Sleep Problems

Warning
Warning:

This site gives you information NOT medical advice. You should consult your medical practitioner if you have any unexplained symptoms of illness or concerns about treatment. Do not stop a prescribed conventional treatment without consulting a doctor. Tell all the practitioners you're working with, conventional or complementary, about any medicines, remedies, herbs or supplements you are taking or considering using.

What do we mean by sleep problems?

We all need to 'recharge our batteries' overnight so that we can be energetic and alert during the day. Most of us spend a third of our lives asleep. But one person in three experiences sleep problems at some time in their lives. Some people don't get enough sleep, others are too restless, and others may feel that they are sleeping too much. Perhaps you have difficulty getting to sleep, or problems staying asleep through the night, or you wake too early in the morning? You may think you're getting enough sleep but if you wake up feeling tired or feel very sleepy during the day, then you might have a sleep problem. Too little sleep can make you feel tired and irritable, and less able to concentrate the next day. But it isn't just how much sleep you get that matters; quality of sleep is important too.

The most common kinds of sleep problem are:

There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help.

How much sleep is enough?

Most adults seem to need seven to eight hours. But some people thrive on three or four, and feel worse if they sleep more. Others need ten hours or more to feel right. Older people will often only have one period of deep sleep during the night, usually in the first three or four hours. After that, they wake more easily. The short periods of being awake can feel much longer than they really are, so it is easy to think you are sleeping less than you actually are.

What causes insomnia?

Insomnia can take many different forms. It can mean taking a long time (more than 30 to 45 minutes) to get to sleep, or waking a lot in the night, or waking early and finding you can't get back to sleep.

Going through a stressful time can trigger short-term sleep problems. For instance, a big life event (like a house or job move, going into hospital or exams), a personal crisis (such as bereavement, conflict in a close relationship or worries about money or a job loss), or minor illness, pain or injury can all cause periods of insomnia. In the same way, the stress of long-haul air travel will disturb sleep rhythms until the body-clock catches up. A noisy neighbourhood and shift-working can make sleep difficult in the long term. But if none of these things is the cause, then there could be a medical reason.

Sleep Apnoea

Lots of people snore. But loud snorers who feel sleepy during the day may be having sleep apnoea (pronounced AP-ne-ah) attacks. Sleep apnoea means having long pauses in breathing during sleep. The pauses can last from ten seconds or much longer, and can happen between 5 and 30 times or more an hour. Then breathing starts again, often with a loud snorting or choking noise. Because sleep apnoea keeps jolting you out of deep sleep and into light sleep it is one of the leading causes of long-term daytime tiredness.

The most common type is called obstructive sleep apnoea because the airway gets blocked during sleep. It mainly affects men (estimated to be as high as 1.25%) and is more common in people who are overweight. Most people won't know they have sleep apnoea unless a family member and/or bed partner notices the signs: loud and irregular snoring, excessive body movements or gasping for breath while you are asleep, and of course persistent daytime tiredness. Alcohol and sleeping pills relax the tongue and throat muscles, which block the airway and so make the problem worse.

If you have a fairly mild case of obstructive sleep apnoea, sleeping on your side may stop your tongue and palate from falling backwards and blocking your airway. And losing weight usually helps reduce the problem in overweight middle-aged men. More serious obstructive sleep apnoea needs medical attention.

Restless Leg Syndrome (RLS)

RLS causes unpleasant sensations in the legs and an irresistible urge to move them when you lie down or relax. It usually gets worse at night, so it can cause sleep problems. Mild RLS can often be helped by the following lifestyle changes:

Further information and advice

For more information visit:

When to see your doctor or pharmacist

If your sleep has been bad for a while you should see your doctor because long-term sleep problems can be caused by treatable medical and psychological conditions. If you have other symptoms, it is important to see your doctor instead of just using this leaflet.

Sleep problems are common in people who have diabetes. Heart problems can disturb sleep too, as can arthritis, asthma, epilepsy and digestive disorders. Misuse of drugs or alcohol, or too much caffeine and even persistent use of sleeping tablets can all result in long-term insomnia. In addition, 1 in 15 people may have sleep apnoea and perhaps 10% of people suffer from restless legs syndrome (3% severely). If you think any of these causes might apply to you, see your GP.

