Sleep problems and insomnia self-help guide

Work through a self-help guide that uses cognitive behavioural therapy (CBT) and expert advice to manage sleep problems.

Section 1 of 14

1. Introduction

Urgent help

This self-help guide is intended for people with mild-to-moderate mental health issues.

If you're feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

For an emergency ambulance phone 999.

It’s common to have problems with sleep. This guide aims to help you:

  • recognise the symptoms of sleep problems
  • understand what sleep problems are, what causes them, and what keeps them going
  • find ways to manage sleep problems

There are a lot of names for sleep problems – you might have heard of conditions like insomnia (when you can’t sleep), or hypersomnia (when you sleep too much). You might also have heard of sleep apnoea, or narcolepsy, where your body can’t control sleeping or staying awake properly.

When people have problems falling or staying asleep, it’s often referred to as insomnia. However, it’s not until the difficulty sleeping starts to significantly affect you during the day that it would actually be considered a medical condition.

Sleep problems can be caused by a range of conditions or circumstances. This guide is for anyone who’s struggling with sleep, regardless of how severe those problems are. If you’re concerned you might have one of the conditions mentioned above, make an appointment with your GP. You can find contact information in Scotland’s Service Directory.

How to use the sleep problems self-help guide

Working through this guide can take around 30 to 40 minutes, but you should feel free to work at your own pace.

Work through the guide on your device, using the “Next” button to move forward and use the “Previous” button instead of the Back button in your browser. To type in a graphic or diary, click or tap the part you’d like to fill in and use your keyboard as usual.

If you’d like to save the guide and return to it later, you’ll need to save it as a PDF on your device before you leave the page. You can then continue filling it out on the PDF. We don’t use a login feature on our mental health self-help guides for privacy reasons.

If you’d like to print the guide at any time, you’ll find an option to save and print the whole guide, including the parts you have added, in each section.

Section 2 of 14

2. Symptoms of a sleep problem

There are some symptoms that are common to experience if you’re struggling with sleep.

Do you have a sleep problem?

Do you think you’re not getting enough sleep?

Do you have trouble getting to sleep or staying asleep?

Are you frequently tired during the day?

If you’re having sleep problems, you might recognise the symptoms and feelings described below.

How your body might feel

  • tired/exhausted
  • restless
  • lacking energy
  • weak/heavy – as if you can’t get out of bed

Thoughts you might have

  • “I’m never going to get enough sleep.”
  • “I’m going to have a terrible day tomorrow.”
  • “I’ll be awake all night.”
  • “I’ll fall asleep at work and get in trouble.”

Feelings you might have

  • so tired it makes you feel upset or depressed
  • tense or stressed
  • irritable or short-tempered
  • angry or impatient
  • worried

Things you might do

  • try to catch up on sleep during the day
  • watch TV or use your phone in bed to pass the time
  • lie awake in bed at night
  • check the time a lot during the night
  • smoke (cannabis or nicotine) hoping it will help you relax
  • drink alcohol hoping it will help you sleep

How your life might be affected

  • you might have an irregular sleep pattern, with no real routine
  • you might have difficulty concentrating
  • it might be hard to motivate yourself to start your day
  • you might not want to spend time with friends and family

If you recognise these symptoms it’s likely you’re having a problem with your sleep.

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3. Understanding sleep

Sleep is vital for our minds and bodies – while we sleep, our brains process memories and our bodies heal and grow.

There are different types and stages of sleep that we cycle through during the night, in what’s called the sleep cycle. These phases of sleep are all important in different ways.

  1. Non-Rapid Eye Movement (NREM) 1 – this is very light sleep. You might jerk or twitch during this stage.
  2. NREM 2 – this is when your body gets ready for deep sleep.
  3. NREM 3 and 4 – deeper sleep. This is the sleep stage that provides the most rest for your body and mind.
  4. REM (Rapid Eye Movement) – This is the stage where your eyelids flutter, which is where it gets its name. It’s during this stage that you dream, and it’s very important for mental and emotional health and development.

It takes around an hour and a half to go through 1 sleep cycle with all of the above stages. For a good night’s sleep, you should go through the cycle 4 or 5 times.

You’ll find more information on this on the Sleep Charity website.

It can be difficult to judge whether you’re getting enough sleep, because different people need different amounts. It depends on things like your age and how active you are.

If you aren’t feeling good during the day, and you’re experiencing symptoms like the ones in the previous section, you might not be getting enough sleep. This guide can help you learn about the problem and take steps to get more sleep.

