Insomnia

• Insomnia

  • Difficulty getting to sleep/Lying awake at night
  • Waking up too early and unable to get back to sleep
  • Feeling tired throughout the day, despite sleeping fully
  • Waking up several times at night
• Transient insomnia

  Lasting days
• Short term insomnia

  Lasting up-to 3 weeks
• Chronic insomnia

  Lasting longer than 3 weeks
• Causes of insomnia

  • Physical (headaches, excessive itching, hormonal causes (hot flushes) etc)
  • Psychological (stress, anxiety, relationship issues, bereavement etc)
  • Environmental (Sound (noisy neighbours/snoring), heat/cold)
  • Medicines (Antidepressants/hypnotics can cause rebound insomnia)
  • Alcohol
• red flag symptoms for insomnia?

  • <16yrs
  • suspected depression
  • chronic insomnia
  • suspected ADR from medication (e.g fluoxteine, MOA, corticosteroids, theophylline)
  • Prostatic hypertrophy and closed angle glaucoma are contraindications to antihistamine therapy
• Treatment for insomnia- Antihistamines


  • Diphenhydramine (Nytol)
  • Promethazine (Phenergan/Sominex)
  • Have sedating properties to help in short term
  • Can be abused - watch out for repeated requests from patients
  • Side effects: dry mouth, constipation, blurred vision
• Insomnia treatment - Herbal Sleep Aids


  • Valerian (Nytol Herbal) (Kalms Night)
  • Do not cause drowsiness the next day
  • Work by promoting calmness - encouraging natural sleep
• Counselling

  1. Try to address the root cause of insomnia (e.g. tackle snoring/stress etc)

  2. Lavender oil, light exercise, warm bath, avoid caffeine/alcohol