Psychological problems that disturb sleep include anxiety disorder, obsessions, phobias and compulsions. Depression also causes sleep problems: waking early and being unable to get back to sleep is the usual clue. So, if you are feeling low, having negative thoughts about yourself, or you find that your moods are more up and down than usual, or your appetite has changed, depression may be the cause of your sleep problem. See your doctor if you think this is the case. Anti-depressant medicines and psychotherapy could improve both your mood and your sleep.

Many medicines, both prescription and over-the-counter, can affect sleep. So if you have recently started taking new medication, speak to your pharmacist about whether this might be the cause of your sleep problems.

simplechangesMake Some Simple Changes


pencil Diet

OverviewIt is important to have a healthy diet with enough fibre (roughage), vitamins and minerals. This means eating plenty of fruit and vegetables and unprocessed cereals. Improving your diet will help boost your energy levels and wellbeing. The Food Standards Agency has eight tips for eating well:

1. Base your meals on starchy foods
2. Eat lots of fruit and veg
3. Eat more fish
4. Cut down on saturated fat and sugar
5. Try to eat less salt, no more than 6g a day
6. Get active and try to be a healthy weight
7. Drink plenty of water
8. Don't skip breakfast; it helps get your body and mind going first thing.

pencil Sleep Hygiene Rules

Time for bed?In order to sleep, you need to be tired. If you exercise regularly it helps relieve tension and helps your body relax. Don't exercise close to bedtime because it may keep you awake. If you're not properly tired, you may drop off but the sleep you get may not be deep, good-quality sleep, and you could find yourself waking unrefreshed. So going to bed too early is a bad move. If you feel sleepy and go to bed but then can't fall asleep, it's better to get up and leave the bedroom. If you can't sleep don't get into the habit of reading, or watching TV in bed instead. Keep the bedroom for sleeping in. It's better to go to another room to read or relax, or have a warm bath. Only go back to bed when you feel that sleep is likely to come more naturally.
Have a consistent bedtimeYour brain and body have their own rhythms of rest and activity. Your brain chemistry and hormone levels vary through the day and night. So having a regular time to sleep and wake can help get you back in synch with your body-clock. This means going to bed regularly, at a time when you are tired. And no matter what sort of sleep you have had, aim to wake at the same time every day, seven days a week. It's best not to make up for a bad night by sleeping in. And if you wake early, rather than lying in bed awake, try to get up and get on with your day. If you establish this sort of strict regime, your body-clock should eventually re-set itself.
Don't cat-napA lot of people like an afternoon nap. But sleep scientists say this interferes with night-time sleep. So if you are sleeping badly, don't make up for it by cat-napping in the day, because this will only disturb your sleep rhythm even more. Some elderly people say daytime naps help them sleep better at night, but most insomniacs get a better night's sleep if they give siestas a miss.
Avoid late-night habitsSome people find a very light bedtime snack stops them from waking hungry in the early hours. The traditional hot milky bedtime drink and digestive biscuit may be helpful. But heavy late-night eating, alcohol and stimulating drinks are definitely out. So is late-night smoking because nicotine wakes the brain up. Sleep laboratories have proved that smokers have more sleep problems. Alcohol can make people sleepy, but the resulting sleep will probably be disturbed and the drinker will wake once the effect wears off. A full bladder won't help you sleep either. Alcohol also makes obstructive sleep apnoea worse.
Make your bedroom a restful placeThe temperature, light and noise level should be as good as you can make them. Make sure your bed is comfortable: not too hard or soft. If your cat or dog sleeps in your bedroom find it it somewhere else if it disturbs you. Perhaps the same goes for the restless or snoring partner who shares your bed too!

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simplechanges Cutting down caffeine

OverviewWhen you feel tired it is tempting to reach for stimulating drinks like tea, coffee, colas or so-called 'energy drinks'. They can give you a quick lift, but if you rely on them for long they only keep you going until your energy stores run down further.
EvidenceIn one study people who stopped caffeine (coffee, tea and cola drinks) slept better and for longer. In another study people had less difficulty falling asleep on days when they drank decaffeinated coffee. Large surveys did not find that people who regularly drink coffee were more likely to have insomnia than people who did not but it is possible that there were other differences between people who drink coffee and people who do not that could explain this.
SafetyIf you are cutting down on large amounts of caffeine, headaches might be a problem for two or three days. It is better to reduce the amount of caffeine slowly over a few days.
CostThere are no costs. In fact you will save money.
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simplechanges Cutting down on alcohol and stopping smoking

OverviewToo much alcohol can affect sleep patterns, and smoking and excessive drinking have effects on our overall health that can affect the quality of sleep.

