Sleep and mental health are closely linked. Poor sleep can worsen anxiety, depression and concentration, and mental health conditions often disrupt sleep. Insomnia — difficulty falling asleep, staying asleep, or waking too early, at least three nights a week for three months despite having the chance to sleep — affects roughly one in ten adults. It is common, but you do not have to live with it.
What causes insomnia?
- Stress, worry or major life changes
- Mental health conditions such as depression, anxiety, PTSD and bipolar disorder
- Medical issues: pain, reflux, frequent urination, menopause, thyroid problems
- Other sleep disorders, such as sleep apnea or restless legs syndrome
- Caffeine, nicotine, alcohol and certain medications
- Irregular schedules, shift work, and screens late at night
Often insomnia starts with a stressful period and then continues because of habits that develop — such as spending long hours in bed awake, napping, or worrying about sleep itself.
CBT-I: the first-line treatment
Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first treatment for chronic insomnia by major medical organizations. It typically takes 4–8 sessions and is also available through digital programs. Core components include:
- Stimulus control: use the bed only for sleep and intimacy; get up if you cannot sleep after about 20 minutes
- Sleep restriction: temporarily matching time in bed to actual sleep time to build stronger sleep drive
- Cognitive work: easing unhelpful beliefs and worry about sleep
- Relaxation techniques and consistent routines
Medication
Sleep medications can help in the short term or in specific situations, but they work best alongside behavioral approaches. Options and risks vary, so discuss them with a clinician — especially for older adults, who are more sensitive to side effects such as falls and next-day drowsiness.
Healthy sleep habits
- Wake up at the same time every day, including weekends
- Get bright daylight in the morning
- Avoid caffeine after early afternoon and limit alcohol
- Keep your bedroom cool, dark and quiet
- Wind down for 30–60 minutes before bed with a calming routine
When to see a doctor
Seek help if poor sleep lasts more than a few weeks, affects daytime functioning, or if you snore loudly, gasp at night, or feel very sleepy during the day — these can be signs of sleep apnea, which needs medical evaluation.
Medical disclaimer: This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified health professional about your situation. See our full disclaimer.