Making sense of sleep problems

It’s very common to have problems with sleep, whether it goes on for a long time or only affects you briefly. As mentioned before, sleep problems can have a variety of causes.

There are 3 common types of sleep problem:

  • problems getting to sleep – lying awake and not being able to fall asleep
  • problems staying asleep – waking up earlier than you want to or waking up during the night
  • poor quality sleep – you sleep, but don’t wake up feeling refreshed or rested

Section 4 of 14

4. What causes sleep problems?

People can experience sleep problems for lots of different reasons. Here are a few examples:

Life changes

Big changes in your life, like moving house, getting a new job, or having a baby, can change your routine and sleep pattern. These changes can also lead you to spend more time thinking, and feeling positive or negative emotions (including excitement or worry). All of this can make it harder to fall asleep and stay asleep.

When these big changes are negative, like the end of a relationship or a bereavement, it can affect your mental health. This can then impact your sleep.

Mental health problems

A number of mental health conditions have an effect on sleep. These include:

  • depression, which can cause you to sleep too much, or not enough
  • anxiety, which can make it difficult to ‘switch off’ and relax, making it harder to fall asleep or stay asleep
  • conditions like post-traumatic stress disorder (PTSD), which can make it harder to feel safe and fall asleep
  • people dealing with difficulties after experiencing trauma can also have nightmares, leading to disturbed sleep

Sleep and mental health can be closely linked – any mental health condition can affect your sleep. Similarly, dealing with sleep problems can cause difficulties with your mental health. If you think you’re experiencing a mental health issue, look at the other mental health self-help guides on NHS inform, or contact your GP. You can find information on local services in Scotland’s Service Directory.

Physical health problems

Physical health issues that can cause problems with sleep include:

Medicines and other health concerns

Other things related to physical health issues can also affect your sleep.

For example, some medications can make it difficult to sleep, while others can cause you to sleep for longer or experience disturbed sleep (such as nightmares or vivid dreams). Some medications, like anti-depressants or painkillers, can make you feel ‘groggy’ or disoriented in the morning, and make it hard to feel awake.

If you’re having trouble with sleep as a result of a medication, talk to your pharmacist – they can offer advice on reducing its effect on your sleep.

It’s also possible that a combination of the issues above is affecting your sleep.

Section 5 of 14

5. What keeps sleep problems going?

Often sleep problems keep going due to thoughts, feelings and behaviours. This can mean that, through no fault of your own, you might create habits that end up affecting sleep. These can include:

Predicting that you won’t sleep well even before you go to bed – this can lead to a ‘self-fulfilling prophecy’ where you think you’ll be awake anyway, so you might do things like use your phone in bed. If you expect to sleep well, you’re more likely to go to bed and settle in, ready for sleep, so you fall asleep faster.

Going to bed when you don’t feel sleepy. It might seem like a good idea to do this if you’re trying to catch up on sleep, but your body might not be ready to sleep at that time.

If you go to bed and lie awake, or spend a lot of time in your bedroom doing things other than sleeping, your brain can start to associate being in bed with being awake. This makes it harder for your body and mind to relax and fall asleep when you get into bed.

When you wake up in the night and can’t get back to sleep, doing things that stimulate your mind or body (e.g.: working, watching TV, drinking tea or coffee). This will also cause your brain to associate being in bed with being awake.

Repeatedly checking the time to see how long you’ve been awake – this can make you feel more anxious, so it’s harder to relax and get to sleep.

Many people start worrying about being tired the next day, being late for work or school, or other possible effects of a bad night’s sleep. This worry can make it harder to sleep.

Thinking about current work projects or big events in your life – even if the topic is positive, thinking and making plans stimulates your mind and can keep you awake.

Taking naps or trying to catch up on sleep – this can confuse your mind and body, and make it harder to get into a good routine for sleep.

Section 6 of 14

6. Activity 1 - understanding your sleep problems

Based on the examples in the previous section, think about what you might be doing or thinking that could be affecting your sleep.

Fill in the boxes below and view the infographic to get an idea of how thoughts, feelings, and behaviours can keep sleep problems going.

On the infographic you can see how feelings, thoughts, and behaviours can affect your sleep.

Section 7 of 14

7. Improving your sleep

There are a lot of options for improving your sleep, and many of them are very easy to put in place.

Developing a sleep/wake routine

Creating a routine for your day that works for you is a big step in improving your sleep.

In the morning

Create a ‘start the day well’ routine that includes getting up at the same time every day. This tells your body that it’s time to wake up.

