Sleep problems are common but can be quite distressing. This page contains information on support and treatments that are available.
Non-medication treatments
The most effective treatment for insomnia is called CBT-I (cognitive behavioural therapy for insomnia). This can be accessed via NHS Talking Therapies self-referral form (orange button). You can then choose a date & time for an initial assessment.
Sleepio is a well-recognised, effective app for insomnia. Unfortunately it is not funded on the NHS in our area, so you do have to pay for it. There is an alternative site called Sleepful, which is also very good, and is free. You can access the app via the App Store or Google Play.
There are many things that you can do to learn all about sleep and try to help yourself. This website is really comprehensive. It’s important to note that the ability to sleep is affected by so many things. The more that you can identify and address, the more likely it is that your sleep will improve. It can often take several weeks though, so patience is needed.
Medication
There are medications available to help with sleep, but they don’t come without risk. None of these are recommended for long-term use, and most should not be used for more than a week or two. Some can cause addiction and the effects wear off. This is particularly true of drugs like zopiclone and zolpidem. This is why we do not put these on repeat, along with the fact that they increase the risk of problems with thinking and memory, dementia and falls. You should not drive for around 12 hours after taking zopiclone or zolpidem, even if you feel OK, as there is evidence that they make you reaction times slower. Never drive if you feel sleepy, regardless of how long ago you took the medicine.
Not all medications are suitable for all people, and your doctor will have to decide which, if any, is appropriate for you.
Antihistamines
Antihistamines are used for allergies. Some can make you drowsy as a side effect and so are sometimes used to help you sleep. Promethazine (Phenergan) is one example. They can cause headaches, dry mouth and constipation. You can buy them over the counter.
Antidepressants
Some antidepressants can be helpful for sleep, again because they have sedation as a side effect. Common examples include amitriptyline, mirtazapine and clomipramine. Mirtazapine and clomipramine are particularly useful if you suffer from anxiety or depression, and amitriptyline can be helpful if you have nerve pain or migraines.
Hypnotics (Z-drugs)
These drugs include zopiclone and zolpidem. They are addictive medications and the effects typically wear off after a couple of weeks of regular use. They are associated with negative effects on thinking and memory, and increase the risk of falls and dementia. They slow your reaction times and can have a hangover effect. We tend to use then for very short periods – less than two weeks – and ideally not every day. They can cause withdrawal symptoms if used for too long. They can be helpful in trying to ‘reset’ the body’s rhythm, or at times of extreme distress such as recent bereavement or trauma.
Melatonin
This is a medication which is licensed for the short-term treatment of insomnia in people over the age of 55, and for jet-lag (we cannot prescribe for jet-lag on the NHS). It is the body’s natural ‘sleep hormone’ and can be helpful in trying to ‘reset’ the body clock. We will also sometimes use it ‘off license’ for people who are not over the age of 55, in conjunction with specialist advice.
If you need to discuss your sleep in more detail, please contact us via our routine healthcare request form (see home page).