Sleep is the thing most people notice first and treat last. It is also one of the few levers in mental health that is treatable in its own right, with a therapy that works and is available here.
This page describes a situation, not a condition. Nothing here is a diagnosis and most people reading it do not need one. If what you are dealing with has lasted a long time, or has stopped responding to changes in the situation itself, the Conditions library covers the clinical picture.
Symptom, driver, or both
Both, and the direction runs each way. Disrupted sleep is one of the most consistent early features of depression, anxiety, mania and post-traumatic stress. It is also a risk factor: sustained poor sleep makes emotional regulation harder, worsens concentration, and can maintain a depressive or anxious episode after whatever started it has passed.
The practical consequence is that sleep is worth treating as its own problem rather than waiting for it to resolve once the mood does. That is the reasoning behind offering insomnia therapy directly, rather than only as a side effect of treating something else.
Cognitive behavioural therapy for insomnia
Cognitive behavioural therapy for insomnia, usually written CBT-I, is the first-line treatment for chronic insomnia internationally and is available in Singapore’s public hospitals. SingHealth describes it as five components:
- Cognitive therapy, which works on the beliefs about sleep that keep people awake.
- Sleep hygiene.
- Relaxation techniques.
- Sleep restriction, which compresses time in bed to rebuild sleep pressure. It is counterintuitive and it is usually the component that does the work.
- Stimulus control, which re-establishes the bed as a place associated with sleeping rather than with lying awake.
It is not sleeping pills and it is not sleep hygiene advice on its own. Sleep hygiene by itself has a poor record against chronic insomnia; it is one of five parts here, not the treatment.
Where it is assessed and treated in Singapore
Five public hospitals run dedicated sleep services: Singapore General Hospital, National University Hospital, Ng Teng Fong General Hospital, Changi General Hospital and Sengkang General Hospital. The SGH Sleep Centre describes itself as the largest in Singapore.
SingHealth lists CBT-I as available at Singapore General Hospital, Changi General Hospital and Sengkang General Hospital, and National University Hospital states that insomnia is best treated with cognitive behavioural therapy, medication, or both.
How common this is
Around one in four people in Singapore sleeps badly. The last national study to measure it put the figure at 27.6 per cent, which means poor sleep is closer to ordinary than to unusual here. If you are lying awake at 3am feeling like the only one, you are not.
Nobody has measured it nationally since. Sleep is not tracked in the national health survey, which is its own small comment on how seriously it gets taken.
When to take it somewhere
Three or more nights a week of difficulty falling or staying asleep, for three months or more, with daytime consequences, is the usual threshold for chronic insomnia and a reasonable point to see a GP. Loud snoring with pauses in breathing, or falling asleep during the day despite adequate time in bed, points at a different problem and should be assessed rather than managed at home.
This page is information, not medical advice. It does not diagnose, treat, or replace an assessment by a qualified professional. If you are in crisis, call 995 or one of the helplines listed on this site.