Moderate drinking means no more than two drinks a day for men and one drink a day for women. A unit of alcohol is half a pint of ordinary strength beer, lager or cider or a small pub measure (25 ml) of spirits or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume). A small (125ml) glass of basic wine is 1 and a 1/2 units.
EvidenceLarge surveys found different results about the effect of moderate drinking on sleep but people who use alcohol to get to sleep tended to drink too much. Cigarette smokers had more trouble with getting to sleep.
SafetyCutting down on smoking and alcohol is safe, but if you are cutting down from heavy use, there can be side effects including loss of appetite and difficulty sleeping. There are unlikely to be side effects if you are cutting down a moderate alcohol intake but if you are a very heavy drinker, it is better to get help with cutting down.
CostNo costs are involved and think of the money you will save!
Find out moreFor more information, see the NHS information sensible drinking.

If you are giving up or cutting down on smoking you can order a Quit Kit from SmokefreeNHS. You can also phone the NHS Free Smoking Helpline on 0800 022 4332
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simplechanges Exercise

OverviewCompared to 100 years ago, when people didn't have cars, washing machines or TV, most of us don't do much physical work these days. Science tells us that our relatively lazy modern lifestyle is bad for our health. Being more active can keep you fit by making your heart and lungs work better, toning your muscles and strengthening your bones and joints. It also stimulates blood circulation to your brain and internal organs, boosts your immune system, and helps protect against osteoporosis. Importantly for people feeling low or depressed, it triggers brain chemicals that lift your mood and can generate a real sense of well-being. It can also be a very good way of meeting people, and it definitely makes a difference to all sorts of health problems.

It's good to get outdoors. One study found that people were much less depressed after taking a walk in the country than if they spent the same time walking round a shopping centre. So it seems that where you get active is almost as important as how active you get. Green spaces could be good for your mood! Many local councils organise Health Walks for people who want to get active in company.

Exercise probably won't help you sleep unless you exercise regularly. Morning exercise probably doesn't help as much as afternoon or early evening exercise. But don't exercise just before sleep because it winds the body up and slows down the process of getting to sleep.
EvidenceSeveral studies have found that physical activity can help you sleep better. One study found that exercise involving regular brisk walking improved sleep in people aged 60 years and over.
SafetyWalking and keeping active in the day are safe. If you have a medical condition or if exercise causes you problems, you should always consult your doctor before starting a new exercise programme.
CostYou can exercise at home for nothing walking and gardening are all exercise. There will probably be a small cost, £5- £8 if you join an organised class. Check at your Leisure Centre for low-cost classes.
Find out moreNatural England is one of several organisations that organise walking schemes designed to help people improve their health. The Walking for Health Programme has about 600 local groups, and around 40,000 people take part in short local walks every week. Find out about Green Gyms where volunteers take on voluntary projects outdoors. Many local councils organise Health Walks for people who want to get active in company.

Check your local leisure centre for exercise classes. See also the Classes section for more information.
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simplechanges Listening to music before bed

OverviewMost research suggests that soft, slow melodies, usually classical music, are helpful if played just before going to sleep. In older adults, music may reduce the time needed to fall asleep, and result in less sleep disturbance and a longer time sleeping.

