Insomnia: trouble falling or staying asleep
अनिद्रा (नींद न आना)
Insomnia is difficulty getting or staying asleep despite having the opportunity, with daytime tiredness, irritability or poor concentration.
Short-term insomnia is common during stress. When it continues for three months or more, CBT for insomnia (CBT-I) is the most effective long-term treatment.
Medically reviewed by Dr. Kuldeep Budania, MBBS, MD Psychiatry
Common symptoms
- Taking a long time to fall asleep
- Waking up often at night or too early
- Feeling unrefreshed, tired or irritable in the day
- Worry about sleep and dreading bedtime
- Poor concentration and memory
Causes
- Stress, anxiety and depression
- Irregular sleep timing, daytime naps, late-night screens
- Pain, frequent urination, breathing problems, hot flushes
- Caffeine, nicotine, alcohol and some medicines
Risk factors
- Shift work and night duty
- Older age and menopause
- Long-term use of sleeping pills (rebound insomnia on stopping)
How it is diagnosed
- Sleep history and a two-week sleep diary
- Screening for depression, anxiety, sleep apnoea, restless legs and substance use
- Review of all medicines
Classification: ICD-10 F51.0, G47.0 · ICD-11 7A00Chronic insomnia (ICD-11 sleep-wake disorders chapter).
Treatment options
- 1CBT-I: fixed wake-up time, bed only for sleep, restricting time in bed, managing night-time worry
- 2Treating underlying depression, anxiety or pain
- 3Medicines only for short periods or specific situations, avoiding habit-forming sleeping pills where possible
- 4Supervised, gradual tapering for people already dependent on sleeping pills
Psychotherapy and counselling
- CBT-I delivered over about 4–8 sessions, effective online
- Relaxation and worry-postponement techniques
Guidance for family
- Keep evening routines calm; limit TV and phones in the bedroom
- Do not give your own sleeping pills to others
When to see a psychiatrist
- Sleep problems on three or more nights a week for over a month
- Daytime sleepiness affecting driving or work
- Loud snoring with pauses in breathing
Thoughts of self-harm or a medical emergency? Call Tele-MANAS 14416 (24×7, free) or 112.
Free self-assessment
A short screening in Hindi or English. Private — nothing is saved. Screening does not establish a diagnosis.
Frequently asked questions
Are sleeping pills safe?
Some are habit-forming and lose effect over time. They should be used only under medical advice and for limited periods.
What is CBT-I?
A structured therapy that resets sleep habits and the worry around sleep. It works as well as medicines in the short term and better in the long term.
Should I sleep in the afternoon to catch up?
Long daytime naps usually worsen night sleep. Keep a fixed wake-up time instead.
Help is available — confidential, in Hindi or English.
Private video consultation from anywhere in India with an Ajmer-based psychiatrist. Psychiatry consultation ₹500.
This page is for education and does not replace a personal consultation. Do not start or stop any medicine without a doctor's advice.