Types of mental health problems

Sleep problems

How to cope with sleep problems

Explains sleep and mental health, gives practical suggestions and information about where to get support.

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.

“Poor sleep leads to worrying. Worrying leads to poor sleep. Worrying about sleep is like your mind trying to fight itself. That’s a horrible place to be.”

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.

“When I get depressed, I sleep so much – at its worst it was 18 hours a day, because it was the only way that I could stop thinking and stop my mind from saying awful things to me.”

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.

“During the day, my brain is fuzzy, my memory is noticeably affected. I barely have energy to function.”

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.

“It’s not possible to relax if you don’t have anywhere comfortable and safe at night. This leads to not sleeping and worrying most of the night.”

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.

“My sleep problems are […] more a case of bedtime procrastination than insomnia as such and, as a consequence, being too tired the next morning. I still haven’t found out what works for me as I can get to sleep once I do get to bed.”

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.

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.

“I was told to go to bed and wake up at the same time every day, but lying in bed, in the dark, for hours and hours … left me far too distressed to be able to fall asleep. So now I only go to bed when I feel like I will fall asleep within about 15 minutes or so, no matter what time of night that is, and then I try to get up at the same time every day.”

Relax before 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.

“A nicely made bed helps. If I’m having an awful day, and the only thing I’ve managed to find the energy to do is make my bed, then that’s OK.”

Breathing exercises

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

“Another thing that has worked for me is to lay down on my back and rest both my hands on my stomach/chest. Concentrating on my breathing and feeling my natural up and down movement makes me stop overthinking.”

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 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.

You can find a sleep diary template on the NHS Live Well website.

“[I] write what’s happened, what did or didn’t help, anything I need to or scribble to let out anger when the words and the tears are stuck.”

Try to make your sleep 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.

“Sometimes when I’m trying to fall asleep I don’t like being alone with my thoughts. I have found [podcasts] an amazing comfort because it’s a friendly voice just speaking so soothingly and telling a winding bedtime story – it just keeps my mind occupied enough not to start spiralling, and to fall asleep.”

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.

“Reminding myself that a bad night of sleep won’t make or break me (because I can make it through, even if it sucks) has helped a lot to allay stress/anxiety about sleep.”

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. Our 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. Our 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. Our pages on nature and mental health have more information.

“Music and brisk walking helps me settle down at night because the pace of my thoughts I can match to the pace of my walking – thus it helps settle my mind a little and tires me out before bed.”

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.

Our 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.
  • If you live in Wales, you can call the Community Advice and Listening Line (C.A.L.L.) on 0800 132 737 (open 24/7) or you can text ‘help’ followed by a question to 81066.

Our page on helplines and listening services lists more options for getting support, including opening hours.

Tips for when you can’t sleep

Watch Jonny Benjamin talk about how his mental health affects his sleep, and how he has learned to manage it.

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 our 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. See our pages on medication for more information.

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

Mind’s services

  • 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 our supportive online community for anyone experiencing a mental health problem.

Other organisations

British Snoring & Sleep Apnoea Association

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

Community Advice and Listening Line (C.A.L.L.)

0800 132 737 (helpline)
81066 (text HELP plus your message)
callhelpline.org.uk
Provides information and support for people experiencing a mental health problem in Wales.

Mental Health Foundation

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

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. Samaritans also have a Welsh Language Line on 0808 164 0123 (7pm–11pm every day).

The Sleep Apnoea Trust Association

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