“Why can’t I sleep?” is the question behind almost every sleeping-tablet request we see — and it’s the right question, because insomnia is a symptom, not a diagnosis. Find the cause, and the treatment usually follows. Here are the nine we see most.
1. Stress and a racing mind
The most common cause by far. The 3am problem-solving loop is a stress response — your brain treating bedtime as its first quiet moment to process the day. A “worry window” earlier in the evening (15 minutes, pen and paper) reliably shrinks it. If anxiety is the engine, see anxiety and insomnia.
2. Caffeine — later and larger than you think
Caffeine’s half-life is 5–6 hours: a 4pm coffee is still one-quarter active at 3am. Tea, cola, energy drinks and dark chocolate all count. Move your caffeine cut-off to early afternoon before concluding you have “insomnia”.
3. Alcohol
Alcohol sedates you into sleep, then fragments the second half of the night as it wears off — with lighter sleep, more waking and earlier mornings. A nightcap is borrowing sleep from 3am.
4. An irregular body clock
Lie-ins, naps and wildly varying bedtimes confuse the circadian system. The fix is unglamorous but powerful: one fixed wake-up time, seven days a week, plus morning daylight.
5. Pain and physical discomfort
Arthritis, back pain, reflux, restless legs — untreated physical symptoms are classic sleep-wreckers, especially in later life. Treating the symptom treats the insomnia; a pharmacist can often help you start.
6. Hormonal changes
Menopause is one of the biggest and least discussed causes of midlife insomnia — night sweats and hormonal shifts both disrupt sleep directly. We’ve written a full guide: menopause and sleep. Pregnancy and thyroid problems also commonly disturb sleep.
7. Medicines you’re already taking
Some antidepressants, steroids, beta-blockers, decongestants and even some “night-time” remedies taken too late can disturb sleep. Bring your full list to a pharmacist for a free review before assuming the problem is you.
8. Hidden sleep apnoea
Loud snoring, gasping, unrefreshing sleep and daytime exhaustion despite “enough” hours point to sleep apnoea — which needs its own assessment, and which makes sedatives like zopiclone more dangerous, not helpful. See sleep apnoea and sleeping tablets.
9. The bedroom itself
Too warm, too light, too noisy, a 15-year-old mattress, a phone on the pillow — environment is the cheapest fix on this list. Aim for cool (~18°C), dark and boring.
When to see your GP
If sleep hasn’t improved after a few weeks of addressing the causes above — or if you have apnoea symptoms, low mood, or pain that isn’t controlled — book a GP appointment. Our guide to talking to your GP about sleep shows how to get the most from it.
Frequently asked questions
How many hours of sleep do I actually need?
Most adults need 7–9 hours, but the range is individual and shifts with age. The better test than hours is how you feel by mid-morning: alert without caffeine is a good sign, exhausted despite “enough” hours is worth investigating.
Is it normal to wake up during the night?
Yes — brief waking between sleep cycles is completely normal. The problem is only when you can’t return to sleep; if you’re awake more than about 20 minutes, get up, do something calm in dim light, and return when sleepy.
When does poor sleep become “insomnia”?
Clinically, insomnia means difficulty falling or staying asleep at least three nights a week for three months or more, with daytime impact. But you don’t need to wait that long to act on the causes — or to see your GP.
Should I try sleeping tablets first?
No — tablets like zopiclone are a short-term option for severe episodes, not a first step. Identifying the cause and CBT-i are the approaches with lasting results; see our guide to alternatives to zopiclone.
Questions about your sleep or your medicines? Speak to one of our pharmacists — advice is free and confidential. If you already have a prescription, you can nominate our pharmacy to dispense and deliver it.
This article is general health information based on NHS and BNF guidance. It is not medical advice, and it is not an advertisement for a prescription-only medicine. Zopiclone is available only on prescription in the UK and cannot be purchased from this website. Always follow your prescriber’s instructions and read the patient information leaflet. If you need urgent help call NHS 111; in an emergency call 999. [Clinical review placeholder — reviewed by NAME, Superintendent Pharmacist, GPhC reg. NUMBER, on DATE.]