Insomnia and Sleep Problems: When to See a GP
Around 1 in 3 Australian adults report sleep problems, and 1 in 10 meet the criteria for chronic insomnia. Poor sleep affects mood, memory, cardiovascular health, immune function, and almost every aspect of wellbeing. The good news: insomnia is treatable, and your GP is the right place to start.
What Is Insomnia?
Insomnia is persistent difficulty with sleep despite having the opportunity to sleep. It can involve:
- Trouble falling asleep (sleep-onset insomnia)
- Waking up during the night and being unable to return to sleep
- Waking too early in the morning
- Feeling unrefreshed after sleep even when total sleep time seems adequate
Insomnia is considered chronic when it occurs at least 3 nights per week for 3 months or longer and causes daytime impairment.
Common Causes of Poor Sleep
- Stress and anxiety: The most common cause. Racing thoughts, worry, or work stress keep the brain alert.
- Depression: Either difficulty sleeping or waking very early
- Poor sleep habits: Irregular schedule, screens before bed, caffeine late in the day
- Medical conditions: Sleep apnoea, restless legs syndrome, chronic pain, reflux, asthma
- Medications: Some antidepressants, blood pressure medications, asthma medications, and decongestants
- Alcohol: Initially sedating but disrupts the second half of the night
- Hormonal changes: Perimenopause, pregnancy, thyroid disorders
- Shift work and jet lag
When to See a GP
- Sleep problems for more than 3–4 weeks
- Sleep problems affecting work, driving, mood, or relationships
- Loud snoring with pauses in breathing — possible sleep apnoea
- Waking gasping or choking
- Extreme daytime sleepiness despite getting enough hours in bed
- Using sleeping tablets regularly for more than a couple of weeks
- Sleep problems alongside depression, anxiety, or thoughts of self-harm
What to Expect at the GP Appointment
Your GP will ask about your sleep pattern, daytime symptoms, mental health, medical history, medications, and lifestyle. Keeping a sleep diary for 2 weeks before your appointment is extremely helpful — note bedtime, wake time, how long it took to fall asleep, any night wakings, and quality on waking.
Your GP may check for underlying medical causes with blood tests (thyroid, iron, glucose) and may refer you for a sleep study if they suspect sleep apnoea.
Treatment: CBT-I First, Medication Second
The most effective treatment for chronic insomnia is Cognitive Behavioural Therapy for Insomnia (CBT-I), not sleeping tablets. CBT-I works by:
- Addressing unhelpful thoughts and worry about sleep
- Restricting time in bed to match actual sleep need (temporarily)
- Strict sleep hygiene — consistent wake time, dark room, no screens
- Stimulus control — only go to bed when sleepy, get up if not asleep within 20 minutes
- Relaxation techniques
CBT-I can be delivered by a psychologist (Medicare rebates apply under a Mental Health Treatment Plan) or through free online programs like This Way Up or MindSpot.
Sleeping Tablets: When and How
Sleeping tablets can be useful short-term for acute insomnia (e.g. after a stressful event or bereavement) but are not recommended long-term. Most sleeping tablets lose effectiveness within 2–4 weeks and can cause tolerance, dependence, and rebound insomnia when stopped.
If you have been using sleeping tablets for more than a few weeks, talk to your GP about a structured withdrawal plan combined with CBT-I.
Sleep Hygiene Basics
- Go to bed and get up at the same time every day — including weekends
- Dark, cool, quiet bedroom
- No screens in the hour before bed
- No caffeine after midday
- No alcohol within 3 hours of bedtime
- Regular exercise — but not too close to bedtime
- Do not eat large meals late at night
- Use the bed only for sleep and sex — not for reading, TV, or scrolling
- If you cannot sleep after 20 minutes, get up and do something quiet until sleepy
Sleep and Mental Health
Poor sleep and mental health are deeply connected. Insomnia doubles your risk of developing depression, and depression commonly causes insomnia. Treating one usually helps the other. If your sleep problems are affecting your mood, ask your GP about a Mental Health Treatment Plan.
Find a Family Doctor Clinic Near You
Do not accept poor sleep as normal. A structured approach with your GP can significantly improve your sleep within weeks.
Frequently Asked Questions
How many hours of sleep do I need?
Most adults need 7–9 hours. Teenagers need 8–10, school-age children 9–11, and toddlers 11–14. Individual needs vary slightly, but consistently getting less than 6 hours is associated with increased health risks.
Are over-the-counter sleep aids safe?
Short-term use (a few nights) is usually fine but over-the-counter sleep medications (typically antihistamines like doxylamine) cause drowsiness the next day, lose effectiveness quickly, and are not suitable for chronic insomnia. See a GP if you are using them regularly.
What is a sleep study?
A sleep study (polysomnography) records your breathing, heart rate, brain activity, oxygen levels, and movements during sleep. It is used to diagnose sleep apnoea, periodic limb movements, and other sleep disorders. Some studies are done in a sleep lab; others are done at home with portable equipment.
Can I claim Medicare for CBT-I?
Yes, if you see a psychologist under a Mental Health Treatment Plan (up to 10 Medicare-subsidised sessions per year). Some psychologists specialise in CBT-I. Your GP can refer you.