What Is Insomnia?
Insomnia is a sleep disorder characterised by difficulty falling asleep, staying asleep, or waking too early and being unable to return to sleep. When this happens at least three nights per week for three months or more, it is classified as chronic insomnia — a condition that significantly impacts quality of life, cognitive function, and physical health.
Short-term insomnia, lasting days to weeks, is usually linked to stress, travel, illness, or a major life event. Chronic insomnia, however, often requires a more structured treatment approach.
Common Causes of Insomnia
Insomnia rarely has a single cause. Contributing factors typically include:
- Stress and anxiety — the most common trigger, activating the body’s fight-or-flight response at bedtime
- Poor sleep hygiene — irregular sleep schedules, screens before bed, and excessive caffeine
- Medical conditions — chronic pain, respiratory issues, and hormonal changes
- Medications — certain antidepressants, blood pressure medications, and decongestants can disrupt sleep
- Substance use — alcohol may help you fall asleep initially but disrupts sleep architecture through the night
Treatment Options for Insomnia
Cognitive Behavioural Therapy for Insomnia (CBT-I) is considered the gold-standard first-line treatment. It addresses the thoughts and behaviours that perpetuate poor sleep without the dependency risks associated with medication.
When CBT-I alone is insufficient, short-term sleep medications may be appropriate. Options range from antihistamine-based OTC aids to prescription medications such as zolpidem, zopiclone, and newer melatonin receptor agonists. These should always be used under medical supervision and for the shortest effective duration.
Combining behavioural therapy with appropriate pharmaceutical support typically produces the best outcomes for people with persistent insomnia.
