Sleep problems

How does sleep relate to mental health?

There’s a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health.

What problems might I have with sleep?

Everyone needs sleep, but many of us have problems with it. You might recognise some of the experiences listed below, or have other difficulties with sleep that aren’t mentioned here.

You might:

find it hard to fall asleep, stay asleep or wake up earlier than you’d like to (also known as insomnia – find out more on the NHS website)
have problems that disturb your sleep, such as panic attacks, flashbacks, nightmares or psychosis
find it hard to wake up or get out of bed
often feel tired or sleepy – this could be because you’re not sleeping enough, not getting good quality sleep or because of health problems
sleep a lot – which could include sleeping at times when you want, or need, to be awake

If you’re having problems sleeping, you might:

be more likely to feel anxious, depressed or suicidal
be more likely to have psychotic episodes – poor sleep can trigger mania, psychosis or paranoia, or make existing symptoms worse
feel lonely or isolated – for example, if you don’t have the energy to see people or they don’t seem to understand
struggle to concentrate, or make plans and decisions
feel irritable or not have energy to do things
have problems with day to day life – for example, at work or with family and friends
be more affected by other health problems, including mental health problems

What causes problems with sleep?

The things that affect our sleep differ for everyone. They can include:

stresses or worries – for example, issues with money, housing or work
problems with where you sleep – for example, if you sleep somewhere uncomfortable or you’re easily disturbed
health conditions relating to sleep, also known as sleep disorders
being a parent or carer
taking medication, including starting or coming off medication
recreational drugs and alcohol
working at night or being a shift worker
current or past trauma
mental and physical health problems, many of which can affect your sleep

For more information about sleep disorders, see the Mental Health Foundation and Royal College of Psychiatrists websites, and our list of useful contacts.

If problems with sleep are worrying you or affecting your day to day life, it’s a good idea to see a doctor who can give you a health check and help you access treatment and support. If you fill in a sleep diary, you could take this to your appointment to show your doctor.

How could mental health problems affect my sleep?

If you live with a mental health problem, this could affect your sleep in lots of ways. For example:

Anxiety can cause racing or repetitive thoughts, and worries that keep you awake. You may also have panic attacks while you’re trying to sleep
Depression and seasonal affective disorder (SAD) can make you sleep more, including staying in bed for longer or sleeping more often. Depression can also cause insomnia
If you’ve gone through trauma, this can cause flashbacks, nightmares or night terrors that disturb your sleep. You might feel unsafe or uncomfortable in bed or in the dark
Paranoia and psychosis may make it difficult to sleep. You may hear voices, or see things you find frightening or disturbing
Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts can also keep you awake and cause insomnia
Psychiatric medication can cause side effects including insomnia, disturbed sleep, nightmares and oversleeping. Stopping psychiatric drugs can also cause sleep problems

More information about sleep problems

Tips to improve your sleep

How can I improve my sleep?

This page has some tips and suggestions for improving your sleep. Some people find these ideas useful, but remember that different things work for different people at different times.

Only try what you feel comfortable with, and try not to put too much pressure on yourself. If something isn’t working for you (or doesn’t feel possible just now), you can try something else, or come back to it another time.

Try to establish a routine

It could help to establish a regular sleeping routine or habits. You might need to try different things before you find what works for you.

You could try going to bed and waking up at around the same time every day. Or it might help to go to bed only once you feel ready to sleep, but still get up around the same time.

Relax before you try to sleep

You may find a relaxation routine can help you prepare for sleep. These are some ideas you could try.

Do something calming

For example, this could be listening to relaxing music or having a bath.

Breathing exercises

See the NHS UK and Mental Health Foundation websites for ones you can try.

Muscle relaxation

Consciously tense and relax your muscles, one after the other, starting with your toes and working up your body until you reach the top of your head.

Visualisation

Picture a scene or landscape that has pleasant memories for you, or that you imagine would be a calming or peaceful place to be.

Meditation

Some people find it helps to try meditation techniques, like mindfulness. You could learn these at a class or from self-help guides.

Fill in a sleep diary

You may find it difficult to work out what’s affecting your sleep. A sleep diary involves recording information about your sleep habits to help you understand your sleep problem and what’s affecting it.

If you want to, you can show your sleep diary to healthcare professionals to help explain what problems you’re having. For example, you could take it with you to a doctor’s appointment.

