If you have severe persistent poor sleep, your doctor may refer you to a psychologist or other health professional. The main treatment used to help people with poor sleep is called cognitive behaviour therapy (CBT). Briefly, CBT is based on the idea that certain ways of thinking can trigger or 'fuel' certain health problems such as poor sleep. The therapist helps you to understand your thought patterns. In particular, to identify any harmful or unhelpful ideas or thoughts which you have that can contribute to you not sleeping well. The aim is then to change your ways of thinking and/or behaviour to avoid these ideas. Also, to help your thoughts to be more realistic and helpful.

CBT for insomnia is almost always used in combination with the techniques described above. That is, 'sleep hygiene', as well as other techniques such as relaxation techniques, exercise, and sleep restriction.

What about sleeping tablets?

Sleeping tablets are not usually advised

In the past, sleeping tablets were commonly prescribed. However, they have been shown to have problems, and are now not commonly prescribed. Possible problems with sleeping tablets include:

• Drowsiness the next day. You may not be safe to drive or to operate machinery.
• Clumsiness and confusion in the night if you have to get up. For example, if you have had a sleeping tablet, you may fall over if you get up in the night to go to the toilet. (Older people who take sleeping tablets have an increased risk of falling and breaking their hip.)
• Tolerance to sleeping tablets may develop if you take them regularly. This means that, in time, the usual dose has no effect. You then need a higher dose to help with sleep. In time, the higher dose then has no effect, and so on.
• Some people become dependant (addicted) on sleeping tablets, and have withdrawal symptoms if the tablets are stopped suddenly.

Sometimes a sleeping tablet is advised

If a sleeping tablet is prescribed, it is usually just a short course (a week or so) to get over a particularly bad patch. Sometimes a doctor will advise sleeping tablets to be taken on only 2 or 3 nights per week, rather than on every night. This prevents tolerance or dependence to the tablet from developing. There are various types of sleeping tablets. Your doctor will advise.

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