It could include:

  • a meditation or some gentle stretching
  • showering and brushing your teeth
  • getting dressed
  • eating breakfast
  • making a plan for the day

You could also include things like walking the dog, listening to music that makes you feel more awake, or daily tasks like taking medications. Going outside can be particularly helpful as exposure to light tells the brain that it’s time to wake up.

If you have trouble getting up in the morning, set your alarm. Decide how long you will lie in bed after your alarm goes off and stick to it. It can help to put your alarm on the other side of the room, so you have to get up to switch it off.

In the afternoon

A good afternoon routine will help set you up for a relaxing evening and a good night’s sleep.

Your routine could include:

  • eating lunch (follow your health professional’s advice if necessary for medications, weight management etc.)
  • some sort of exercise in the afternoon or early evening, like a walk, yoga session, or class at the gym

In the evening

Create an ‘end the day well’ routine that helps your body and mind relax and prepare for sleep.

Your routine could include:

  • eating dinner (follow your health professional’s advice if necessary)
  • taking a bath or shower and brushing your teeth
  • changing into your sleepwear
  • taking any medications you need to take at night
  • a regular bedtime – but remember, don’t go to bed if you don’t feel sleepy
  • noting down anything you have to remember for the next day
  • listening to the radio or a podcast
  • reading a book
  • meditation
  • doing a relaxation exercise
  • doing some gentle stretching

Things that can interfere with a good routine

There are a few habits that can get in the way of good sleep, so it’s important to keep them out of your routine.

Your routine shouldn’t include:

  • work or study in the evening – avoid doing anything like this for at least an hour and a half before you start your bedtime routine
  • thinking about work or tasks you have to finish for the next day – try to think of bedtime as a chance to clear your mind and put aside responsibilities until the morning
  • naps – avoid napping if you can, because it can make it harder for you to sleep at night
  • exercise too late in the day – try not to exercise too close to bedtime, as you might find it wakes up your body and mind too much for you to fall asleep easily
  • too much caffeine – avoid coffee, tea, and other caffeinated drinks within 6 hours of when you’re planning to go to bed
  • alcohol too close to bedtime – avoid alcohol in the 4 hours before your ‘end the day well’ routine begins
  • anything that will make you feel alert or upset in the evening, like watching a scary film or starting a stressful task
  • extra light right before you go to bed – in the hour before you try to go to sleep, stay away from bright lights in your home and especially avoid blue-tinted light from TVs, phones, computers, gaming consoles, or tablets
  • staying in bed if you can’t sleep – if you go to bed at your bedtime but can’t fall asleep after 15 minutes, get up and do something relaxing until you begin to feel sleepy

If you must nap, make sure your nap is finished by mid-afternoon (3pm at the latest) and try to only nap for 20 minutes at most. If you’re used to napping for a long time, or having lots of naps, cut down gradually. Start by reducing the length of your naps and cutting out naps later in the day.

For help developing a routine, you can visit The Sleep Charity’s website. There are resources, including planners and diaries, to help you develop sleep routines that fit in with your life.

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8. Making sure you get a good night’s sleep

There are a number of different things you can do to make sure your routine works. Try out the tips below to help you get to sleep, stay asleep, and wake up feeling rested.

Your environment

It helps to set up your sleeping space so it’s as comfortable and relaxing as possible.


You can try arranging your bedroom in a way that you find comforting and soothing. It’ll help if you can try to avoid having mess or clutter in the room.


It can help to make your bed as comfortable as possible – for example, making sure you have clean bedding that’s washed and changed regularly. You could also try using a lavender-scented pillow spray or diffuser.


Many people find it helpful to keep their bedroom as dark as possible, using curtains or blinds to block out any outside light. You might find blackout curtains or an eye mask useful.

Alternatively, you could use a nightlight to help you feel calm if sleeping in the dark is uncomfortable.

It’s best to avoid having a TV or computer in your bedroom. If you do have a TV in the room, you should turn it off while you’re trying to sleep.

If you think you’ll be tempted to lie awake in bed and use your phone, or keep checking the time on it if you’re struggling to sleep, it’s a good idea to keep the phone out of reach.


Try to keep your room as quiet as you can. If there’s noise coming into the bedroom, wearing earplugs might be helpful.

You could also put on some gentle background music or sounds to help you feel calm, but don’t use the TV for this.


Keeping your room at a comfortable temperature is very helpful when it comes to dropping off and staying asleep. It’s best to keep your bedroom quite cool and your bed quite warm – for example, you might like to sleep with the window open, but use a heavy duvet.

