Skip to content

Condition

Insomnia

Poor sleep is treated as a lifestyle complaint and it is a clinical one. It affects weight, blood sugar, mood and blood pressure, and it usually has an identifiable cause.

Defined by
Difficulty despite adequate opportunity
First-line treatment
CBT-I, not medication
Commonly missed
Sleep apnoea, thyroid, iron
Affects
Weight, sugar, mood, blood pressure

Insomnia means difficulty falling or staying asleep despite adequate opportunity, with daytime consequences. The first-line treatment is cognitive behavioural therapy for insomnia rather than medication. Sleep apnoea, thyroid disease, low iron and caffeine are common and treatable contributors.

Symptoms of insomnia

Symptoms vary, and few people have all of them. These are the ones most commonly reported.

Difficulty falling asleepMore than about 30 minutes
Waking through the nightAnd struggling to return to sleep
Waking too earlyOften associated with low mood
Unrefreshing sleepEven after adequate hours
Daytime fatigue and poor concentrationThe functional consequence
Irritability and low moodBoth cause and effect
Snoring or gasping in sleepSuggests sleep apnoea, not insomnia
Restless legs at nightOften iron-related

2-minute check

What kind of sleep problem is this?

Four questions. Your result appears immediately — we do not ask for an email.

Where is the difficulty?

Do you snore heavily, or has anyone noticed you stop breathing?

Any caffeine after 2pm?

Any urge to move your legs at night?

When to see a doctor

Arrange a medical appointment rather than waiting if you have:

  • Snoring with gasping or witnessed pauses in breathing
  • Falling asleep during the day, particularly while driving
  • Insomnia with low mood or thoughts of self-harm
  • Sleep problems persisting more than three months
  • Before starting or stopping any sleep medication

What causes insomnia

Sleep is driven by two systems. Most insomnia involves a disruption to one or both, and they respond to different things.

Step 1 Sleep pressure is disrupted

Naps, irregular timing or caffeine reduce the drive to sleep.

Step 2 The body clock shifts

Late light exposure and irregular waking move the rhythm.

Step 3 Arousal stays raised

Stress, screens or a raised baseline prevent the wind-down.

Step 4 Conditioning sets in

The bed becomes associated with being awake, sustaining the problem.

Risk factors

  • Irregular sleep and waking times
  • Caffeine, particularly in the afternoon
  • Alcohol, which fragments sleep
  • Screen light in the evening
  • Shift work
  • Anxiety and depression
  • An overactive thyroid
  • Low iron, causing restless legs
  • Untreated sleep apnoea
  • Menopause

How insomnia is diagnosed

Tests commonly used, and what each one shows
TestWhat it indicates
A sleep diary over two weeksThe most useful single investigation
Thyroid functionAn overactive thyroid disrupts sleep
FerritinLow iron causes restless legs syndrome
Vitamin D and B12Both associated with sleep quality
Sleep studyWhere apnoea is suspected
HbA1cNight-time glucose swings disturb sleep

Not sure which of these you have had?The assessment asks, and tells you which are worth requesting.

Check my health parameters

What happens if it is left untreated

Stated factually, because these risks are real and manageable rather than inevitable.

  • Weight gain and insulin resistance
  • Raised blood pressure
  • Depression and anxiety
  • Impaired concentration and accident risk
  • Reduced immunity
  • Dependence on sleep medication

How Health Total treats insomnia

Our protocol runs alongside whatever your doctor has prescribed. We do not ask anyone to stop medication.

  1. 1

    Establish the actual pattern

    Two weeks of a sleep diary separates difficulty falling asleep from difficulty staying asleep, and they have different causes.

  2. 2

    Exclude apnoea and restless legs

    Neither responds to sleeping tablets, both are common, and both are missed routinely.

  3. 3

    Fix timing before anything else

    A consistent waking time — including weekends — anchors the body clock more effectively than a consistent bedtime.

  4. 4

    Deal with caffeine, alcohol and evening light

    Alcohol helps people fall asleep and reliably worsens the second half of the night.

  5. 5

    Support CBT-I rather than replace it

    It is the best-evidenced treatment for chronic insomnia. Nutrition addresses the physical contributors alongside it.

What makes this different

A standard diet plan

  • Sleeping tablets as the first answer
  • Apnoea never considered
  • Bedtime focused on, waking time ignored
  • Alcohol assumed to help

How we do it

  • Pattern established with a diary
  • Apnoea and restless legs excluded
  • Consistent waking time as the anchor
  • Honest about what alcohol does

Nine questions. Two minutes.You will see your result before we ask for your name.

Start my free assessment

Audited results

Publication pending. Aggregate outcome figures for this condition — sample size, inclusion criteria, mean and median change, range and dropout rate — will appear here once the audited outcome report is complete and signed by a second clinician.

Under the ASCI Healthcare Guidelines, a success rate, timeline or efficacy claim requires peer-reviewed data or the organisation’s own audited outcome report. We would rather publish nothing here than publish a number we cannot substantiate.

Case studies

De-identified clinical records — the plan as delivered, the markers as measured, and adherence as it actually was. Each signed by the supervising clinician and verified by a second.

Clinician-audited

Case file 1

Awaiting the case production line — dependency D6.

Clinician-audited

Case file 2

Awaiting the case production line — dependency D6.

Clinician-audited

Case file 3

Awaiting the case production line — dependency D6.

The standard each case must meet before publication →

Published with specific, informed and withdrawable consent. Individual results vary.

Why Health Total for insomnia

Clinicians, named

Over 200 doctors and nutritionists. Every condition page here carries the name and credentials of the person who wrote it and the person who reviewed it.

Indian food, Indian bodies

Thirty years of treating Indian patients, with plans built from Indian kitchens and read against Asia-Pacific metabolic cut-offs.

Our own data

Outcomes come from audited internal records, not from studies conducted elsewhere on other populations.

Somewhere to walk in

Physical centres across India, which most app-based programmes cannot offer.

Recipes for insomnia

All recipes →

Articles

All articles →

Questions we are asked

Does alcohol help me sleep?

It helps you fall asleep and then reliably damages the second half of the night, suppressing deep sleep and causing early waking. It is one of the most common reasons people sleep badly while believing it helps.

How many hours do I actually need?

Most adults need seven to nine, but the more useful measure is how you function during the day. Some people genuinely need less. Chasing a number causes its own anxiety about sleep, which makes sleep worse.

Do melatonin supplements work?

For jet lag and for shifting a delayed body clock, there is reasonable evidence. For ordinary insomnia the effect is modest. Timing matters more than dose, and it is worth discussing with your doctor rather than self-prescribing.

Is it better to fix my bedtime or my waking time?

Waking time, consistently, including weekends. It anchors the body clock far more effectively, and sleep pressure then builds naturally toward an appropriate bedtime.

Start with your own numbers.Free assessment, free first consultation, and no figure quoted that we cannot substantiate.

Start my free assessment

References

  1. Indian Society for Sleep Research guidelines on insomnia.
  2. American Academy of Sleep Medicine clinical practice guideline for chronic insomnia.
  3. [Further references to be completed by the medical review panel.]

Related conditions

Anxiety Stress Weight gain & obesity
Start my free assessment WhatsApp