What is insomnia?
Insomnia means regular difficulty getting to sleep, staying asleep, or waking too early, together with daytime consequences such as fatigue, irritability and poor concentration. It is classed as chronic when it occurs at least three nights a week for three months or more. Short-term insomnia is often triggered by stress or illness; in chronic insomnia, worry about sleep itself typically becomes part of the problem.
Around a third of adults experience insomnia symptoms at some point, and it becomes more common with age, in shift workers, and alongside anxiety, depression, pain and the menopause. Diagnosis is based on a clinical sleep history, sometimes supported by sleep diaries; overnight sleep studies are reserved for suspected conditions such as sleep apnoea rather than routine insomnia.
Common symptoms
- Difficulty falling asleep despite feeling tired
- Waking repeatedly during the night
- Waking too early and being unable to return to sleep
- Daytime fatigue and low energy
- Irritability or low mood
- Poor concentration and memory
- Anxiety about sleep itself
How long will you wait?
NHS options are typically digital CBT-I (such as Sleepio, where commissioned) with quick access, or referral via talking therapies where waits range from a few weeks to a few months; specialist sleep clinic referrals can take several months.
Privately, you can typically see a sleep specialist or CBT-I therapist within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- CBT for insomnia (CBT-I). The recommended first-line treatment, retraining sleep patterns and unhelpful beliefs, available face-to-face or digitally.
- Sleep hygiene and behavioural techniques. Consistent wake times, stimulus control and sleep restriction methods that rebuild a strong sleep drive.
- Short-term medication. Brief courses of sleeping tablets or melatonin (in over-55s) for acute insomnia, not intended for long-term use.
- Treating underlying conditions. Addressing anxiety, depression, pain, restless legs or menopausal symptoms that disturb sleep.
What does private treatment cost?
As a guide, private CBT-I costs around £80–£150 per session (often 4–6 sessions), a sleep specialist consultation around £250–£350, and a diagnostic sleep study £300–£1,500 if needed.
Does health insurance cover insomnia?
Insurers vary on insomnia: investigation of suspected underlying conditions such as sleep apnoea is usually covered, but standalone insomnia treatment may fall under mental health benefits, which are often an optional add-on with session limits. Chronic, long-standing insomnia may be excluded as a pre-existing or chronic condition. Check whether CBT-I with a psychologist is claimable under your policy's outpatient or mental health terms.
Frequently asked questions
Why is CBT-I recommended over sleeping tablets?
Because it works better in the long run. Sleeping tablets can help for a week or two but lose effectiveness, carry dependence risks and do not fix the underlying pattern. CBT-I addresses the behaviours and anxieties that perpetuate insomnia, and most people improve within four to six sessions, with benefits that persist for years after treatment ends. NICE recommends it as first-line treatment.
Could my insomnia be sleep apnoea instead?
It is worth considering if you snore loudly, wake gasping, or feel excessively sleepy in the day despite adequate time in bed — especially if a partner has noticed pauses in your breathing. Sleep apnoea is common, underdiagnosed and very treatable. A clinician can assess your risk and arrange a home sleep study, which is a simple overnight test.
How much sleep do I actually need?
Most adults function well on seven to nine hours, but the range is genuinely individual and tends to shorten a little with age. The best guide is how you feel by day: if you are alert without relying on caffeine and naps, your sleep is probably sufficient. Fixating on a target number often feeds the very anxiety that keeps insomnia going.