EvidenceThere have been lots of studies into how listening to music improves sleep.
SafetyListening to soft music is safe!
CostNo costs are involved.
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simplechanges Meditation

OverviewMeditation is a state of mind, not a religion, though it features in most major religions, especially Eastern ones. Meditation seems to harmonise the activity between the two sides of the frontal brain, and encourages a 'relaxation response'. The relaxation response happens when the body and mind do the opposite of what they do when you feel stressed. In meditation the body is relaxed while the mind is alert. You don't need an experienced teacher or a spiritual faith in order to take up meditation. You can learn the basics from a book or a podcast. Meditation is easily accessible, and it is remarkably effective, both for rapid stress reduction and as a way of promoting long-term health.
EvidenceSeveral small studies suggest that meditation may help people with sleep problems. The evidence isn't yet very strong but meditation would be well worth trying if you have a long-term sleep problem.
SafetyThere are generally no safety problems with meditation unless you have a severe or long-standing mental health problem.
CostMeditation involves certain (simple) techniques that can be easily practised at home. There are many books and audio aids available and some people find it useful to join a class initially.
Find out moreVisit The British Holistic Medical Association for podcasts and leaflets. Also see the information about Yoga in the 'Classes' section.
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simplechanges Progressive muscular relaxation (PMR)

OverviewFalling asleep is easier if you are relaxed. If you are feeling stressed or anxious, it can be difficult for your mind to switch off and let go of the day. There are a number of things you can do to help you relax, which may help with your sleep patterns.

A useful technique is progressive muscular relaxation. Progressive muscular relaxation works by tensing and relaxing various muscle groups in your body, starting from your feet and working your way up. At each level, try to notice how it feels when your muscles are tense, and how it feels when you let go and relax. Gradually you will get used to the feeling of relaxation and learn how to make it happen at will. As with most relaxation methods, you need to start by finding a quiet, relaxing place to practise. Put yourself in a comfortable position, whether standing, sitting or lying, and start by allowing your out-breath to get softer, longer and deeper.
EvidenceThe research suggests that using muscular relaxation techniques can help you get to sleep quicker, sleep longer and wake up less often.
SafetyRelaxation techniques are generally safe unless you have a severe or long-standing mental health problem (see our leaflet on Stress and Anxiety).
CostProgressive muscular relaxation can be learned from a book, CD, DVD or during exercise classes such as yoga classes (see the 'Classes' section for more information). No costs are involved, although you may need to buy a CD, DVD or book.
Find out moreVisit The British Holistic Medical Association for podcasts and leaflets. See also the Stress and Anxiety leaflet in this series.
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simplechanges Self-help audio aids

OverviewAs well as listening to music (see above), listening to natural sounds like waves or gentle wind or even quiet heartbeat rhythms in bed may help you drift off to sleep naturally. Having the radio on quietly, with the snooze button on, helps many people.
EvidenceA small amount of research has been carried out into sleep audios, and these studies suggest they can help.
SafetyThere are no safety problems.
CostYou can buy sleep CDs in some bookshops and some libraries keep them in stock.
Find out moreVisit The British Holistic Medical Association for podcasts and leaflets.
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simplechanges Taking a warm bath in the evening

OverviewWith or without some relaxing bath salts or oils, the tranquilising effects of warm water need no research to tell you it feels good and makes you feel sleepy.
EvidenceSeveral studies showed that a warm bath in the evening improved the sleep of women of 60 years and over.
SafetyTaking a warm bath is safe but don't fall asleep!
CostNo costs are involved.
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buysomethingBuy Something


pencil Before You Buy

OverviewFor safe use of over-the-counter medicines, herbal remedies and supplements:

Consult a qualified person (such as a pharmacist) before buying or taking any medicine, remedy or supplement:
- if you have a serious medical condition
- if you are breast-feeding, pregnant or planning to become pregnant
- if you are already taking other medicines, herbal remedies or supplements
- if you suffer from allergies

Always read the package insert before taking any product.
Avoid taking the product if you think you may be allergic to any of the ingredients.
Do not combine any over-the-counter medicines, remedies or supplements with other medicines, remedies or supplements unless you have first checked with a qualified person (such as the pharmacist in your local chemist).

Seek advice from your doctor or pharmacist:
- If your symptoms do not get better
- if your symptoms get worse
- if you get new symptoms or have a side effect

The information here, including dosages, only applies to adults (over 16 years). Keep all medicines out of the reach of children.

pencil Herbal remedies and food supplements

OverviewThere are several kinds of herbal 'sleeping tablets' that you can buy over the counter. They usually have hops, passiflora or valerian in them. The scientific evidence on them isn't very strong, but many people say they find them helpful. As long as you keep to the recommended dose and only use them for a few days at a time, perhaps in addition to relaxation techniques, it is unlikely to be a problem. These herbs are generally safe but serious side-effects can be caused by big doses. It is therefore important to follow the directions about how much to take. Some people are allergic to certain plant families so proceed with care if you think you might have an allergy. And if you are on any other medication, check with your pharmacist whether it is safe to take a herb as well.

pencil Medicines that can be bought at a pharmacy

OverviewAll sleeping medications should be used cautiously, in moderation, for as short a time as possible, and in the smallest dose that works. Though these medicines can be easily bought, they should not be used for long without consulting a doctor. Their misuse is dangerous. Do not take anything with other medicines, remedies or supplements unless you have checked with the pharmacist in your local chemist.

