Help for Insomnia and Sleep Problems in the UK: Where to Start

The NHS says you have insomnia if you regularly find it hard to go to sleep, wake several times in the night, lie awake, wake early and cannot get back to sleep, still feel tired after waking, or feel tired, irritable or unable to concentrate during the day. Less than 3 months is short-term insomnia; 3 months or longer is long-term insomnia. On average, adults need 7 to 9 hours of sleep.

The NHS lists the most common causes as stress, anxiety or depression; noise; a room that's too hot or cold; an uncomfortable bed; alcohol, caffeine or nicotine; drugs; jet lag; and shift work. Some health conditions and many medicines can also cause it. Source: NHS: insomnia.

The NHS suggests you:

• only go to bed when you're sleepy, and get up at the same time every day
• relax for at least 1 hour before bed, for example with a bath or a book
• keep your bedroom dark and quiet, and your bed comfortable
• exercise regularly during the day, but not in the 4 hours before bed
• avoid alcohol, tea, coffee and smoking for at least 6 hours before bed, and big meals late at night
• avoid screens right before bed, daytime naps, and sleeping in after a bad night

The NHS says pharmacy sleep aids cannot cure insomnia, may help for 1 to 2 weeks only, and can have side effects such as drowsiness, so check with a doctor first.

The NHS says to see a GP if changing your sleeping habits has not helped, you've had trouble sleeping for months, or it is affecting your daily life in a way that makes it hard to cope. A GP will try to find the cause. Sometimes you'll be offered CBT, face to face with a therapist or through an online self-help programme, to change the thoughts and behaviours that keep you from sleeping. You may be referred to a sleep clinic if you might have another sleep disorder, such as sleep apnoea. GPs now rarely prescribe sleeping pills, and only for a few days or weeks.

If worry or low mood is keeping you awake, help for that may help your sleep too. In England, if you're registered with a GP and aged 18 or over (16 or over in some areas), you can refer yourself to NHS Talking Therapies without seeing a GP. In Scotland, Wales and Northern Ireland, a GP is usually the first step. For under-18s, see NHS: mental health support for children and young people.

Some private practitioners have specific training in CBT for insomnia (often called CBT-I); others help with the stress, anxiety, trauma or low mood behind poor sleep. Ask about their experience with sleep. Professions that may help include:

• Counsellors and psychotherapists, on accredited registers such as BACP, UKCP and NCPS.
• Practitioner psychologists, such as clinical and counselling psychologists, on the HCPC register.
• CBT therapists, often accredited by BABCP.
• Arts therapists (art, music and drama) and dance movement psychotherapists, if putting feelings into words is hard.
• Occupational therapists, who can help with daily routines, pacing and sleep habits, especially alongside pain, illness or shift work.
• Psychiatrists, medical doctors who can assess, diagnose and prescribe.

Whoever you choose, check their register and ask about fees, session length and how you will review progress together. See questions to ask before you book and how much therapy costs. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.