At 3am, when the world outside seems wrapped in silence, Arifa lies wide awake, staring at the ceiling fan spinning above her.
She has counted sheep, replayed the day's events in her head, and even made herself a cup of warm milk, yet sleep remains elusive. By the time dawn breaks, she drags herself out of bed, exhausted and irritable, knowing that the coming day will be another uphill battle. For millions of people like Arifa, this restless cycle has a name: insomnia.
Insomnia is the most common sleep disorder, marked by difficulty falling asleep, staying asleep, or getting restful sleep. Unlike the occasional sleepless night, chronic insomnia can cast a long shadow over daily life, leaving sufferers tired, anxious, and unable to focus. Experts warn that it's not just a nighttime problem — insomnia can affect work, relationships, and overall mental and physical health.
What does insomnia feel like?
According to Harvard Health, people with insomnia often describe nights filled with unwanted awakenings, restless tossing and turning, or early mornings when they wake up long before the alarm and can't drift back to sleep. By day, the effects linger: fatigue, irritability, anxiety, and trouble concentrating.
Why does it happen?
Short-term insomnia is often triggered by lifestyle or environmental factors. Stress, travel, a noisy room, an uncomfortable mattress, or even too much caffeine late in the day can keep sleep at bay.
For some, insomnia becomes chronic, persisting at least three nights a week for three months or more. Chronic cases are usually tied to deeper issues like depression, anxiety, PTSD, chronic pain, heart disease, or conditions such as sleep apnea and restless legs syndrome.
Pregnant women also face a higher risk of insomnia, thanks to hormone changes, frequent urination, leg cramps, and the struggle to find a comfortable sleeping position.
Breaking the cycle: Treatments that work
The good news is that insomnia can be treated, often without medication. Doctors emphasise lifestyle changes and sleep hygiene as the first step:
- Going to bed and waking up at the same time every day
- Sleeping in loose, comfortable clothing on a supportive mattress
- Eliminating noise or bright light from the bedroom
- Avoiding heavy meals, alcohol, caffeine, or smoking close to bedtime
- Exercising daily, but not right before bed
For many, Cognitive Behavioural Therapy for Insomnia (CBT-I) is considered the most effective treatment. This includes relaxation techniques, sleep restriction programs that retrain the body's natural sleep drive, and reconditioning, which helps people associate the bed only with sleep and rest.
The role of medication
Prescription medications can be used for short-term relief. Some antidepressants in low doses can also aid sleep. However, doctors caution against long-term reliance, as many sleep medications carry risks of dependence.
Over-the-counter sleep aids and melatonin supplements are sometimes used, but their effectiveness and safety vary. For older adults in particular, antihistamine-based sleep aids can have side effects such as confusion or blurred vision.
In cases where insomnia is linked to another medical condition, treating the root cause often improves sleep, for example, using CPAP machines for sleep apnea or medication for restless legs syndrome.
The bottom line
Nearly half of all insomnia cases are tied to mental health issues such as anxiety or depression, creating a vicious cycle: sleepless nights worsen mood disorders, which in turn deepen insomnia. This is why addressing both mental health and sleep is critical for recovery.
For people like Arifa, the road to restful sleep often starts with small, consistent changes — turning off screens an hour before bed, creating a calming routine, and learning to quiet the racing thoughts that come with stress. Over time, these habits, combined with therapy or medical support when necessary, can make the difference between long nights of frustration and the simple joy of waking up refreshed.
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