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| Insomnia Information | Q. I have insomnia, but I don’t want to take (any more) sleeping tablets. What can I do?
A. Most types of insomnia benefit from cognitive behavioral therapy (or 'CBT'). However, there is a shortage of trained CBT 'insomnia therapists' in the UK, though CBT (as a generic therapeutic skill) is widely available in the NHS.
Our recommendation is that you consult your GP again, explain your reluctance to consume sleeping tablets, and ask for a referral to a clinical psychologist.
Most of NHS clinical psychologists will be able to use CBT strategies for sleep and insomnia management (though they don't always know that CBT can be used in this way). We advise you to ring the psychologist first and satisfy yourself that they can offer/have experience with cognitive behavior therapy for insomnia.
Q. I have been taking sleeping tablets for years, but I still sleep poorly. What can I do?
A. Sleeping tablets prescribed by your doctor are intended only for short-term use (say 3-4 weeks). They are not aimed for the long-term treatment of chronic insomnia. And after several weeks of continuous use many patients develop some degree of ‘tolerance’ to their sleep medication, which means that the drugs become progressively less effective.
Unfortunately, if we suddenly discontinue drugs to which we have developed a tolerance, we may experience ‘withdrawal effects’ – unpleasant symptoms while the body adjusts. Paradoxically, the abrupt discontinuation of sleeping tablets can result in a special type of insomnia called ‘rebound insomnia’, typically one or more nights of very disturbed sleep.
So, if you have been taking sleeping tablets for months or years, consult your doctor before attempting to discontinue use.
And if you have been taking sleeping tablets for more than 4 weeks and your sleep is still unsatisfactory, cognitive behavioural therapy (CBT – see question above) can help you to both sleep better and discontinue your tablets.
Q. Do I need 8 hours of sleep a night?
A. Almost certainly not. The quantity of sleep a person needs is influenced by several factors, including age. Because adults get older, their sleep tends to become shorter, lighter and more fragmented. As with most features of adult ageing, these changes are slow, but universal.
Consequently the amount of sleep we get will depend, among other things, on how old we are.
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