What is insomnia?
Insomnia means difficulty falling asleep, staying asleep or waking too early, at least three nights a week for three months or more, with daytime consequences. It affects around a third of adults at some point and is particularly common in people with ADHD, whose body clock often runs late.
Our psychiatrists with a special interest in sleep assess insomnia alongside delayed sleep phase, restless legs, nightmares and the sleep effects of medication.
Signs and symptoms
Night-time
- Lying awake for a long time before falling asleep
- Waking frequently or too early
- A racing mind at bedtime
- Restlessness in the legs
Daytime
- Fatigue and sleepiness
- Poor concentration and memory
- Irritability and low mood
- Relying on caffeine to function
Patterns
- A body clock that runs hours later than you'd like
- Anxiety about sleep itself
- Dependence on sleeping tablets or alcohol
Linked conditions
- ADHD
- Anxiety and depression
- Sleep apnoea (which we can help you get tested for)
How we assess insomnia
A 60-minute consultation with a psychiatrist experienced in sleep disorders. We review your sleep pattern using a sleep diary and the Insomnia Severity Index, your mental and physical health, medication, caffeine and alcohol use, and screen for ADHD and sleep apnoea.
You receive a written report within five working days with a clear plan.
How we treat insomnia
Cognitive behavioural therapy for insomnia (CBT-I) is the NICE first-line treatment and is more effective than sleeping tablets in the long term. Your plan may include:
- CBT-I delivered by our psychologists over 4–8 sessions
- Chronotherapy and light exposure for a delayed body clock
- Melatonin where appropriate, particularly for ADHD-related sleep problems
- Adjustment of ADHD or other medication timing
- Short-term medication only where clearly needed, with a plan to stop