Insomnia
Insomnia — difficulty falling asleep, staying asleep, or waking too early — affects one in three adults at some point. Chronic insomnia has serious consequences for mental health, physical health, and daily functioning. The good news is that insomnia responds very well to the right treatment, without relying on sleeping tablets long-term.
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This page provides general health information only and is not a substitute for professional medical advice.
What is insomnia?
Insomnia is defined as persistent difficulty initiating or maintaining sleep, or waking earlier than desired, occurring at least three nights per week for at least three months, and causing daytime impairment. Short-term insomnia triggered by stress or life events is very common; chronic insomnia that persists beyond three months warrants proper treatment.
A key driver of chronic insomnia is the cycle of unhelpful thoughts and behaviours that develop around sleep — spending excessive time in bed, clock-watching, and anxiety about sleep — which perpetuate the problem long after the original trigger has resolved.
Symptoms & impact
- Difficulty falling asleep, despite feeling tired
- Frequent night waking or difficulty returning to sleep
- Early morning awakening with inability to get back to sleep
- Unrefreshing, non-restorative sleep
- Daytime fatigue, low mood, and irritability
- Difficulty concentrating, impaired memory, and reduced performance
- Increased risk of anxiety, depression, and physical health problems with chronic insomnia
Causes
- Stress, anxiety, and overthinking at bedtime
- Depression and other mental health conditions
- Poor sleep habits — irregular schedules, excessive screen use, stimulants before bed
- Physical conditions — chronic pain, sleep apnoea, restless legs syndrome
- Medications — certain antidepressants, corticosteroids, and stimulants
- Caffeine, alcohol, and nicotine
- Major life changes — relocation, new job, relationship changes — all common among expats
- Jet lag and shift work
When to see a doctor
See a doctor if insomnia has persisted for more than a month, is affecting your daily functioning, or if you are relying on alcohol or over-the-counter sleep aids. A medical assessment will identify any underlying causes and open the door to effective treatment.
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Treatment options
- Cognitive Behavioural Therapy for Insomnia (CBT-I) — the gold-standard treatment; more effective than sleeping tablets and produces lasting results without side effects
- Sleep restriction therapy — a structured programme that consolidates sleep and rebuilds sleep drive
- Sleep hygiene optimisation — consistent schedule, dark and cool bedroom, limiting screens and caffeine
- Short-term medication — zopiclone, melatonin, or low-dose sedating antihistamines for acute insomnia; not recommended for long-term use
- Treating underlying conditions — anxiety, depression, pain, or sleep apnoea contributing to insomnia
How eMedClinic can help
Our doctors and psychologists assess insomnia, identify contributing factors, and recommend the most effective treatment pathway. We provide access to CBT-I, prescribe short-term medication where appropriate, and treat underlying conditions such as anxiety and depression that are perpetuating poor sleep.
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