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What we treat

Sleep problems

It’s rare to meet someone who doesn’t have the odd restless night. Stress, temperature and even some types of food and drink can affect our ability to get a good night’s sleep. But if you find yourself regularly lying awake, waking up too early, or feeling exhausted even after a full eight hours, it may be time to start looking at your sleep health, especially if your lack of sleep is impacting negatively on your everyday life

Sleep problems – often called 'insomnia' – can feel like a never-ending vicious cycle. A poor night’s sleep can not only leave you tired and lacking energy during the day, sleep deprivation can also affect your mood, making you grumpy and irritable. This overtiredness and stress can then lead to more sleepless nights, as well as to anxiety around getting a better night’s sleep, which in turn can then make it even harder to drop off. When this continues over a period of time, it can begin to take a toll on your health, work performance and quality of life.

How much sleep is enough varies from person to person, but most adults need seven to eight hours a night. Sleepless nights are not something you have to put up with. Simple changes in your daily habits can often help.



Types of sleep problems

Sleep problems affect people in different ways. You may find that you regularly experience just one of these sleep issues, or possibly a mixture over time. Either way, the most common sleep complaints are:

Trouble falling asleep

We all know someone who can fall asleep as soon as their head hits the pillow. Most of us wish we could. Sleep professionals recommend that a good, healthy time to fall asleep is anywhere up to 30 minutes. Yet some people find that it can take much longer than this to drift off, sometimes lying awake for hours and suffering as a result when the alarm goes off.

Night time waking

Some people have no trouble falling asleep but find they can’t achieve a particularly good night’s sleep once they do. This is either because they wake up repeatedly in the night for short periods, or because they wake up in the middle of the night and are then unable to fall back asleep again for hours.

Early waking

Some people find that no matter what they do, their bodies seem to wake them up before dawn and won’t let them fall back asleep. While some might see this as useful, it’s usually unwelcome in those it affects. Starting the day so early often leads sufferers to ‘crash’ later in the morning and to fall asleep earlier in the evening, creating a cycle that’s hard to break.

Causes

Insomnia may be the primary problem, or it may be associated with other mental health conditions. Chronic insomnia is usually a result of stress, life events or habits that disrupt sleep. Treating the underlying cause can resolve the insomnia, but sometimes it can last for years.

Common causes of chronic insomnia include:

  • Stress. 
  • Travelling or work schedule. Your circadian rhythms act as an internal clock, steering such things as your sleep-wake cycle, hunger and body temperature. Disrupting these rhythms through things like jet lag from traveling across multiple time zones, working a late or early shift, or frequently changing shifts, can lead to sleep problems.
  • Poor sleep habits. For example, an irregular bedtime schedule, naps, an uncomfortable sleep environment, stimulating activities before bed, and using your bed for work, eating or watching TV. Looking at screens just before bed can also interfere with your sleep cycle.
  • Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down and wake your body up.
Additional common causes of chronic insomnia include:

  • Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, can disrupt your sleep. Waking too early can be a sign of depression.
  • Medications. Certain antidepressants and medications for asthma or blood pressure and many other prescription drugs can interfere with sleep.
  • Medical conditions. Conditions linked to sleep problems include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), Parkinson's disease and Alzheimer's disease.
  • Sleep-related disorders. Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may keep you from falling asleep.
  • Caffeine, nicotine and alcohol. Coffee, tea, cola, Red Bull and other caffeinated drinks are stimulants, so drinking them in the late afternoon or evening can prevent you from falling asleep at night. Nicotine is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but the sleep won’t be restful as it prevents deeper stages of sleep and often causes waking in the middle of the night.

Sleep issues and mental health

Sleep issues and mental wellbeing are very closely linked. A continued lack of sleep can affect your emotional wellbeing, while certain mental health problems can cause problems falling or staying asleep. So it’s no surprise that one of the most common issues that people being treated for a mental health disorder complain about is trouble sleeping or always feeling tired.

Sleep helps our brains and bodies to recharge. While we’re asleep we go through a series of sleep cycles and our brains run through a number of processes that are necessary to help us function effectively during the day. Without sleep, our ability to think rationally and to regulate our emotions is compromised, potentially increasing the effects of a mental health disorder or our risk of developing one.

At the same time, some common mental health disorders such as depression or anxiety can cause sleep problems. People with anxiety may spend a long time struggling to fall asleep due to excessive worrying, while many people with depression also experience insomnia or sleeping too much.

The link between mental health and sleep issues means that treating one issue often has a positive effect on the other.

How can CBT help
with sleep issues?

Cognitive behavioural therapy (CBT) helps you look at and understand how your thoughts and actions affect the way that you feel or deal with certain situations. CBT has been proven to be very effective at treating sleep issues and disorders, as it helps you confront the root of the problem. The cognitive (thinking) part of CBT helps you control or eliminate negative thoughts and actions that keep you awake, and in their place promotes more positive and realistic thoughts and behaviours. If necessary, CBT also eliminates the cycle that can develop where you worry so much about getting to sleep that you can't fall asleep.

CBT has a strong focus on developing good relaxation techniques that can help relieve tension and minimise sleep anxiety, preparing you for better sleep. It will also help you identify any changes you can make to improve your sleeping habits.

The behavioural aspect of CBT is about identifying any negative behaviours or lifestyle habits that may be impacting your sleep. Behaviours such as watching TV in bed or drinking caffeine too late in the day could all be affecting your ability to drift off and achieve quality sleep.

CBT teaches you new techniques that can be used in many different scenarios to help you develop better sleeping habits that can be used for life.

Strategies include, for example:
  • Stimulus control therapy. This method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a regular bedtime and wake time and avoid naps. Other habits you may be taught to form include using the bed only for sleep and sex, and leaving the bedroom if you can't go to sleep within 20 minutes, only returning when you're sleepy.
  • Relaxation techniques. Progressive muscle relaxation and breathing exercises are ways to reduce anxiety at bedtime, by helping you control your breathing, heart rate, muscle tension and mood so that you can relax.
  • Sleep restriction. This therapy decreases the time you spend in bed and avoids daytime naps, causing partial sleep deprivation, which then makes you more sleepy the following night. Once your sleep has improved, your time in bed is gradually increased.

Start the process


If you would like to find out about other mental health support options available in your area, visit the NHS website.

In a health emergency
Call Samaritans on 116 123 if you need to talk to someone
Call 111 if you’re experiencing a mental health crisis
Call 999 or go to A&E if your life is at immediate risk
Call 116 123 If you need to talk to someone
Call 111 if you are experiencing a mental health crisis
Call 999 or go to a&e if your life is at immediate risk