Frequently asked questions about insomnia
The twenty questions asked most often about insomnia, sleeping pills, self-assessment tools and the consultation process. Short answers, with sources.
Key points
- The questions below are drawn from what patients ask most often and from the misunderstandings that circulate online.
- Each answer is brief and links through to a detailed page if you want to read further.
About the condition
How long should insomnia last before seeing a doctor?
More than two weeks, with an effect on your days, is reason enough. The three-month mark is only the line between calling it acute or chronic, not a condition for being seen.
Does sleeping little mean insomnia?
Not necessarily. If you are alert during the day and not troubled by your sleep, that may simply be your natural sleep need. The diagnostic criteria rest on daytime consequences, not on hours.
Is insomnia dangerous?
Chronic insomnia is associated with a higher risk of depression, reduced performance and accidents from sleepiness. That does not mean one bad night does harm, and excessive worry about the harm is itself one of the things that keeps insomnia going.
About medication
Are sleeping pills addictive?
It depends on the group. The more common problem is that the body adapts, so the old dose works less well, and stopping brings rebound insomnia. That is why coming off needs a taper.
Does melatonin treat insomnia?
Current clinical guidelines do not recommend melatonin for chronic insomnia, for lack of evidence. It has a different role in circadian rhythm disorders, and those are a separate problem.
Are herbal products safer?
"Herbal" means neither safe nor effective. Many preparations are not recommended for lack of evidence, the actual content often differs from the label, and some interact with other medicines.
About tests and diagnosis
Is an online questionnaire enough for a diagnosis?
No. Every questionnaire is a screening tool. It says you should be assessed; it does not say what you have.
Do I need a sleep study?
Usually no. International guidelines state clearly that polysomnography is not used routinely to diagnose insomnia. That test is needed when sleep apnoea or unusual behaviour during sleep is suspected.
About the consultation
Is a video consultation enough?
For insomnia it is enough in most cases. Where a sleep study or a physical examination is needed, you are directed to an appropriate facility.
How long until it improves?
With behavioural therapy most people see a clear change after 4 to 6 weeks. The first week is usually harder, and that is how the method is designed rather than a failure.
Frequently asked questions
- I have taken sleeping pills for years. Can I still come off?
- Yes. Long use only means the taper will be slower and the behavioural foundation needs more care. Do not stop abruptly on your own.
- Is sleep hygiene enough to treat insomnia?
- No. International guidelines state clearly that sleep hygiene used on its own is NOT recommended for chronic insomnia. It is a supporting component of CBT-I.
- What should I do when I lie there unable to sleep?
- Get out of bed, go to another room and do something undemanding in dim light, and return only when you are genuinely sleepy. Lying there trying is what reinforces the bed-wakefulness association.
References
- Behavioral and psychological treatments for chronic insomnia disorder in adults: an AASM clinical practice guideline - American Academy of Sleep Medicine, 2021 · DOI 10.5664/jcsm.8986
- Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults - American Academy of Sleep Medicine, 2017 · DOI 10.5664/jcsm.6470
- Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline from the American College of Physicians - American College of Physicians, 2016 · DOI 10.7326/M15-2175
- Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults - American Academy of Sleep Medicine, 2008 · DOI 10.5664/jcsm.27286