Changes to your routine or environment

While it’s important to maintain a good routine and environment, remember that you can still get a good night’s sleep if something changes. Travelling, changes to your work schedule, family responsibilities, and many other considerations can interrupt your routine or change your environment.

The important thing to remember is that this routine and these recommended changes to your sleep environment are there to teach your mind and body how to get a good night’s sleep. You aren’t dependent on them to sleep well. In time, you might find you don’t even need the routine, or to use tools like sleep masks and earplugs.

Do your best to stick with the routine and keep your environment restful, but remember that you can get a good night’s sleep even if everything isn’t perfect. Once your body and mind have adjusted to better sleeping habits, you’ll find it much easier to stay consistently well-rested.

Section 9 of 14

9. Waking up and nightmares

Sometimes the hard part isn’t getting to sleep, but staying asleep and waking up at the right time for your sleep cycle. These tips will help you fall asleep again after your sleep has been disrupted.

What to do if you wake up in the night

  1. Remember it’s normal to wake up during the night. Telling yourself that it’s normal and not something to worry about can help with feeling frustrated, upset, or stressed about waking up.
  2. Try using a relaxation exercise or meditation – you can find some here, and there’s more information on relaxation later in the guide.
  3. If you’re still awake after about 20 minutes, get up for a while. Try doing something peaceful, like making a cup of herbal tea, reading a calming book, or listening to soothing music.
  4. Don’t watch TV or do anything else that makes you feel awake. When you start to feel sleepy again, go back to bed.

Repeat these steps as many times as you need to during the night – this will teach your brain that bed is for sleeping, not lying awake.

It’s possible that waking up frequently in the night could be related to a health issue. If you’re experiencing other symptoms, or you feel concerned, visit your GP. You can find a local GP in Scotland’s Service Directory.

What to do if you have a nightmare

  1. Remind yourself you’re at home, and you’re safe. Name the objects in your room and in the area of your home (e.g. wardrobe, lamp, bus stop). Look out the window if that helps you feel connected to reality.
  2. Try thinking of a different ending for your dream – one where everything turns out okay. Make it funny or silly if you can – for example, you could decide the monster chasing you was trying to give back your wallet that you dropped, and you all end up back at your house having tea and biscuits.

You can also prepare yourself a back-to-reality kit:

  • put a fresh damp towel or a spray bottle of water beside your bed to gently refresh your face when you first wake up
  • keep a soothing object beside your bed, like a photo or a soft toy
  • if there’s a smell you particularly like, such as a perfume or essential oil, keep something with that scent by your bed that you can sniff after waking up from a nightmare

If you’re experiencing recurring nightmares due to something that has happened in your life, it could help to visit your GP and explore ways of coping. You can find a local GP in Scotland’s Service Directory.

Section 10 of 14

10. Calming a busy mind

If you tend to lie awake at night and worry, this can make it difficult for you to fall asleep and stay asleep. One way to relieve this is to set aside ‘worry time’ – a period during the day when you focus on your worries. This can help reduce the amount of time you spend thinking about them at night.

Worry time:

  1. Decide a time in the day that’s worry time – this should last about 10 to 15 minutes.
  2. Keep a notepad on your bedside table and write down any worries that you think of at night. Remind yourself that you have worry time put aside during the day.
  3. During the day, once your worry time arrives, let yourself worry about the things you’ve written in your notepad. You might find it helpful to note down possible solutions or plans while you’re focused on your worries.
  4. Stop as soon as your worry time is finished – or earlier, if you run out of worries before the 15 minutes is up. After the 15 minutes are up, go back to writing down any worries for your next worry time.

If you find that you’re worrying a lot, you might find this Anxiety guide helpful.


If you often have a busy mind, this calming breathing exercise can help when you’re trying to drop off to sleep, or get back to sleep if you’ve woken up in the night. It involves focusing on and slowing down your breathing.

  1. Get into a comfortable position in bed.
  2. Try to breathe in a steady rhythm. It can help to picture something steady and repetitive, like waves coming in and going out, or a balloon inflating and deflating.
  3. You could also count: for example, “in, 1,2,3… out, 1,2,3”.
  4. Repeat the steady breathing for a few minutes.

It’s normal for your busy mind to distract you when doing this exercise. Keep practicing and don’t feel discouraged. It takes time for your mind to get used to relaxing and focusing like this, and getting distracted doesn’t mean you’re doing anything incorrectly.

Problem solving

If you have a lot of problems, or one specific problem that’s keeping you awake at night, our problem solving guide can help you find a solution.

