When to get help

If you are having thoughts of harming yourself, please contact emergency services or a crisis line now. In the UK and Ireland you can call Samaritans on 116 123; in the US, call or text 988.

When to see a doctor

Talk to a doctor or another health professional if any of these sound familiar:

You have slept badly on at least three nights a week for more than three weeks.
Poor sleep comes with low mood, anxiety, or losing interest in things you usually enjoy.
You wake up tired even after a full night, most days.
Someone has noticed you snore loudly, gasp, or stop breathing for a moment in your sleep.
You fall asleep during the day without meaning to, or have nearly done so while driving.
You have an uncomfortable urge to move your legs in the evening or at night.
You work shifts and your sleep has stopped recovering on days off.
You are relying on alcohol or sleeping tablets most nights to get to sleep.

None of these mean something serious is wrong. They mean it is worth a proper conversation.

What CBT-I is

CBT-I, cognitive behavioural therapy for insomnia, is the treatment most sleep guidelines recommend first for long-term insomnia in adults, ahead of sleeping tablets. It is a structured programme, usually over six to eight weeks, delivered by a trained clinician, in a group, or through an approved digital programme.

It usually combines a few parts:

Stimulus control: keeping bed for sleep, and getting up when you cannot sleep.
Sleep restriction: temporarily limiting time in bed to match the sleep you are actually getting, then widening it.
Cognitive work: loosening unhelpful beliefs and worries about sleep.
Relaxation and sleep habits: practical changes to evenings, light, caffeine and routine.

Parts of it can feel hard at first, especially sleep restriction, which is why it is best done with support. Ask your doctor whether it is available where you live.

What to ask a doctor

It helps to keep a simple sleep diary for a week or two before the appointment: when you went to bed, roughly when you fell asleep, when you woke, and how you felt the next day. Then you might ask:

Could anything physical be affecting my sleep, such as my breathing, iron levels or thyroid?
Could any medicine I take be keeping me awake or making me tired?
Is CBT-I available to me, in person or as a digital programme?
Should I be referred to a sleep clinic?
If you suggest a medicine, how long should I take it, and what are the alternatives?

In the meantime

Keep a regular wake-up time, get some daylight in the morning, and get up if you have been lying awake for a while and it is turning into a struggle. The tools here can help on the nights in between. They are wellness tools, not medical treatment, and they do not replace care.