Sleep: what helps

Insomnia can mean lying awake, waking repeatedly or waking too early. It can also leave you tired or unable to concentrate the next day. The effect on your day is worth describing when you ask for help.

How much sleep you may need

The NHS says adults need 7 to 9 hours of sleep on average, though sleep needs vary. The US Office on Women’s Health says most adult women need seven or more hours to feel rested. The wording differs, and neither recommendation measures how well you sleep as an individual.

When talking about sleep, include the time you spend awake as well as the time you go to bed. The Office on Women’s Health suggests noting bedtime, waking, naps and how you feel during the day. If you have periods, it also suggests recording your cycle alongside sleep.

Keep a regular waking time

A consistent waking time is a useful starting point. NHS advice is to go to bed when sleepy and get up at the same time each day. A dark, quiet bedroom and a comfortable bed can help. Make a little space to wind down with something like reading or a bath.

NHLBI also recommends a cool room and avoiding television or electronic screens around bedtime. Keep caffeine, nicotine and alcohol away from bedtime. Alcohol may make falling asleep easier at first, but it can leave sleep lighter and make waking during the night more likely.

You could choose a small change to try first, such as a regular waking time or putting the phone somewhere else while you wind down. Write down what you tried and what was difficult. Bring those notes to an appointment if you need one. You can be honest about what was hard to keep up.

Periods and menopause can affect nights

The Office on Women’s Health reports that many women have trouble falling or staying asleep in the days before a period. During perimenopause and menopause, hot flushes and night sweats can also disturb sleep. They may play a part, but avoid assuming they explain every difficult night.

Tell your clinician about pain, hot flushes, shifts at work or medicines as well as sleep itself. These can all contribute to sleep problems. You could describe a pattern plainly: “I wake soaked in sweat,” or “I struggle to sleep after a late shift.”

When sleep habits are not enough

Long-term insomnia has treatment options beyond bedtime habits. Cognitive behavioural therapy for insomnia, or CBT-I, is usually the first option recommended by NHLBI. It works on thoughts and behaviours that interfere with sleep. You can have it in person, by phone or online.

CBT-I can include ways to reduce worry about sleep, relaxation and a structured plan for time in bed. Ask about a clinician-led programme rather than devising your own sleep-restriction schedule. The NHS says CBT may be offered with a therapist or through an online self-help programme.

Check with your doctor before taking a sleep aid. Pharmacy sleep aids cannot cure insomnia, and some cause drowsiness. Prescription sleeping pills can have serious side effects and cause dependence. Ask your pharmacist or doctor what is suitable; do not stop a prescribed sleep medicine without talking to your doctor.

Ask about breathing as well as sleep

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, if habit changes have not helped or poor sleep makes daily life hard to manage. Also arrange an assessment if your breathing stops and starts during sleep, you gasp or choke, or you are always very tired during the day.

These can be signs of sleep apnoea. A clinician may arrange overnight breathing tests, often done at home. If someone has noticed the symptoms, tell the clinician what they saw. Do not drive when you feel sleepy.

If sleep apnoea is found, treatment may include a CPAP machine. This pumps air through a mask during sleep to help keep the airways open. The NHS says it can improve sleep and reduce tiredness. Ask the sleep team what treatment is suitable and tell them if equipment is uncomfortable or difficult to use.