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Good sleep is possible, with the right approach
Sleep difficulties can affect mental health, physical health, and daily functioning. There are different possible causes, so persistent sleep problems are worth discussing with a GP or qualified professional. NICE guidance includes cognitive behavioural approaches among the options that may be considered.
General information, not medical advice
This page is for general information and does not diagnose, treat, or replace advice from a GP or other qualified health professional. If symptoms are new, severe, worsening, or you are worried about your safety, seek appropriate medical or urgent support.
Signs and symptoms
You might be experiencing sleep problems if you recognise any of the following:
- Difficulty falling asleep despite being tired
- Waking frequently during the night
- Waking too early and being unable to return to sleep
- Unrefreshing sleep, waking still tired
- Daytime fatigue, irritability, and difficulty concentrating
- Anxiety about sleep and bedtime
- Reliance on alcohol or sleep aids to fall asleep
- Impact on mood, relationships, and work
What causes sleep problems?
Sleep Problems is rarely caused by a single factor. Common contributing factors include:
- Anxiety and worry activating the mind at bedtime
- Poor sleep hygiene and habits
- Irregular sleep schedules
- Depression, which disrupts sleep architecture
- Chronic pain or physical health conditions
- Excessive caffeine, alcohol, or screen use
- Life stress, grief, or major change
How therapy can help
CBT-I is a structured approach that considers sleep-related behaviours, routines, and thoughts. When anxiety, grief, or stress is affecting sleep, talking therapy may also offer a place to explore those concerns. A GP or suitably trained professional can assess possible medical causes and discuss suitable support.
Therapeutic approaches we use
CBT for Insomnia (CBT-I)
A structured approach that may combine sleep scheduling, stimulus control, sleep education, and work on unhelpful sleep-related thoughts.
Sleep Restriction Therapy
Temporarily restricts time in bed to consolidate sleep, improving sleep efficiency and reducing the time lying awake.
Stimulus Control
Rebuilds the association between your bed and sleep (rather than wakefulness and anxiety).
Talking Therapy for Underlying Stress
Where anxiety, grief, or life stress is keeping your mind active at night, addressing it directly in conversation can reduce how much it disrupts sleep.
Frequently asked questions
Is CBT-I really better than sleeping tablets?
Yes. Research consistently shows CBT-I produces better long-term outcomes than medication, with no side effects or dependency risk. It addresses the cause, not just the symptom.
What if my sleep problems are caused by something physical?
If you suspect a physical cause (e.g., sleep apnoea), see your GP for investigation. CBT-I can still be helpful alongside medical treatment.
Will I have to give up lying in or napping?
CBT-I may include structured changes to time spent in bed and daily sleep routines. These should be explained and adapted by a suitably trained professional; seek medical advice where another health condition may affect sleep.
How long does CBT-I take?
CBT-I is usually delivered as a structured course, but length and response vary. A qualified professional can explain what a proposed programme involves and whether it fits your needs.
Content information and sources
Editorial status: Content checked against UK clinical guidance and NHS information. Reviewed . This is an editorial check; no named clinician is represented as having reviewed this page.
Authoritative UK sources relevant to this topic:
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