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Insomnia will often improve by making changes to your bedtime habits. If these don't help, your GP may be able to recommend other treatments.
If you've had insomnia for more than four weeks, your GP may recommend cognitive and behavioural treatments or suggest a short course of prescription sleeping tablets as a temporary measure.
If it's possible to identify an underlying cause of your sleeping difficulties, treating this may be enough to return your sleep to normal.
The various treatments forÂ insomnia are outlined below. You can also read a summary of the pros and cons of the treatments for insomnia, allowing you to compare your treatment options.
Your GP will be able to advise you about what you can do at home to help you sleep. This is known as "sleep hygiene" and includes:
Read more about self-help tips forÂ insomnia.
If changing your sleeping habits doesn't help, your GP may be able to refer you for a type of cognitive behavioural therapy (CBT)Â that's specifically designed for people with insomnia (CBT-I).
The aim ofÂ CBT-I is to change unhelpful thoughts and behaviours that may be contributing to your insomnia. It'sÂ an effective treatment for many people and can have long-lasting results.
CBT-IÂ mayÂ include:
CBT-I isÂ sometimes carried out by a specially trained GP. Alternatively, you may be referred to a clinical psychologist.
The therapy may be carried out in a small group with other people who have similar sleep problems, or one-to-one with a therapist. Self-help books and online courses may also be used.
Sleeping tablets (hypnotics) are medications that encourage sleep. In the past, they were frequently used to help with insomnia, but they're used much less often nowadays.
They will generally only be considered:
Doctors are usually reluctant to recommend sleeping tablets in the long-term because they just mask the symptoms without treating the underlying cause.
They can also cause potentially dangerous side effects, such as drowsiness the following morning, and some people become dependent on them.
If they are recommended, you should have the smallest effective dose possible for the shortest time (usually no more than two to four weeks).Â
A number of sleeping tablets are available to buy over the counter (OTC) from pharmacies. These are usually a type ofÂ antihistamine medicine that causes you to feel drowsy.
Taking OTC sleeping tablets regularly isn't usually recommended if you have insomnia, because it's not clear how effective they are, they don't tackle the underlying cause of your sleeping difficulties and they can cause side effects.
In particular, they can cause you to feel drowsy the next morning, which can make activities such as driving and operating machinery dangerous.
Speak to your GP for advice if you find yourself needing to take OTC sleeping tablets regularly.
Benzodiazepines are prescription medicines that can reduce anxiety and promote calmness, relaxation and sleep. Your GP may prescribe them for a short time if you have severe insomnia or it's causing extreme distress.
Examples of benzodiazepines include temazepam, loprazolam, lormetazepam, diazepam and nitrazepam.
Long-term treatment with benzodiazepines isn't usually recommended because they can become less effective over time and some people become dependent upon them.
They can also cause a number of side effects, including:
You should avoid driving if you feel drowsy, dizzy, or unable to concentrate or make decisions, as you may not be able to do so safely.
Zâ€“drugs are a newer type of medicine that work in a similar way to benzodiazepines and are similarly effective. They include zaleplon, zolpidem and zopiclone.
As with benzodiazepines, long-term treatment with Zâ€“drugs isn't normally recommended because they can become less effective over time and some people become dependent on them.
They're usually only prescribed for a maximum of two to four weeks.
Side effects of Z-drugs can include:
Zâ€“drugs can also sometimes cause psychiatric reactions, such as delusions,Â nightmares and hallucinations. Contact your GP if you experience any of these effects.
Read the National Institute for Health and Care Excellence (NICE) guidance onÂ zaleplon, zolpidem and zopiclone for the short-term management of insomnia for more information.
For adults aged 55 or over, a medication called Circadin is sometimes used to help relieve insomnia for a few weeks. It contains a naturally occurring hormone called melatonin, which helps to regulate the sleep cycle.
Circadin is usually only recommended for three weeks at first, but it can be continued for a total of 13 weeks if it helps.
Common side effects of Circadin include:
The following treatments aren't normally recommended for insomnia, because it's not clear how effective they are and they can sometimes cause side effects:
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