Does any of this sound like you?
- You're exhausted all day, then wide awake the moment your head hits the pillow.
- You check the clock and do the maths on how many hours are left.
- You wake at 3am and your thoughts are already running.
- You've started dreading bedtime.
What's actually going on
Sleep can't be forced. It arrives when your body feels safe enough to let go, which is why effort makes it worse: trying to sleep is a form of alertness.
After a few bad nights the bed itself can become a cue for being awake. Your brain learns 'bed = lying here worrying', and the pattern starts to run on its own even after the original stress has passed.
Anxiety and sleep problems often travel together. Each makes the other worse, so working on one usually helps both.
The 20-minute rule
This is one of the core ideas behind CBT for insomnia, the approach most sleep guidelines recommend first.
- If you've been lying awake for what feels like 20 minutes, don't watch the clock. Just guess.
- Get up and go somewhere dim. Do something calm and a bit dull: fold laundry, read something printed.
- Go back to bed only when you feel sleepy, not just tired.
- Keep the same wake-up time every day, however the night went. That's what resets your body clock.
Small things that help
- An hour before bed with screens dimmed and work closed.
- Writing tomorrow's to-do list before bed, so your brain doesn't have to hold it.
- Keeping naps short and before 3pm.
- Having no caffeine after lunch, and not relying on alcohol to fall asleep, since it breaks up sleep later in the night.
- Turning the clock away from you.
When it's time to talk to someone
Any one of these is reason enough. You don't need to wait until things are bad.
- Poor sleep three or more nights a week for a month or longer.
- Daytime tiredness is affecting your safety, for example when driving.
- Sleep trouble came with a low mood, anxiety or a difficult event.
- Someone has noticed you snore heavily or stop breathing at night. Speak to a doctor about that.
The GAD-7 is a short questionnaire clinicians use worldwide. Answer 7 questions privately and get a plain-words read-out.
How therapy helps
When sleep trouble comes from a busy, anxious or grieving mind, therapy works on what's keeping you awake as well as on sleep habits. Our practitioners who use CBT can include sleep-focused techniques in your sessions.
If a medical cause is possible, we'll suggest checking in with your doctor alongside.
New to the terms? Read the plain-words glossary, or see what happens in a first session.
What people ask
Should I try sleeping pills?
That's a conversation for your doctor. Guidelines generally recommend psychological approaches first for long-term sleep problems, because the benefits tend to last after treatment ends.
How much sleep do I actually need?
Most adults do well on seven to nine hours, but it varies. How you feel during the day matters more than hitting an exact number.
