Sleep Problems: When to See Your GP

ByFamily Doctor Editorial

Poor sleep isn’t just a nuisance — it’s linked to heart disease, depression, weight gain, poor memory, and accidents. Most of us cope with occasional bad nights, but persistent sleep problems deserve medical attention. This guide covers when to involve your GP, what testing is available, and what helps.

When Sleep Problems Become a GP Issue

Book a GP appointment if you have:

  • Difficulty falling asleep or staying asleep most nights for over a month
  • Waking feeling unrefreshed despite adequate time in bed
  • Daytime tiredness affecting work, driving, or concentration
  • Loud snoring, witnessed pauses in breathing, or gasping at night
  • Restless legs, leg jerking, or unusual movements during sleep
  • Unrefreshing sleep with associated mood changes, headaches, or irritability
  • Sudden onset of insomnia after a life change or stressor that hasn’t resolved

Common Sleep Problems

Insomnia

Trouble falling or staying asleep despite opportunity. Can be short-term (stress, illness, life event) or chronic (ongoing for months). Often driven by anxiety, depression, poor sleep habits, or coexisting with other sleep disorders.

Sleep apnoea

Repeated pauses in breathing during sleep, often with snoring and gasping. Causes fragmented sleep and daytime tiredness. Strongly linked to high blood pressure, heart disease, stroke, and type 2 diabetes. Often undiagnosed but highly treatable with CPAP, mandibular splints, or sometimes surgery.

Restless legs syndrome

An urge to move the legs, often with uncomfortable sensations, relieved by movement. Worse in evening and at rest. Can severely disrupt sleep. Sometimes linked to iron deficiency, kidney disease, or medications.

Circadian rhythm disorders

Sleeping much later or earlier than society expects. Common in shift workers, adolescents, and older adults.

Parasomnias

Unusual behaviours during sleep — sleep walking, night terrors, acting out dreams. Some require investigation.

What Your GP Will Do

  • Take a detailed sleep history — timing, duration, quality, partner’s observations
  • Screen for depression, anxiety, chronic pain, and shift-work factors
  • Check for physical causes — thyroid, anaemia, iron deficiency, restless legs, menopause
  • Review medications that might be affecting sleep (stimulants, decongestants, some antidepressants)
  • Use validated questionnaires (Epworth Sleepiness Scale, STOP-Bang for sleep apnoea risk)
  • Recommend a sleep study if apnoea or another sleep disorder is suspected

Sleep Studies

  • Home sleep test — portable device worn overnight at home. Used to diagnose sleep apnoea. Medicare-funded for eligible patients.
  • In-lab sleep study (polysomnography) — overnight stay at a sleep lab with full monitoring. For complex cases or when home testing is inconclusive.

Your GP or a respiratory/sleep specialist will review the results and discuss treatment.

Cognitive Behavioural Therapy for Insomnia (CBT-I)

CBT-I is the first-line treatment for chronic insomnia — more effective than sleeping tablets long-term. It addresses thoughts and behaviours that keep insomnia going. Components include sleep restriction, stimulus control, cognitive restructuring, and relaxation. Available through psychologists (often covered under a Mental Health Treatment Plan) and online programs (This Way Up, Sleepio).

Sleep Hygiene Basics

  • Regular sleep and wake times, including weekends
  • Cool, dark, quiet bedroom
  • No screens in the last hour before bed
  • Limit caffeine after midday
  • Limit alcohol — disrupts the second half of sleep even if it helps you fall asleep
  • Regular exercise, but not in the 2-3 hours before bed
  • Don’t watch the clock — it increases anxiety
  • If awake over 20 minutes, get up briefly and do something calm

Sleep Medications

Used short-term or occasionally. Not first-line for chronic insomnia.

  • Melatonin — modest benefit, safer than sedatives, especially for older adults and shift workers.
  • Non-benzodiazepine hypnotics (zopiclone, zolpidem) — useful short-term; tolerance and dependence possible with long-term use.
  • Benzodiazepines (temazepam) — mostly used for severe short-term insomnia; significant addiction risk.
  • Sedating antidepressants — mirtazapine, amitriptyline at low dose; useful when depression coexists.
  • Newer agents — suvorexant (orexin antagonist); different mechanism from older drugs.

Frequently Asked Questions

How much sleep do I need?

Most adults need 7-9 hours. Older adults often do well with 7-8. Quality matters as much as quantity.

Can I drive if I have sleep apnoea?

Untreated significant sleep apnoea with daytime sleepiness affects driving safety and may require declaration to the licensing authority. Treatment usually resolves this. Your GP will advise on your specific circumstances.

Are over-the-counter sleep aids safe?

Occasional use is fine for most. Long-term use of antihistamine-based sleep aids can cause confusion in older adults and isn’t recommended. Check with your GP if using them regularly.

Is CBT-I bulk billed?

Psychology sessions under a Mental Health Treatment Plan attract Medicare rebates. Some psychologists bulk bill, others charge a gap. Check with the provider and your clinic.

Book a Sleep Review

Don’t accept poor sleep as normal. Find your nearest Family Doctor clinic and book a long appointment.

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