Insomnia (Poor Sleep) - A Summary

General tips for sleeping better (often called 'Sleep Hygiene')

• Reduce caffeine - do not have any food, drugs, or drinks that contain caffeine or other stimulants for six hours before bedtime. Some people have found that cutting out caffeine completely through the entire day has helped.
• Do not smoke within six hours before bedtime.
• Do not drink alcohol within six hours before bedtime.
• Do not have a heavy meal just before bedtime (although a light snack may be helpful).
• Do not exercise within a few hours of bedtime. However, regular exercise during the daytime is good as it can help you to feel more relaxed and tired at bedtime.
• Body rhythms - try to get into a routine of wakefulness during the day, and sleepiness at night. The body becomes used to rhythms or routines. If you keep to a pattern, you are more likely to sleep well. Therefore:
  • No matter how tired you are, do not sleep or nap during the day.
  • It is best to go to bed only when sleepy-tired in the late evening.
  • Switch the light out as soon as you get into bed.
  • Always get up at the same time each day, seven days a week, however short the time asleep. Use an alarm to help with this. Resist the temptation to 'lie-in' - even if you have a poor night's sleep. Do not use weekends to 'catch up' on sleep, as this may upset the natural body rhythm that you have got used to in the week.
• The bedroom should be a quiet, relaxing place to sleep.
  • It should not be too hot, cold, or noisy.
  • Earplugs and eye shades may be useful if you are sleeping with a snoring or wakeful partner.
  • Make sure the bedroom is dark with good curtains to stop early morning sunlight.
  • Don't use the bedroom for activities such as work, eating or television.
  • Consider changing your bed if it is old, or not comfortable.
  • Hide your alarm clock under your bed. Many people will 'clock watch' and this does not help you to get off to sleep.
• Mood and atmosphere - try to relax and 'wind down' before going to bed. For example:
  • A stroll followed by a bath, some reading, and a warm drink (without caffeine) may be relaxing in the late evening.
  • Do not do anything that is mentally demanding within 90 minutes of going to bed - such as studying.
  • Go to bed when sleepy-tired.
  • Some people find playing soft music is helpful at bedtime. Try a player with a time switch that turns the music off after about 30 minutes.
• If you cannot get off to sleep after 20-30 minutes - then get up. Go into another room, and do something else such as reading or watching TV rather than brooding in bed. Go back to bed when sleepy. You can repeat this as often as necessary until you are asleep.

Relaxation techniques

These aim to reduce your mental and physical arousal before going to bed. Relaxation techniques may help even if you are not anxious, but find it hard to get off to sleep. There are a number of techniques. For example, progressive muscular relaxation has been shown to help promote sleep. This technique consists of tensing and relaxing various muscle groups in sequence. It is described more fully in another leaflet called 'Relaxation Exercises'.

Your GP or a counsellor may be able to recommend a tape or CD that takes you through deep breathing exercises, and other methods to help you relax.

Daytime exercise

Regular daytime exercise can help you to feel more relaxed and tired at bedtime. This may help you to sleep better. (However, you should not do exercise near to bedtime if you have insomnia.) If possible, do some exercise on most days. Even a walk in the afternoon or early evening is better than nothing. However, ideally, you should aim for at least 30 minutes of moderate exercise on five or more days a week.

Moderate exercise means that you get warm and slightly out of breath. You do not need to go to a gym! Brisk walking, jogging, cycling, climbing stairs, heavy DIY, heavy gardening, dancing, and heavy housework are all moderate-intensity physical exercises. See separate leaflet called 'Physical Activity for Health' for more details.

Behavioural and cognitive therapies

If you have severe persistent poor sleep, your doctor may refer you to a psychologist or other health professional for behavioural and cognitive therapies. Research studies have found that there is a good chance that behavioural and cognitive therapies will improve sleep in adults with insomnia.

A final note

See a doctor if you feel that illness or medication is causing poor sleep. Depression is a common cause of poor sleep and can usually be treated. Some prescribed drugs can sometimes affect sleep. A change in medication may be possible. Sleeping tablets are not usually the answer for poor sleep. However, a short course may be prescribed if poor sleep is severe.