Most people who struggle to fall asleep have one of three things going on. Their mind is still busy, often with stress or worry. Their body clock is running later than the time they go to bed. Or something in the evening is keeping them awake, such as caffeine, alcohol, nicotine, screens, a late meal or late exercise.
The HSE says sleep difficulties are common and usually get better within a few weeks. If it happens 3 or more times a week for more than 3 months, that is insomnia. The treatment with the strongest backing is a structured therapy called CBT-I, not sleeping pills.
This page is about falling asleep at the start of the night. If you fall asleep fine but wake in the small hours, see how to fall back asleep after waking at 3am.
Get help now
Trouble falling asleep is rarely an emergency. But get help straight away if it comes with a crisis in your mental health.
Call 112 or 999 in Ireland, 999 in the UK or 911 in the US, or go to an emergency department, if:
Ask for an urgent GP appointment if:
See a GP soon if:
Do not drive when you feel sleepy. Both the NHS and HSE say this.
If you are having thoughts of suicide: in Ireland, call Samaritans free on 116 123, Pieta on 1800 247 247, or text 50808 (Text About It). In the UK, call Samaritans on 116 123 or, in England, NHS 111 and choose the mental health option. In the US, call or text 988.
The HSE says not sleeping well for a short while can be perfectly normal. The NHS calls insomnia under 3 months short-term, and 3 months or longer long-term.
The HSE makes a point that matters if you feel stuck. The reason sleep trouble started can differ from the reason it continues. A stressful month may start it, and habits formed during it can keep it going.
The NHS lists stress, anxiety and depression as the most common causes of insomnia. The HSE describes the familiar version. You lie in bed going over the day and everything you have to do tomorrow, and this makes it harder to fall asleep.
Difficulty sleeping is a listed symptom of generalised anxiety disorder. Finding it hard to fall asleep is a listed symptom of depression. Stress and poor sleep can also feed each other, which we explain separately.
Your internal clock runs on a roughly 24-hour cycle, cued by light, meals and activity. If it runs later than your bedtime, you may lie awake even when you feel tired.
The US National Heart, Lung, and Blood Institute (NHLBI) describes delayed sleep-wake phase disorder. You fall asleep later than you would like and find it hard to wake on time. The NHLBI says it is one of the most common circadian rhythm disorders.
The NHLBI also describes "social jet lag": much later sleep times on days off than on workdays. It is not a disorder, but it can make Sunday night hard.
Jet lag and shift work also push the clock out of line.
Noise, a room that is too hot or cold, light and an uncomfortable bed are all on the NHS and HSE lists.
If you get a strong urge to move your legs when you lie down, it may be restless legs syndrome. The NHS says symptoms are usually worse at night when resting. It suggests walking, stretching or massaging your legs when symptoms come on. It is easy to mislabel as insomnia, and our guide explains how to tell them apart. It is worth knowing because the first step is usually a blood test for iron, not a sleep routine.
The HSE lists several conditions that make it harder to get to sleep:
The NHS says many medicines can cause insomnia. For example, it lists problems sleeping as a side effect of the antidepressant sertraline. It lists trouble sleeping as a side effect of methylphenidate, a medicine used for ADHD.
The HSE advises talking to your GP if your medicines stop you falling asleep. Do not stop or change a prescribed medicine on your own. Any change is a decision for your prescriber.
The NHS and HSE also list bipolar disorder, schizophrenia, Alzheimer's disease and Parkinson's disease. Feeling you need little sleep, with high energy, is different from insomnia and worth raising with a GP soon.
These steps come from NHS and HSE guidance:
An honest caveat: tips like these are a starting point, not a treatment for long-term insomnia. The American Academy of Sleep Medicine (AASM) advises clinicians not to use sleep hygiene on its own to treat chronic insomnia.
Cognitive behavioural therapy for insomnia (CBT-I) is a structured talking therapy. The NHS says it helps you change the thoughts and behaviours that keep you from sleeping.
The guidelines are consistent:
In Ireland, the HSE says your GP may refer you to a free guided online CBT service run by the HSE with SilverCloud. CBT-I is also offered as guided self-help, one-to-one sessions or group sessions. In the UK, the NHS says CBT may be face to face or through an online self-help programme. Our guide to CBT-I explains what it involves and what to expect.
The NHS and HSE both say GPs now rarely prescribe sleeping pills for insomnia. They can have serious side effects and you can become dependent on them. When they are used, it is for a few days or weeks at most. That is usually when insomnia is very bad or other treatments have not worked.
Pharmacies sell sleep aids, some containing an antihistamine and some herbal ingredients such as valerian. The NHS and HSE say these cannot cure insomnia. They should not be taken for longer than 1 to 2 weeks. They can leave you drowsy the next day, which affects driving. Check with your GP or pharmacist first.
No supplement, including any Proco sells, is a treatment for insomnia.
The NHS advises seeing a GP if changing your sleeping habits has not helped. It also advises going if you have had trouble sleeping for months, or it is making it hard to cope. The HSE suggests talking to a GP if a sleep problem has lasted a month and new habits have not helped.
Your GP will try to find the cause. They are likely to ask about your sleep pattern, mood, caffeine, alcohol, medicines and other health problems. Bring your sleep diary. If they suspect another sleep disorder, such as sleep apnoea, they may refer you to a sleep clinic.
Being tired and being ready to sleep are not the same. Worry can keep your mind alert however tired your body is. A body clock running late can make you feel wide awake at bedtime. The HSE suggests getting up and doing something boring until you feel sleepy, rather than lying there.
The HSE recommends it. Get up, keep the lights low and do something relaxing or boring without a screen. Go back to bed when you feel sleepy. This rule is also part of CBT-I.
They can help in the short term. GPs prescribe them rarely, and only for a few days or weeks, because of side effects and the risk of dependence. CBT-I is the recommended first treatment for long-term insomnia.
The HSE suggests seeing a GP if a sleep problem has lasted a month and changing your habits has not helped. Go sooner if it is affecting your mood or making it hard to cope.
This article is general information, not medical advice. Talk to your GP, pharmacist or prescriber about your own sleep problem, and before starting, stopping or changing any medicine.
Reviewed by: Proco Team
Last updated: November 2026