Insomnia Treatment in Marylebone, London

Insomnia becomes chronic when it runs three nights a week or more for three months or longer. It looks like taking half an hour or more to fall asleep, waking in the night or early in the morning and not getting back, or sleeping the hours and still waking unrefreshed. The daytime cost is the part that brings people in: fatigue, irritability and a working memory that has stopped holding things.

The mechanism is hyperarousal. Your nervous system stays alert exactly when it should be settling, and over months the bed itself becomes a cue for wakefulness rather than sleep. That learned association is why the problem outlives whatever started it, and why treatment has to address behaviour as well as physiology.

Which is why cognitive behavioural therapy for insomnia is first line, and why it is the first treatment listed on this page. It works on a consistent rise time, on how long you spend in bed awake, and on breaking that association. Courses commonly run to between four and eight sessions. If you have not had it, that is where your clinician will start you.

The evidence for magnetic stimulation in primary insomnia is early and small. There is no NICE guidance recommending it for insomnia as there is for depression. Where the evidence is better is indirect: insomnia sits alongside depression in a large share of cases, and treating the depression often improves the sleep. If that is your picture, a course is a reasonable conversation. If insomnia is your only complaint, it is a weaker one, and you should hear that from us first.

One thing we will not do is treat around a missed diagnosis. Obstructive sleep apnoea, restless legs, thyroid disease and chronic pain all fragment sleep and none of them responds to stimulation. If your history points that way, we will refer you for a sleep study before discussing a course rather than after you have paid for one.