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buysomething Antihistamines

OverviewAnyone who takes antihistamines for hay fever will tell you they can make you sleepy. You can buy antihistamine tablets over the counter but they should only be used in the short term for sleep problems. This is because the body gets used to them, so the effects wear off over time. Diphenhydramine (e.g. Nytol and Nightcalm) and promethazine (e.g. Sominex and Phenergan Nightime) are a self-treatment drugs available over the counter.
EvidenceSeveral studies of promethazine and of diphenhydramine have shown that these antihistamine drugs improve sleep in people with insomnia.
SafetyThe most common side-effects are sleepiness during the day, dry mouth, and constipation. These drugs should be avoided by men with prostate problems and people with glaucoma. Elderly people may get confused and over-sedated if they use them. Antihistamines may also interact with other medication. Your pharmacist can advise on whether they are suitable for you, what dose to take and about any possible interactions. Antihistamines should not be taken with alcohol.
CostAntihistamines can be bought for relatively low cost from most pharmacies.
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buysomething B complex or other vitamins and supplements

OverviewAlthough B vitamins are sometimes said to help insomnia we could find no research evidence for this, though we did find some evidence that they don't work for sleep problems.
EvidenceWe could not find any research showing that vitamins ease sleep problems.
SafetyVitamins are generally inexpensive and safe if not taken in large amounts. But very high doses of vitamin A, D or E can make you ill or may increase the risk of developing other health problems.
CostB vitamins can be bought for relatively low cost from most pharmacies and health food retailers.
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buysomething Chamomile

OverviewThere are two types of chamomile. German chamomile (Matricaria recutita) has traditionally been used to help people sleep. It can be made into a tea, and sweetened with sugar or a little honey. A relaxing essential oil made from it is used in aromatherapy.
EvidenceThough this herb has been used for centuries to help people sleep, there has only been one small trial of looking at whether it affects sleep problems.
SafetyChamomile is generally safe but it can cause a reaction if you are allergic to flowers of the daisy family (such as daisies, chrysanthemums, geraniums).
CostApproximate costs will be no more than £10 per month for tea and essential oil.
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buysomething Hops

OverviewHops (Humulus lupus) are said to have sedative and sleep-enhancing effects and have traditionally been used in pillows to aid sleep. Hops are also sometimes included in tablets that are available from healthfood shops as sleep aids.

EvidenceThere have been a number of studies using hops and valerian together, which suggest that this mixture might help mild sleep problems.
SafetyHops are generally safe but hop allergy has been reported in a patient who had previous severe allergic reactions to peanut, chestnut and banana. People with such allergies should probably avoid using hops.
CostHop preparations can be bought for relatively low cost from most health food shops.
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buysomething Lavender

OverviewLavender (Lavandula angustofolia) is a traditional sleep aid. Lavender contains an oil which, according to a few small studies, has a sedative effect. Aromatherapists use it for aromatherapy massage (see Massage), but a few drops can also be added to your bath. It seems to have a calming effect and is said to relax muscles. Having the smell of lavender in the bedroom can help you sleep, according to some research.
EvidenceSeveral small studies suggest lavender fragrance may ease sleep problems but only one study was well-designed.
SafetyLavender seems to be safe for most adults unless you are allergic or hypersensitive to it, in which case you should avoid it. If taken as a tea, lavender can cause constipation and headaches. Applying lavender to the skin can sometimes cause irritation.
CostApproximate costs will be no more than £10 per month for essential oil preparations.
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buysomething Melatonin

