Why Can't I Sleep? Conversations About Insomnia

Introduction

"Doctor, I'm exhausted."

Many people spend night after night lying awake wondering why sleep no longer comes easily. Some cannot fall asleep, while others wake in the early hours and cannot return to sleep. The answer is often more complex than people expect.

Sleep is more than closing your eyes

Insomnia involves difficulty falling asleep, staying asleep, or waking earlier than intended, together with daytime impairment despite having adequate opportunity for sleep. It is not defined only by the number of hours slept.¹

Sometimes insomnia is the problem. Sometimes it is the symptom.

A psychiatrist asks not only how many hours you sleep, but why your sleep has changed. Common causes include anxiety, depression, chronic stress, grief, chronic pain, sleep apnea, restless legs syndrome, caffeine, alcohol, certain medications, and irregular work schedules.

The vicious cycle of worrying about sleep

The harder people try to sleep, the more anxious they become — and the less likely sleep is to come. Breaking that cycle is an important part of treatment.

Sleeping tablets are not always the first answer

Medication can help selected patients, but Cognitive Behavioural Therapy for Insomnia (CBT-I) is strongly recommended for chronic insomnia. CBT-I uses several structured components to address the thoughts and behaviours that perpetuate sleep difficulty; sleep hygiene advice alone is not considered an adequate stand-alone treatment for chronic insomnia.¹

Small habits can make a big difference

• Keep a regular sleep schedule, including on weekends
• Avoid caffeine late in the day
• Reduce screen time before bed
• Keep the bedroom cool, quiet and dark
• Exercise regularly, but not too close to bedtime

These habits can support healthy sleep, but persistent insomnia may require a structured assessment and treatment rather than sleep-hygiene measures alone.¹

When should you seek help?

Seek medical advice if insomnia persists for several weeks, affects daily life, is associated with anxiety or depression, or causes severe daytime fatigue.

Who can help with insomnia in Dubai?

Persistent insomnia can have medical, psychological, sleep-related, or medication-related causes. A proper assessment can help identify what is driving the sleep problem and whether treatment such as CBT-I, addressing an underlying condition, or medication when appropriate may help.

A final thought

Sleep is one of the foundations of physical and emotional health. Treating insomnia is rarely about forcing sleep — it is about understanding and removing the obstacles that prevent it.

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• Book an appointment with Dr. Indira at Dubai Healthcare City.