Can't Sleep? Insomnia Treatment and When to See a Sleep Doctor in Kathmandu

What counts as insomnia

Most adults need about seven to nine hours of sleep. Insomnia is not simply sleeping less: it is difficulty falling asleep, waking often, or waking too early and not getting back to sleep, together with tiredness, poor concentration or low mood during the day. In Nepali: निद्रा नलाग्ने, राम्रो निद्रा नआउने.

Common causes

• Stress, worry and racing thoughts, and anxiety.
• Depression, which often causes early-morning waking.
• Caffeine (tea, coffee, energy drinks), tobacco and alcohol, especially in the evening.
• Irregular routines, shift work, and late-night phone or screen use.
• Pain, thyroid problems, breathing problems during sleep (sleep apnoea), restless legs, and some medicines.

Habits that help

• Wake at the same time every day, including weekends.
• Stop caffeine by early afternoon and avoid heavy meals, tobacco and alcohol late at night.
• Keep the bedroom dark, quiet and cool, and use the bed only for sleep.
• Wind down for an hour: dim lights, put the phone away.
• If you cannot sleep after about twenty minutes, get up, do something calm and return when sleepy. Avoid watching the clock.
• Get daylight and some exercise during the day.

CBT for insomnia

Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first treatment for long-lasting insomnia. It combines a sleep schedule that fits your body, ways to quiet worry at night, and changing beliefs about sleep. It usually works over several weeks and its benefits last longer than sleeping tablets.

Sleeping tablets: what to know

When to see a doctor

• Poor sleep on most nights for more than three to four weeks.
• Daytime tiredness, low mood or worry that affects work, studies or relationships.
• Loud snoring with pauses in breathing, or waking up gasping, which may suggest sleep apnoea.
• Sleeping far too much, or unusual behaviour at night.

Psychiatrist or sleep clinic?

Insomnia linked to anxiety, depression, stress or substance use is well handled by a psychiatrist, who can also provide CBT and review medicines. If a breathing problem or another sleep disorder is suspected, tests in a sleep laboratory may be needed, and your doctor can advise you. Our psychiatrists assess sleep problems, and you can book a consultation in person or online.