OverviewMelatonin has been widely promoted as a remedy for sleeplessness caused by jet-lag. Melatonin is sold without a prescription in health food stores and drug stores in the United States. In the UK it is a prescription-only medicine called Circadin. Current research suggests that it is probably safe for most adults to use melatonin for a few days when getting over jet-lag, but its long-term side-effects (if any) are unknown.
EvidenceThere is some research to suggest that melatonin is useful for jetlag and other kinds of sleep problems. Its main effect seems to be in reducing the time it takes to fall asleep.
SafetyMelatonin may interact with various medications but we don't know which ones. It may not be safe if you are pregnant, breast-feeding, or taking other medications except for minor painkillers and oral contraceptives. We don't know what it may do if taken for long periods. It is possible that melatonin might make you less alert. It might make migraine, depression, and certain eye diseases, such as retinitis pigmentosa worse.
CostMelatonin is available on prescription.
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buysomething Passion Flower

OverviewPassion flower (Passiflora incarnata) can be bought as tablets or drops, on its own or mixed with other ingredients. It is supposed to quieten down the central nervous system.
EvidenceIn one small study some people reported better sleep.
SafetyPassion flower is generally considered to be a safe herb with few reported serious side effects.
CostApproximate costs will be no more than £10 per month for passion flower preparations.
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buysomething Valerian

OverviewValerian (Valeriana officinalis) is another herb that has traditionally been used for sleep problems. It is available in many over-the-counter herbal sleeping tablets.
EvidenceValerian is a promising treatment for sleep problems. Research shows it improves the quality of sleep and reduces the time to fall asleep.
SafetyMost side effects from valerian are mild. If used for longer than two to four months it may actually cause sleep problems.
CostApproximate costs will be no more than £10 per month for valerian preparations.
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attendvisitAttend Classes / Visit Practitioner


attendvisitTreatment Options:


attendvisit Acupuncture

OverviewAcupuncture is a traditional form of treatment that began in China thousands of years ago. Thin needles are inserted into the skin at certain points on the body, which practitioners believe will help restore health. The treatment sometimes also involves heat, pressure, electrical currents or soft-laser light. In the UK, acupuncture is most commonly used for pain relief.
EvidenceSome small studies suggest that acupuncture may help with sleep problems but the studies have not been convincing.
SafetyAcupuncture is generally safe if practised by a trained acupuncturist. The most common side-effects are slight discomfort (common) and bruising (occasionally).
CostA session may cost £35-£50. Frequency of treatment will depend on you and your practitioner.
Find out moreThe following professional organisations can help you find a qualified practitioner:
Acupuncture Association of Chartered Physiotherapists
British Academy of Western Medical Acupuncture
British Acupuncture Council
British Medical Acupuncture Society
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attendvisit Hypnosis, autogenic training (AT) and guided imagery

OverviewIf sleeplessness has been a long-term problem you might have started to feel that it will never get better. Hypnotherapy (the same thing as hypnosis) might help you overcome this sort of negative thinking. It can help you learn to relax too. Whether or not it is safe and effective depends on the skill of the practitioner and how you feel about working with them. At present, it is hard to find out whether a hypnotherapist has been appropriately trained because the field of hypnotherapy is not well regulated.

Autogenic training (AT) is a type of self-hypnosis. It involves simple phrases that you repeat to yourself silently as you release tension from each part of your body. These phrases suggest
particular sensations that calm negative thoughts and reduce tensions in the body. It begins by encouraging you to find a relaxing place and position, and allow the out-breath to get softer, longer and slower. AT can train you to reach very deep states of relaxation.

Using a guided imagery recording can help you slip into a calm, dreamy state of mind. Like AT, this technique can help you imagine a safe, comfortable place where you are able to feel yourself relaxing more and more deeply.
EvidenceSome research has been carried out on all of these techniques for sleep problems. The results are promising but more studies are needed.
SafetyThese techniques are safe for most people if carried out by or under the guidance of a qualified practitioner. If you have a long-term mental health problem you should ask your GP whether these methods would be appropriate for you.
CostYou can buy guided imagery CDs in shops and pharmacies and some libraries keep them in stock. The British Holistic Medical Association produces a guided imagery pack.
Find out moreHypnotherapists who are also doctors or psychologists have strong regulatory organisations. See The British Association of Medical Hypnosis
The British Autogenic Society (BAS)
is the professional and educational organisation for autogenic therapists.

