Insomnia Treatment Online — Ireland

About insomnia

Insomnia — persistent difficulty falling asleep, staying asleep, or non-restorative sleep — affects around 1 in 10 adults in Ireland chronically, with many more experiencing transient sleep problems. Insomnia significantly impacts mood, daytime functioning, and physical health. The good news: there are well-evidenced treatments — and the first-line is not a sleeping pill.

Symptoms and signs

• Difficulty falling asleep at the start of the night
• Difficulty staying asleep — frequent awakenings, prolonged time awake at night
• Early-morning waking with inability to return to sleep
• Non-restorative sleep (waking feeling unrefreshed)
• Daytime impact — fatigue, poor concentration, irritability, mood disturbance, errors at work
• Persists for 3 nights a week or more over 3+ months for chronic insomnia

Causes and contributing factors

Per NICE CKS, insomnia is often multifactorial:

• Lifestyle: irregular sleep schedule, screen use late at night, caffeine, alcohol, evening exercise
• Stress and worry — particularly bedtime worry
• Mental health — anxiety and depression frequently coexist with insomnia
• Physical conditions — chronic pain, hot flushes, GORD, BPH, restless legs
• Medications — some antidepressants, decongestants, steroids
• Underlying sleep disorder — sleep apnoea (especially with snoring/witnessed apnoeas/daytime sleepiness), restless legs, parasomnias

When to seek help — and when in-person review is needed

An Online Doctor consultation is appropriate for typical chronic insomnia and to explore CBT-I options. In-person assessment is appropriate if: you snore loudly and have daytime sleepiness or witnessed pauses in breathing (consider sleep apnoea — needs sleep-clinic referral); restless legs causing significant nighttime distress; symptoms of significant depression with sleep disturbance; suspected narcolepsy or parasomnias; or if standard approaches haven't helped after 6–12 months.

Treatment options

Per NICE and ICGP guidance:

• Cognitive Behavioural Therapy for Insomnia (CBT-I) — first-line treatment. More effective than medication in the long term. Available via HSE Counselling in Primary Care, private therapists, and structured online programmes (e.g. Sleepio, SHUTi)
• Sleep hygiene measures — necessary but rarely sufficient on their own
• Short-term hypnotic medication — zopiclone, zolpidem, or short-acting benzodiazepines. Reserved for short-course use (typically up to 2 weeks) per HPRA guidance; not for chronic insomnia
• Melatonin — modest evidence; licensed in Ireland for adults over 55 with insomnia (Circadin) and in some other situations (jet lag, certain sleep-phase disorders)
• Treat underlying causes — anxiety/depression, pain, menopausal symptoms, sleep apnoea

Self-care and sleep hygiene

Keep a regular wake-up time (most important). Use the bed only for sleep and intimacy — not work, scrolling, or TV. Avoid caffeine after midday and alcohol within 3 hours of bed (alcohol worsens sleep quality even if it makes you drowsy initially). Wind down for 30–60 minutes before bed. Keep the bedroom cool, dark, and quiet. If you can't sleep within 20 minutes, get up briefly and do something dull, then return to bed. Get bright light early in the day.

Frequently asked questions

Are sleeping tablets bad for me?

Long-term use of "Z-drugs" (zopiclone, zolpidem) and benzodiazepines is associated with dependence, falls, cognitive impairment, and tolerance per HPRA and NICE guidance. Short-term use during a crisis can be appropriate, but chronic insomnia should be treated with CBT-I where possible.

What's CBT-I?

Cognitive Behavioural Therapy for Insomnia is a structured, time-limited treatment (usually 4–8 sessions). It combines sleep restriction (initially counter-intuitive but very effective), stimulus control, cognitive techniques for worry/sleep-related thinking, and relaxation. Online programmes are an effective alternative to in-person therapy.

Should I take melatonin?

For most insomnia, evidence is modest. It's most useful for jet lag and certain circadian-rhythm disorders. Standard over-the-counter melatonin in Ireland is regulated as a food supplement (variable quality); Circadin is a licensed prescription option for adults over 55. Discuss with an Online Doctor whether it's appropriate.

Could it be sleep apnoea?

Suspect this if you snore loudly, have witnessed pauses in breathing during sleep, or have significant daytime sleepiness despite enough time in bed. It's diagnosed by a sleep study (in-person), and treatment (often CPAP) can be transformative. Mention these features to your Online Doctor.

Sources: HSE.ie, NICE CKS Insomnia, ICGP. General information only.