Sleep problems: GP reviewed information
Sleep problems are common and closely linked to mental wellbeing. Poor sleep can worsen stress, anxiety and low mood, while mental health difficulties can in turn disrupt sleep. For many people, sleep problems sit at the centre of a wider pattern rather than existing on their own.
This page explains common sleep problems seen in general practice, how GPs assess them, what may be contributing, and when further support or investigation is appropriate.
This information is for general education and does not replace a personalised medical or mental health assessment. If you are feeling unsafe, at risk of harm, or unable to cope, please seek urgent help via NHS 111, your local urgent mental health service, or emergency services.
Common sleep problems
Sleep problems can take different forms and may change over time.
People may experience:
- Difficulty falling asleep
- Waking frequently during the night
- Waking earlier than intended
- Non-restorative or unrefreshing sleep
- Excessive daytime sleepiness
- Variable sleep patterns across the week
The impact of poor sleep is often felt during the day rather than at night.
How sleep and mental health are linked
Sleep and mental health influence each other in both directions.
Poor sleep can:
- Reduce emotional resilience
- Increase anxiety and irritability
- Lower mood
- Impair concentration and memory
Mental health difficulties can:
- Make it harder to switch off
- Increase night-time worry or rumination
- Disrupt normal sleep rhythms
Addressing sleep often improves mental wellbeing, even when sleep is not the original concern.
Common causes of sleep problems
Stress and over-activation
Ongoing stress can keep the nervous system in a heightened state, making it difficult to relax at night. Read more: Stress and burnout.
Anxiety and racing thoughts
Anxiety commonly interferes with:
- Falling asleep
- Returning to sleep after waking
- Sleep quality overall
Read more: Anxiety.
Low mood and depression
Sleep disturbance is a core feature of low mood and depression and may involve early waking or prolonged sleep without feeling rested.
Read more: Low mood and depression.
Physical symptoms and discomfort
Pain, palpitations, reflux or gastrointestinal symptoms may disrupt sleep and contribute to night-time awakenings.
Read more: Physical symptoms linked to stress.
Lifestyle and routine factors
Sleep may also be affected by:
- Irregular sleep schedules
- Excess screen use before bed
- Alcohol or caffeine intake
- Shift work or changing routines
How GPs assess sleep problems
Assessment focuses on understanding patterns rather than isolated nights.
A GP may explore:
- Sleep timing and routine
- Duration and quality of sleep
- Night-time awakenings and triggers
- Daytime symptoms
- Mental health symptoms
- Alcohol, caffeine and medication use
- Physical symptoms affecting sleep
Sleep diaries can sometimes help identify contributing factors.
When investigations may be considered
Most sleep problems do not require tests.
Investigations may be considered if:
- Symptoms suggest an underlying medical condition
- There is excessive daytime sleepiness
- Sleep apnoea is suspected
- Sleep disturbance is unexplained or worsening
Testing is targeted and based on clinical context.
Approaches to improving sleep
Management usually focuses on addressing contributing factors rather than sleep alone.
Common GP-recommended approaches include:
- Improving sleep routine and consistency
- Reducing stimulation before bedtime
- Addressing stress or anxiety
- Managing physical symptoms
- Psychological therapies where appropriate
Sleeping tablets are generally used cautiously and short-term only, as they do not address underlying causes.
When to seek further medical review
You should seek GP review if:
- Sleep problems persist for several weeks
- Poor sleep affects work, driving or relationships
- Symptoms are worsening
- Sleep disturbance is accompanied by low mood or anxiety
- You feel unable to cope due to exhaustion
Early support can prevent longer-term problems.
When to seek urgent medical help
Seek urgent help if sleep problems are accompanied by:
- Suicidal thoughts
- Severe daytime sleepiness affecting safety
- Sudden behavioural or mental state changes
- New neurological symptoms
- Thoughts of self-harm or feeling unsafe
In these situations, urgent NHS services or emergency care are appropriate.
GP insight
Sleep problems are rarely “just sleep problems”. In general practice they often signal stress, anxiety or low mood, and improvement usually comes from addressing the wider picture rather than focusing on sleep alone.
Visit our Mental Health hub or browse more health topics in the AccessGP Knowledge Base.
If sleep problems are ongoing or affecting your wellbeing, an online GP appointment can help assess contributing factors and agree on appropriate next steps.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 23 January 2026