Sleeping tablets are the most common first response to insomnia and the least likely to fix it on their own. Persistent sleep problems usually have drivers — stress, anxiety, low mood, or habits that have quietly formed around the bad nights — and treating those is what produces durable change.
What is a sleep disorder?
Sleep disorders affect sleep quality, timing, or duration — such as insomnia — and are frequently connected to underlying stress, anxiety, or depression. Occasional poor sleep is not a disorder; insomnia is diagnosed when difficulty falling asleep, staying asleep, or waking too early recurs over weeks or months and causes daytime consequences such as fatigue, poor concentration or low mood.
Sleep problems are often both symptom and cause. Depression, anxiety, ADHD and trauma all disrupt sleep, and poor sleep in turn worsens mood and concentration — which is why treating sleep in isolation often fails. Persistent insomnia is also maintained less by the original trigger than by what develops in response: longer hours in bed, irregular timing, napping, and anxiety about sleep itself. Those are the factors treatment targets.
What causes a sleep disorder?
Sleep difficulties usually begin with an identifiable trigger, then persist through habits formed in response. Both parts matter, because the original cause and what now maintains the problem are often different. Common contributors include:
- Stress, anxiety, or a period of significant worry
- Depression, which characteristically causes early morning waking
- Irregular sleep timing, shift work, or frequent travel
- Caffeine, nicotine, and alcohol — alcohol fragments sleep even when it speeds onset
- Screen use and stimulating activity close to bedtime
- Pain, breathing problems, or other medical conditions
- Some prescribed medications
- Anxiety about sleep itself, which becomes self-perpetuating
Common symptoms
Symptoms vary between people, and you do not need to recognise all of these to benefit from an assessment.
- Difficulty falling or staying asleep
- Waking up too early or waking frequently
- Excessive daytime sleepiness
- Irritability or poor concentration
- Low energy through the day
- Racing thoughts at bedtime
When to seek help
If poor sleep lasts more than a few weeks and impairs daytime functioning, professional evaluation helps address root causes.
How a sleep disorder is diagnosed
Assessment establishes the pattern, not just the complaint: when you go to bed, how long it takes to fall asleep, how often you wake, and the daytime consequences. You may be asked to keep a sleep diary for a week or two, which usually reveals more than recall alone. Dr Kritika Surana will also ask about mood, anxiety and stress — the most common drivers of persistent insomnia — and about caffeine, alcohol, nicotine and medication use.
Some sleep problems are not primarily psychiatric. Loud snoring with pauses in breathing, daytime sleepiness despite adequate time in bed, or unusual movements during sleep may point to obstructive sleep apnoea, warranting referral for a sleep study rather than psychiatric treatment alone.
Treatment options
The first-line treatment for persistent insomnia is psychological, not pharmacological — behavioural treatment produces better and more durable results than sleeping tablets.
CBT for insomnia (CBT-I). The recommended first-line treatment. It targets the factors maintaining poor sleep: regularising sleep and wake times, restricting time in bed to rebuild the association between bed and sleep, and addressing the anxious thinking that keeps people alert. It is structured, time-limited, and its effects generally persist after treatment ends.
Treating what underlies it. Where depression, anxiety, ADHD or trauma is driving the disturbance, treating that condition is part of treating the sleep, which frequently improves as a result.
Medication. Sleeping tablets can help briefly in acute situations, but they are not a long-term solution: tolerance develops, the underlying pattern goes unaddressed, and stopping often causes rebound worsening. Where used, they are short-term and alongside behavioural work.
Practical sleep habits. Consistent wake time, morning light, limiting caffeine after midday, and keeping the bed for sleep are fitted to your circumstances.
What recovery looks like
Sleep improves gradually, and the first phase can feel harder — restricting time in bed initially increases tiredness before consolidating sleep. This is explained in advance so it is expected. Most people see meaningful improvement within four to eight weeks of consistent CBT-I, and the gains tend to last, because what changes is the underlying pattern rather than the symptom being suppressed.
Occasional bad nights continue for everyone and are not a relapse. Part of treatment is reducing the anxiety a single poor night provokes, since that anxiety is often what turns a bad night into a bad month.
How Trio Mindspace can help
Dr Kritika Surana evaluates psychological and behavioural contributors, using targeted therapy (such as CBT-I), lifestyle strategies, and medication when necessary.
Every plan begins with a full assessment rather than an assumption. Dr Kritika Surana will explain what she thinks is happening, set out the options, and agree the approach with you before anything starts. You can read more about her background and approach, or see all conditions treated at the clinic.
Frequently asked questions
Cognitive Behavioural Therapy for Insomnia is a structured, short-term programme that retrains the association between bed and sleep. It addresses sleep timing, the habits that maintain insomnia, and the anxious thinking that builds around bedtime. It is the recommended first-line treatment for chronic insomnia in most guidelines.
Not as a default. Sedatives can help briefly in specific situations, but they do not resolve the underlying cause and can create dependence. Where they are used, it is deliberately short-term and alongside behavioural treatment.
Bedtime is often the first quiet moment of the day, so unprocessed worry surfaces then. It is one of the most common features of stress-related insomnia, and it responds well to specific techniques rather than to trying harder to sleep.
Possibly. Sleep apnoea, thyroid problems and certain medications all disturb sleep. Assessment includes screening for these, with referral where a non-psychiatric cause looks likely.
Generally no. Sleeping tablets can help for short periods in acute situations, but tolerance develops with regular use, the underlying pattern remains unaddressed, and stopping frequently causes a temporary worsening of sleep. Behavioural treatment (CBT-I) is the recommended first-line approach for persistent insomnia and produces longer-lasting results.
Alcohol shortens the time it takes to fall asleep but worsens sleep quality. It suppresses restorative sleep stages, fragments the second half of the night, and often causes early waking. Using alcohol to sleep tends to worsen insomnia over time.
Most adults need somewhere between seven and nine hours, but there is genuine individual variation. The more useful measure is how you function during the day rather than the number itself. Chasing a target figure often increases anxiety about sleep, which makes sleep worse.
It depends on the pattern. Where insomnia is linked to stress, anxiety, low mood or an irregular routine, psychiatric assessment is appropriate. Where there is loud snoring with breathing pauses, marked daytime sleepiness despite adequate time in bed, or unusual behaviours during sleep, a sleep study may be needed — and Dr Kritika Surana will advise on referral if the assessment points that way.