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attendvisit Massage

OverviewThere are many different types of massage, some more vigorous and going deeper into the muscles than others. Massage has traditionally been used for relaxation. It may be just on one part of the body (for example, the back and shoulders), or it can be done on the whole body. Aromatherapy massage uses pleasant-smelling essential oils.

EvidenceFew trials have been carried out to test the effectiveness of massage in easing sleep problems.
SafetyMassage is safe if carried out by a qualified massage therapist, and it rarely causes problems. Vigorous massage should be avoided if you have blood disorders, some forms of cancer, skin problems or are on blood-thinning medications (such as warfarin). Allergies or skin irritation can occur with some essential oils used in massage.
CostMonthly cost will depend on how regularly you receive treatments.
Find out moreIt is important to find a qualified practitioner such as one registered with
The General Council for Massage Therapies
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attendvisit Psychological therapies

OverviewWhen people think of 'talking therapies' they usually mean either counselling or psychotherapy. Counselling and psychotherapy aim to help people change thoughts, feelings and attitudes. Counsellors help you talk about difficult feelings and understand conflict. It can be helpful just to have time alone with a counsellor to talk in confidence about how you feel. Spending time reflecting on problems often brings insight and puts things into perspective. Psychotherapy helps people learn better ways of thinking or behaving that can reduce their symptoms, disability and distress. Some psychotherapists are trained to help you explore possible causes of distress or symptoms in your past. Cognitive behavioural therapy (CBT) is the type of psychotherapy that is currently most widely available in the NHS.

Instead of exploring causes of distress or symptoms in the past (like many other types of therapy), CBT looks for ways to improve your state of mind right now. The therapist does this by helping you spot unhelpful thought processes and change them. The Royal College of Psychiatrists says "CBT can help you to change how you think ('cognitive') and what you do ('behavioural')". For instance, CBT can help you make sense of what seem like overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you.

During CBT sessions to address sleep problems, people learn how to improve sleep problems by using sleep hygiene and relaxation methods, and by changing unhelpful beliefs about sleep. If sleeplessness has been a long-term problem you might have started to feel that it will ever get better. CBT might help you overcome thoughts like these.
EvidenceA number of good studies have shown that CBT can improve sleep problems.
SafetyThese techniques are generally safe if carried out by or under the guidance of a qualified counsellor or psychologist.
CostIn most areas your GP can refer you for CBT or a psychological therapist in the NHS. There are often long waiting lists. A session of CBT or psychological therapy may cost between £20-£50. Frequency will depend on you and your therapist. A typical course of CBT lasts between 6-12 weekly sessions.
Find out moreIt is important to find a qualified counsellor or psychologist. Contact The British Psychological Society
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attendvisit Tai Chi

OverviewTai Chi is also known as 'moving meditation' It is a series of slow, graceful, controlled movements, which develop strength, balance, posture and inner peace. It is a discipline that has to be learned in a class from a teacher and can then be practised at home.
EvidenceSeveral studies suggest that Tai Chi may improve sleep quality, particularly in elderly people.
SafetySupervised exercise programmes are safe for most people although at first you might feel more tired. Anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should avoid strenuous exercise.
CostOnce you have learned the movements, you can do this at home, at no cost.
Find out moreClasses are run in most areas by both private tutors and by adult education services or you can contact the The Tai Chi Union.
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attendvisit Yoga

OverviewYoga, as taught in the UK, generally includes physical postures or stretches, breathing techniques, meditation and relaxation. There are several different types of yoga. Some of them are mainly based on the physical exercises (some types are much more strenuous than others). Others focus more on meditation.


EvidenceSeveral small studies have found that practising yoga can help with sleep problems although one trial found it did not help.
SafetyYoga is generally safe when practiced appropriately and at the right level. Classes are run for different ability levels so look for one that is right for you. Yoga stretches should be increased slowly. If in doubt, check with your doctor, osteopath or physiotherapist. Avoid with severe osteoporosis or acute joint or back pain, or recent injuries.
CostOnce you have learned the techniques you can do this at home, at no cost.
Find out moreClasses are run in most areas by both private tutors and by adult education services. To find a qualified teacher near you see also the The Yoga Alliance
and the The British Wheel of Yoga
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