When to seek help for sleep

Almost everyone has the odd rough night. But when poor sleep becomes the pattern rather than the exception, it stops being something to just push through.

What's happening

Sleep problems exist on a spectrum, from occasional restlessness before a big day to chronic insomnia, sleep apnoea, or sleep disturbed by anxiety, depression, pain or other health conditions. It can be hard to know when a rough patch has become something that needs professional support, especially because tiredness can make everything - including the decision to seek help - feel harder.

Signs to notice

• Difficulty falling or staying asleep at least three nights a week for a month or more.
• Waking unrefreshed even after a full night in bed.
• Loud snoring, gasping, or pauses in breathing during sleep, especially if a partner has noticed this.
• Feeling excessively sleepy during the day, to the point of nodding off at work or while driving.
• Sleep problems that started or worsened alongside low mood, anxiety, grief or a major life change.
• Relying on alcohol, sleeping tablets, or other substances to fall asleep most nights.

What helps

• Keep a simple sleep diary for one to two weeks, noting bedtime, wake time, and how rested you feel. This gives a professional useful information to work with.
• Try consistent, evidence-based basics first: a regular sleep and wake time, a calming wind-down routine, and limiting screens, caffeine and alcohol close to bedtime.
• Don't wait for a crisis point - reaching out earlier usually means a quicker path to feeling better.
• Be honest with a professional about how sleep is affecting your mood, work and relationships, even if it feels embarrassing.
• Involve a partner or housemate in noticing patterns you might miss yourself, such as breathing pauses during sleep, which are hard to detect on your own.

When to reach out for help

Seek professional support if poor sleep has lasted more than a few weeks, if you notice signs of sleep apnoea (loud snoring, gasping, daytime sleepiness), if sleep problems are tied to anxiety or low mood, or if you're using substances to cope with sleeplessness. A professional can assess what's driving your sleep difficulties and recommend an appropriate treatment path, which might include CBT-I, addressing an underlying health condition, or other support.

Getting help in South Africa

Start with your GP, who can assess for physical causes and refer you to a sleep clinic or specialist if needed. Your Cleared Mind EAP counsellor is available for confidential support around sleep, stress and related mental health concerns. SADAG's Mental Health Line (011 234 4837) offers further support and guidance.