Treatment Of Insomnia in Jordan

Insomnia is difficulty falling asleep, staying asleep, or early waking without being able to return to sleep, **with a clear impact on the person’s day** — fatigue, reduced concentration and low mood. That last condition matters: someone who sleeps few hours and wakes refreshed does not have insomnia. The key to treatment is that chronic insomnia **is maintained by factors different from those that started it**. It may begin with stress, pain or grief, then a closed loop forms: anxiety about not sleeping raises tension at bedtime, long periods are spent awake in bed, and the brain learns to associate the bed with wakefulness rather than sleep. Treating the original cause alone does not break that loop. For this reason **the first-line treatment for chronic insomnia is not sleeping pills** but **cognitive behavioural therapy for insomnia (CBT-I)** — the best-evidenced option, whose effect persists after it ends, unlike hypnotics after which insomnia usually returns. Its components are practical and specific: **restricting time in bed** to approximate actual sleep time then widening it gradually; **stimulus control**, not lying awake in bed but getting up and returning when sleepy; correcting anxious thoughts about sleep; relaxation techniques; and fixing the **wake time** every day — a constant wake time has more effect than a constant bedtime. Before that, what may be the real cause must be investigated: **obstructive sleep apnoea** (snoring, breathing pauses, daytime sleepiness), restless legs syndrome, chronic pain, depression and anxiety, thyroid overactivity, and medications and stimulants — **caffeine in particular lasts many hours**, while screens and long daytime naps worsen matters. Hypnotics have a limited short-term place decided by a physician, carry dependence and tolerance, and are neither started nor stopped except under supervision.