Insomnia is a sleep disorder characterised by difficulty in either falling asleep, staying asleep, or both, resulting in insufficient rest and impacting daily functioning. It can be short-term or long-term, affecting individuals at various points in their lives.

What Causes Insomnia?

Insomnia can be triggered by various factors, both internal and external. Common causes include:

• Medication: Certain medicines, such as beta blockers and some antidepressants (e.g., fluoxetine and sertraline), may cause insomnia as a side effect. Prescription and over-the-counter drugs can lead to drug-induced insomnia, with varying severity depending on the individual.

• Mental Health Conditions: Disorders like ADHD, schizophrenia, and bipolar disorder can contribute to insomnia. In some cases, such as bipolar disorder, sleep issues are a core symptom. Insufficient sleep can worsen mental health conditions, making it important to seek medical advice.

• Menopause: Many women experience insomnia during menopause due to hormonal changes. Symptoms such as hot flushes, night sweats, and anxiety can interfere with sleep.

• Pregnancy: Hormonal changes, discomfort, and common side effects like heartburn and nausea often cause insomnia during pregnancy, especially in the first trimester. While it doesn’t harm the baby, it can leave mothers feeling exhausted.

• Restless Leg Syndrome (RLS): Also known as Willis-Ekbom disease, RLS causes an overwhelming urge to move the legs, particularly at night, making sleep difficult.

• External Factors: Noise, an uncomfortable bed, or room temperature can disrupt sleep. Addressing these issues can often improve sleep quality.

• No Clear Cause: In some cases, there is no specific cause for insomnia, known as primary insomnia.

Symptoms of Insomnia Common symptoms include:

• Difficulty falling asleep

• Waking up frequently during the night

• Feeling exhausted during the day

• Irregular sleep patterns

• Lack of energy and difficulty concentrating

• Waking up without feeling refreshed

Types of Insomnia

• Sleep-Onset Insomnia: More common in younger adults, this type refers to difficulty falling asleep at the start of the night, often leading to exhaustion and impaired cognitive function.

• Sleep-Maintenance Insomnia: Often seen in older adults, this type involves waking up during the night and struggling to fall back asleep. It can persist for days, weeks, or even years, and may be managed through lifestyle changes.

Diagnosing Insomnia While there is no specific test for diagnosing insomnia, the NHS provides a self-assessment tool to gauge sleep quality. If results indicate poor sleep, it’s advisable to consult a GP for further evaluation. In persistent cases, a referral to a sleep specialist may be necessary.

Treating Insomnia The key to treating insomnia lies in improving sleep hygiene by addressing factors that hinder or promote sleep. While sleeping pills are not commonly recommended, a short course under medical supervision may help reset sleep patterns. Effective treatments include:

• Cognitive Behavioural Therapy for Insomnia (CBT-I): A highly effective, first-line treatment for chronic insomnia. CBT-I helps identify and reframe thoughts and behaviours that contribute to sleep difficulties, using techniques such as relaxation exercises and stimulus control therapy.

• Adjusting Bedtime Routines: Simple changes like avoiding screens before bed, maintaining a consistent sleep schedule, and creating a relaxing pre-sleep routine can help regulate the body’s internal clock.

• Improving Sleep Environment: Addressing external factors, such as noise or discomfort, can significantly improve sleep. For example, earplugs may help block out noise if you live near a busy road.

Medical Cannabis for Insomnia Although clinical evidence is still emerging, research from the UK Medical Cannabis Registry suggests that medical cannabis may offer benefits for insomnia by interacting with the body’s endocannabinoid system, which regulates the sleep-wake cycle. Cannabinoids in medical cannabis may improve sleep quality and reduce anxiety. If you’re interested in learning more, you can complete the eligibility assessment to see if you qualify for a consultation with one of our specialists, who can guide you through the process and provide personalised advice.