further, or seek help today.
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Loud snoring with pauses
Suggests obstructive sleep apnoea, not primary insomnia - see our OSA guide.
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Falling asleep while driving
Legal and safety emergency - do not drive; seek urgent assessment.
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New insomnia in later life
Especially with memory or personality change - deserves review to exclude depression, delirium or dementia.
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Insomnia with weight loss
Weight loss, night sweats or fever with insomnia - see a GP.
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Insomnia during pregnancy
Especially with restless legs or persistent snoring - discuss with your midwife or GP.
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Alcohol used to sleep
Backfires quickly and worsens sleep quality. Support is available.
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Insomnia with severe low mood
Especially with any thoughts of self-harm - contact your GP promptly, Samaritans 116 123, or NHS 111.
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Restless legs at night
A creeping urge to move the legs when settling - treatable, but a different diagnosis.
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Sleep terrors or acting out dreams
Especially in older adults - can herald neurological conditions. See a GP.
Living with it
A stubborn condition, but a very treatable one.
Four things that make the biggest difference day to day - timing, environment, alcohol and expectations.
A quiet reminder
Consistency beats intensity, every time.
Small, steady changes - kept up for weeks - do more than a heroic weekend of “catching up”.
- 01 Timing
Fix your wake time first
A consistent wake time (weekends included) is the single most useful anchor for insomnia treatment.
- 02 Bed
Bed is for sleep, not TV
Reserve the bed for sleep and sex; get up if you are still awake after 20 minutes.
- 03 Alcohol
It’s a false friend
Alcohol may help you fall asleep faster but fragments the second half of the night.
- 04 Expectations
Eight hours is not law
Adults need 7-9 hours on average, but individuals vary. Chasing a specific number can worsen insomnia.
Frequently asked
Everything we get asked about insomnia.
Quick answers on CBT-I, medication, alcohol, screens and when to see a GP.
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When is insomnia a disorder?
When difficulty falling asleep, staying asleep or waking too early happens at least three nights a week for at least three months, with a daytime cost. Shorter periods count as acute insomnia.
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Do I need a sleep study?
Not usually. A sleep study is arranged when obstructive sleep apnoea, narcolepsy or another sleep disorder is suspected.
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What is CBT-I?
Cognitive Behavioural Therapy for Insomnia - a structured programme (sleep restriction, stimulus control, cognitive work) that outperforms sleeping tablets long-term.
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Should I take melatonin?
Licensed short-term in over-55s. It has modest effect and is generally well tolerated. Speak to a GP or pharmacist rather than importing unregulated supplements.
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Are sleeping tablets safe?
For short-term use in acute insomnia, yes. Long-term use leads to tolerance, dependency and worsening sleep quality - and interacts with many other medicines.
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Why does alcohol make me sleep worse?
It shortens sleep-onset but fragments deeper stages of sleep and REM. It’s one of the fastest changes you can make.
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Is 8 hours the right amount?
A useful average, but individuals vary between 6 and 9 hours. Consistency and daytime function matter more than a specific number.
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Can screens really affect sleep?
Yes - both through blue light delaying melatonin and through the arousing content. Limit screens in the last hour before bed.
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Should I nap?
For most people with insomnia, no - naps reduce night-time sleep drive. Shift workers and older adults can use very short naps carefully.
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When should I see a GP?
If insomnia lasts more than 4 weeks despite good sleep habits, or if you have snoring with pauses, daytime sleep-attacks, or your mood is affected.