A sleep diary could include information about:

what time you go to bed and what time you get up
total number of hours of sleep, or a rough idea if you’re not sure
overall quality of sleep, ranked 1–5
how many times you wake up in the night, how long you’re awake and what you do while you’re awake
whether you have nightmares, night terrors or sleep paralysis, or have sleepwalked during the night
whether you sleep during the day and for how long
any medication you’re taking, including the dose and what time you take it
the amount of caffeine, alcohol or nicotine you have
the amount of physical activity you do
what you eat and drink
your general feelings and moods, including any anxious or repetitive thoughts

You should keep your sleep diary for at least two weeks.

The Sleep Charity has a sleep diary template on its website that you could try.

Try to make your sleeping area more comfortable

You might not have much control over where you sleep – for example, if you’re staying in hospital or temporary accommodation. But there might still be small changes you can make, or ask someone to help you with. For example:

Try different temperature, light and noise levels to see what works for you
Lots of people find dark, quiet and cool environments best, but everyone is different
If you can’t sleep in darkness, try keeping a light or bedside lamp switched on
If silence makes it harder to sleep, listen to music, nature sounds, a podcast or the radio
You might find it helpful to try different bedding – for example, a warmer or cooler duvet, or a different pillow
If you’re affected by issues with a partner – for example, snoring or problems sharing a bed – the British Snoring & Sleep Apnoea Association has information on its website and a helpline

Think about screens and device settings

Using screens in the evening, including on tablets and mobile phones, can negatively affect your sleep.

It can help to think about when and how you use screens. For example, you could try:

avoiding screens an hour or two before bed
cutting down on screen time before you try to sleep
avoiding stimulating activities, such as playing games
using a blue light filter, night mode or dark mode – you might be able to find these options in your device settings and in individual app settings
adjusting other settings – for example, changing the brightness, or using silent, flight or airplane, or do not disturb mode

Look after yourself

Looking after yourself physically can help improve your sleep. Try these to see if they help.

Think about your diet

Some types of foods can affect your sleep, including caffeine and sugar. It can also help to avoid eating large meals right before going to bed. Mind’s pages on food and mood have more information.

Try to do some physical activity

Physical activity can help you sleep, including gentle physical activity. It can be particularly helpful to be active outdoors. Some people find they need to stop any physical activity a few hours before going to sleep. Mind’s pages on physical activity and mental health have more information.

Spend time outside

Being outside in green space can help you relax and improve your wellbeing. Spending time in natural light can also be helpful for your sleep. Mind’s pages on nature and mental health have more information.

Find support for connected issues

If you’re experiencing other issues alongside sleep problems, such as money worries or addiction to recreational drugs or alcohol, getting support for these things can help with your sleep problems too.

Mind’s pages on money and mental health, addiction and dependency, and mental health effects of drugs and alcohol have information about organisations that can help.

Some medication, including psychiatric medication, can affect your sleep. If you’re taking any type of medication and having problems with your sleep, talk to your doctor or a pharmacist.

Support during the night

If you’re awake and you need support with difficult feelings or worries, here are some options that are available 24/7.

To talk about anything that is upsetting you, you can contact Samaritans – call 116 123 (free from any phone) or email jo@samaritans.org

Treatments to help with sleep problems

Any treatments you’re offered for sleep problems will depend on what type of problems you’re having and any particular causes.

Talking therapies

Cognitive behavioural therapy for insomnia (CBT-I) is a type of CBT designed to help with insomnia. You may also be offered talking therapy to help with mental health problems that are affecting your sleep. See these pages on talking therapy and counselling for more information.

Medication

You might be offered sleeping pills to help with short periods of severe insomnia, or you might be prescribed medication for other types of sleep problems.

Referral to a sleep clinic

Sleep clinics are used to assess sleep problems, which can include using equipment at home or staying overnight for an assessment. To access a sleep clinic, you’ll usually need a referral from your GP.

Useful contacts

British Snoring & Sleep Apnoea Association

britishsnoring.co.uk
Information and support for people affected by snoring and sleep apnoea.

Mental Health Foundation

mentalhealth.org.uk
Provides information about mental health problems, including personal stories, podcasts and videos.

Mind

Mind’s helplines provide information and support by phone and email.

Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.

Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.

Narcolepsy UK

0345 450 0394
narcolepsy.org.uk
Supports people with narcolepsy, their families, carers and others interested in improving their quality of life.

NHS Live Well

nhs.uk/livewell
Advice, tips and tools to help with health and wellbeing.

NHS UK

nhs.uk
Information about health problems and treatments, including details of local NHS services in England.

Royal College of Psychiatrists

rcpsych.ac.uk
Professional body for psychiatrists. Includes information about mental health problems and treatments.

Samaritans

116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person.

The Sleep Apnoea Trust Association

sleep-apnoea-trust.org
Information and support for people who experience sleep apnoea, and their partners and families.