The Sleep Epidemic: Why the NHS Fails to Address the Root Cause of Insomnia

In the UK, we are facing a sleep crisis. Reports suggest that up to one in three people suffer from poor sleep, with insomnia affecting significant numbers. Yet, conventional medicine—especially within the NHS—is often ill-equipped to deal with the underlying causes of this epidemic. Instead, the default solution frequently involves reaching for the prescription pad, offering sleeping pills as a band-aid for what is often a multifaceted and deeply rooted issue.

The Problem with Sleeping Pills

While sleeping pills, such as benzodiazepines or Z-drugs (e.g., zolpidem and zopiclone), may provide short-term relief, they fail to address the root cause of insomnia. Worse still, they can lead to dependency, tolerance, and a host of side effects, including daytime drowsiness, memory issues, and an increased risk of falls in older adults.

The NHS prescribes these medications cautiously, yet the underlying problem remains: the healthcare system is not designed to delve into the complex interplay of physiological, psychological, and environmental factors that contribute to chronic insomnia. In conventional settings, the average GP appointment lasts just 10 minutes—hardly enough time to uncover the intricate tapestry of contributors to poor sleep.

Why Functional Medicine Offers a Better Approach

Functional medicine, by contrast, seeks to uncover and address the root causes of insomnia. It recognises that sleep disturbances rarely exist in isolation. They are often symptoms of deeper imbalances within the body, influenced by factors such as stress, diet, hormonal changes, gut health, and circadian rhythm disruptions.

Rather than masking symptoms with a pill, functional medicine adopts a holistic and patient-centred approach, which includes:

1. Comprehensive Health Assessments

Functional medicine practitioners take the time to explore a patient’s full medical history, lifestyle, and environment. This includes evaluating stress levels, nutrient deficiencies, exposure to blue light, and even past trauma, all of which can contribute to poor sleep.

2. Identifying and Treating Underlying Conditions

Insomnia can stem from a range of underlying issues, including:

Adrenal dysfunction: Chronic stress and cortisol imbalances disrupt sleep cycles.

• Gut dysbiosis: Poor gut health affects neurotransmitters like serotonin, which play a key role in sleep regulation.
• Nutrient deficiencies: Low magnesium, B6, or zinc levels can impair the body’s ability to relax and stay asleep.
• Hormonal imbalances: Perimenopause, thyroid disorders, and insulin resistance all have profound effects on sleep quality.

3. Personalised Interventions

Functional medicine focuses on tailored solutions that may include:

• Sleep hygiene education: Adjusting light exposure, creating a calming bedtime routine, and maintaining consistent sleep-wake times.
• Stress management: Techniques such as mindfulness, breathwork, and vagus nerve stimulation can reduce cortisol levels.
• Nutritional therapy: Dietary adjustments to balance blood sugar and replenish sleep-supporting nutrients like magnesium and tryptophan.
• Natural supplements: Melatonin for circadian rhythm regulation, adaptogens to support adrenal health, or magnesium glycinate to promote relaxation.

4. Addressing Cognitive and Emotional Barriers

Chronic insomnia often involves a psychological component. Functional medicine integrates cognitive-behavioural therapy for insomnia (CBT-I) and other mind-body approaches to break the cycle of worry and sleeplessness.

The Cost of Ignoring the Root Cause

When insomnia is treated as an isolated symptom, the consequences are far-reaching. Chronic sleep deprivation increases the risk of obesity, diabetes, cardiovascular disease, and even Alzheimer’s disease. It impairs mental health, contributing to anxiety and depression. By failing to address the root causes, we are perpetuating a cycle of poor health outcomes that burden individuals and the healthcare system alike.

A Call for Change

The NHS must pivot from symptom management to root cause resolution. This shift will require more than just additional funding—it demands a reimagining of how we view sleep and its central role in health. Training clinicians in functional and integrative approaches could transform the way insomnia is treated, reducing reliance on pharmaceuticals and empowering patients with sustainable, long-term solutions.

For individuals struggling with sleep, the message is clear: you don’t have to rely on sleeping pills. There are better ways to restore your natural sleep rhythms and address the deeper issues keeping you awake at night. Functional medicine offers a framework to achieve this, helping you reclaim restorative, rejuvenating sleep.