Insomnia: What To Do
Persistent difficulty falling asleep, staying asleep or waking too early, with daytime consequences.
Last revised
The recommended first-line treatment is a talking therapy rather than medication, and most people have never been offered it.
Key takeaways
- Definition of chronic insomnia: 3 or more nights a week for 3 months or more
- First-line treatment: CBT for insomnia (CBT-I)
- Most useful single change: Keep the same wake time every day, including weekends.
- Commonest mistake: Going to bed earlier to make up for a bad night.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Keep the same wake time every day, including weekends
- Get up and leave the bedroom if you have been awake around twenty minutes
- Get daylight soon after waking
- Ask a GP about CBT-I, available on the NHS and digitally
Do not
- Going to bed earlier to make up for a bad night
- Alcohol as a sleep aid, which fragments the second half of the night
- Sleep restriction unsupervised if you have epilepsy, bipolar disorder or severe daytime sleepiness
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Definition of chronic insomnia | 3 or more nights a week for 3 months or more |
| First-line treatment | CBT for insomnia (CBT-I) |
| Get out of bed after | about 20 minutes awake |
| Most important timing anchor | a fixed wake time, 7 days a week |
| Adult sleep recommendation | 7-9 hours |
Where to go next
- Insomnia: The Quick Reference
- What the Guidance Really Says About Insomnia
- Insomnia — the reference entry
- Sleep Apnoea: Sorting the Evidence From the Noise
- Caffeine and Sleep: Sorting the Evidence From the Noise
When to get help
See a GP if insomnia has lasted three months or more, if you snore loudly and wake unrefreshed, or if you fall asleep involuntarily during the day — the last two suggest obstructive sleep apnoea, which needs diagnosis rather than sleep hygiene. Do not drive when sleepy.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.