What treatments are available?
You can’t always resolve the things that are affecting your sleep yourself. If you can’t find solutions to the problem on your own, you may find that you need additional help.
Visit your family doctor
Your family doctor should be able to discuss and treat any potential physical causes of your sleep problems, such as chronic pain or sleep apnoea. They can also give you advice about treatment options if your sleeping problems are caused by a mental health problem, such as depression or bipolar disorder. Your doctor should discuss all your treatment options with you, and your views and preferences should always be taken into account when making decisions about your treatment.
If you think your sleep problems are caused by medication you are taking, it is important to discuss this with your doctor. They may be able to prescribe you an alternative medication, change your dosage, or advise you on how to take your medication in order to minimise the impact it has on your sleep.
Several talking treatments have been developed for treating sleep problems, and have been shown to be effective. Talking treatments offered for sleep problems include:
- Cognitive behavioural therapy (CBT), which helps you to recognise and change unhelpful thought patterns and habits around sleep
- Stimulus control therapy, which aims to challenge unhelpful psychological associations about sleep and help you develop more positive ones
- Relaxation therapy, which teaches you relaxation techniques to help improve your sleep
- Sleep restriction therapy, which reprograms your sleep routine by limiting the amount of sleep you have each night, before building up to a normal amount
If your sleeping problems are caused by a mental health problem, such as depression, anxiety or post-traumatic stress disorder (PTSD), a talking treatment may help you address the mental health problem.
If other techniques for improving sleep are unsuccessful, your family doctor may offer you sleeping pills. Sleeping pills can be helpful in dealing with short periods of severe insomnia, as they can help you break a cycle of being unable to sleep and return to a more regular sleep pattern. However, they should only be used as a last resort and on a short-term basis, as they are highly addictive and become less effective over time.
Sleeping pills available for prescription include benzodiazepines (such as nitrazepam) and the ‘Z drugs’ – zaleplon, zolpidem and zopiclone. You should not take benzodiazepines if you have sleep apnoea as they can make it worse. Therefore, it is important that your doctor makes sure that your sleep problems are not caused by sleep apnoea.
Melatonin, the natural hormone which regulates your body’s response to the day/night cycle, has also been developed as a prescription sleeping pill for people aged 55 and over.
Some antihistamines are marketed as sleeping pills because they have the side effect of making you sleepy. You can buy this type of sleeping pill in a pharmacy without a prescription. However, as with prescription sleeping pills, they should not be taken for more than a night or two, and may have side effects.
If you have insomnia and depression, you may be offered a tricyclic antidepressant, because some of these have the side effect of making you sleepy. Other drugs that may be prescribed to promote sleep are some of the newer antipsychotics, such as olanzapine, which also cause drowsiness as a side effect.
Complementary and alternative therapies
Some people have reported that alternative therapies such as acupuncture, acupressure, reflexology and hypnosis have been useful in helping them relax and improve sleep.