Sleep hygiene advice has not worked for you. There is a reason for that, and there is a treatment with better evidence than tablets.
Insomnia is a sleep disorder, not a habit problem. It is diagnosed when you have trouble falling asleep, staying asleep, or waking too early at least three nights a week for three months or more, and it affects your day. The first-line treatment is not medication — it is a structured talking therapy called CBT-I, which works for roughly seven in ten people and keeps working after it stops.
Bad sleep versus insomnia
Everyone sleeps badly sometimes. A deadline, a new baby, a night of noise from the street, a generator running till 2am — that is disrupted sleep, and it resolves when the cause does.
Insomnia is different in three ways:
- It persists after the original trigger is gone. The exam finished in March and you are still awake at 3am in August.
- It follows you. It is not the mattress, because it happens in hotels too.
- It has taken on a life of its own. You are now anxious about sleeping, and the anxiety is doing more damage than whatever started it.
That third point is the one that matters clinically, because it is what turns a rough patch into a disorder. Once your bed becomes a place where you lie there failing, your brain learns that association and starts producing alertness on contact with the pillow. People describe it as the body being exhausted and the mind switching on the moment the light goes off.
This is why generic sleep tips stop working. Our guide to sleeping better for your mental health is genuinely useful for ordinary poor sleep. If you have had insomnia for months, you have almost certainly tried all of it already, and being told to avoid screens is beginning to feel like an insult.
What keeps it going
Clinicians think about insomnia in terms of what perpetuates it rather than what started it, because those are usually different things.
The perpetuating factors are, uncomfortably, the things you have done to cope:
- Spending longer in bed. Going up at 9pm to “catch up” gives you nine hours of opportunity for six hours of sleep, which guarantees three hours of lying awake.
- Napping in the afternoon. Understandable, and it borrows from tonight.
- Trying harder. Sleep is one of the few things that reliably retreats when pursued.
- Checking the time. Every check is a small arithmetic panic about how much is left.
- Staying in bed awake. This is the one that deepens the bed–wakefulness association most.
None of that is a character flaw. Every one of them is a reasonable response to exhaustion, which is exactly why insomnia is so persistent.
Sleeping tablets, honestly
Many people in Nigeria end up on something to sleep — sometimes prescribed, often bought over the counter without one.
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Short courses of prescribed medication have a legitimate place, particularly in a crisis. But the common sedatives tend to lose effect within weeks, and stopping them frequently produces a stretch of sleep that is worse than before you started, which reads as proof you needed them. That cycle is how dependence forms, and benzodiazepine dependence in particular is under-recognised here.
Two things worth saying plainly. Never start or stop a prescribed sleeping medication on your own — stopping some of them abruptly is genuinely dangerous, and it needs a doctor’s supervision. And if you have been buying sedatives without a prescription, tell a clinician; it is more common than you would think and they are not there to judge you.
CBT-I: the treatment with the evidence
Cognitive behavioural therapy for insomnia is the recommended first-line treatment in most international clinical guidelines, ahead of medication. It usually runs four to eight sessions.
It is not relaxation training, and it is not comfortable at first. The core components:
Sleep restriction. Counter-intuitive and the most effective part. You temporarily reduce time in bed to match the sleep you are actually getting, which builds sleep pressure and re-establishes fast sleep onset. Then you extend it back gradually. The first ten days are hard. It works.
Stimulus control. Bed is for sleep. Awake for more than about twenty minutes, you get up and go elsewhere until you are sleepy. This is how the bed–wakefulness association gets unlearned.
Cognitive work. Dismantling the catastrophic arithmetic — if I don’t sleep now, tomorrow is ruined — which is itself keeping you awake.
A consistent wake time. Fixed, including weekends. The wake time anchors the whole rhythm; the bedtime follows it.
A therapist trained in CBT-I can deliver this over video as effectively as in a room. You can filter for sleep and anxiety specialisms in our directory.
What else to rule out
Insomnia often travels with something else, and treating the sleep alone will not hold if the other thing is untreated.
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- Anxiety. The most common companion. If your nights are spent rehearsing conversations and scanning for problems, look at the anxiety hub.
- Depression. Early-morning waking — up at 4am, unable to return to sleep, mood at its worst — is a recognised pattern. See signs of depression in men if that is relevant, and the depression hub generally.
- Physical causes. Loud snoring with daytime sleepiness, thyroid problems, chronic pain, some medications. These need a doctor, not a therapist.
- Your environment. Generator noise, heat, shift work and a street that does not quiet down are real, not excuses. CBT-I still works, but the plan has to account for them honestly.
When to get help
Book something if you have had disturbed sleep at least three nights a week for three months, if you are relying on tablets or alcohol to get to sleep, or if the exhaustion is now affecting your work, your driving or your relationships.
Insomnia has a treatment with good evidence behind it. Years of lying awake is not a personality trait, and it is not something you have to simply accept.
Frequently asked questions
What is the difference between insomnia and just sleeping badly?
Duration and independence. Insomnia lasts at least three months, occurs three or more nights a week, follows you between locations, and continues after the original trigger has gone.
Does CBT-I work for everyone?
No treatment does, but it helps roughly seven in ten people and, unlike medication, the benefit tends to persist after treatment ends.
Are sleeping tablets bad?
Not inherently, and short prescribed courses have a place. The problems are tolerance, dependence, and rebound insomnia on stopping. Never start or stop one without a doctor.
Can I get CBT-I online in Nigeria?
Yes. It is a structured talking therapy and works over video. Filter for sleep and anxiety in our directory.
Why do I feel exhausted but wide awake at night?
Usually a conditioned arousal response — the bed has become associated with being awake — often combined with a body clock that has drifted. Both are what CBT-I is designed to correct.