Section 11 of 14

11. Activity 2 - Challenging unhelpful thoughts

The aim of this activity is to use the challenging questions below to replace unhelpful thoughts about sleep with thoughts that are more calming. You can use the thoughts you wrote down in Activity 1 as a starting point.

You’ll also be able to record how much your worry reduces, so you can see the process working.

Complete the table below to challenge your unhelpful thoughts.

Section 12 of 14

12. Calming a restless body

If your body feels tense or restless, or you find yourself tossing and turning when you’re trying to sleep, progressive muscle relaxation can help calm your body and mind.

Progressive muscle relaxation

Lie on your back and get comfortable. If you have lower back issues, it can help to put a pillow under your knees.

This exercise uses your whole body, but if there’s a body part that is painful you can miss it out – this exercise isn’t about making you feel uncomfortable or increasing your pain.

Go through each part of your body – we recommend doing it in this order:

  1. Right hand and arm
  2. Left hand and arm
  3. Right leg and foot
  4. Left leg and foot
  5. Stomach
  6. Chest
  7. Back muscles
  8. Shoulders
  9. Neck and throat
  10. Face

Follow these steps:

  1. Tense up your right hand and arm and hold it for a few seconds as you breathe in.
  2. Release the tension as you breathe out.
  3. Do this for each body part.
  4. Next, lightly tense up your right hand and arm as you breathe in, with just enough tension to notice.
  5. Release the tension as you breathe out.
  6. Do this for each body part.
  7. Finally, focus on each body part in turn and concentrate on just releasing it while you breathe normally. This can help you release any final tension in your body.

Section 13 of 14

13. Looking after yourself

Often people don’t realise how much their lifestyle in general can affect sleep. Some habits can be unhealthy for the body and mind, and that has a negative impact on your sleep.

It can be difficult to overcome these habits, but making an effort to replace unhelpful parts of your lifestyle with positive habits can improve your sleep.

The tips below will help you to get started and find information, help and support in the long term.


People often drink alcohol to help them drop off. However, alcohol can actually interfere with the quality of sleep. Drinking alcohol makes it harder to settle into a good sleep cycle, as your body is working to process the alcohol and get it out of your body.

If you’re having a drink, try to keep your consumption within the recommended guidelines. Remember that on average, it takes an hour for your body to process 1 unit of alcohol – although that time can vary depending on a number of factors, such as your weight and age. This means it makes sense to leave some time between having your last drink of the evening and going to bed.

If you’re regularly drinking more than the recommended guidelines, or you’re concerned about your alcohol use, there is help available. Many people find themselves drinking alcohol to try to cope with low mood, anxiety, or other mental health issues. Our resources on alcohol offer more information and help.

Smoking and nicotine

Tobacco and nicotine replacement products contain ingredients that act as a stimulant. Even if smoking or using other nicotine products makes you feel calmer at first, it can keep you awake at night and make it harder to stay asleep.

If you’d like to stop smoking or cut down on your nicotine consumption, there’s a lot of help available. Read about stopping smoking and how to find support.

Substance use

Many people use substances to help them sleep, or to cope with difficult thoughts and feelings. Often these are illegal drugs, like cannabis or heroin. However, many people use prescription drugs like painkillers in a way that isn’t recommended by a doctor, whether they’ve been prescribed to them personally or bought elsewhere.

Some drugs have a stimulant effect, so they can make it harder to sleep. Others, even if they make you feel relaxed and sleepy, can get less effective over time so you need to use more.

Help is available if you’re struggling with either illegal drug use or prescription medicines. Visit the Scottish Drugs Services Directory for support in your local area, or talk to your GP.

Healthy eating

A healthy, balanced diet is very helpful when it comes to sleep. If you stay away from sugary or fatty foods – especially just before bed – you can avoid feeling too alert and awake when you’re trying to go to sleep.

Your body is active while it’s digesting, which can make it hard to sleep, so it’s best not to eat a large meal right before bed. If you’re hungry at bedtime try to eat something light so you don’t feel too full.

Regular mealtimes with plenty of water can also prevent you feeling hungry or thirsty when you’re trying to drop off.

Visit our pages on helthy eating and nutrition for more information and help with meal planning and weight management.


Keeping fit and active is good for both physical and mental health. Regular exercise can help you fall asleep faster, and wake up less during the night.

As mentioned earlier in the guide, exercising too close to bedtime sometimes makes it harder to fall asleep because it can make you feel energised. Try to leave yourself plenty of time to wind down after exercise and do your evening routine.

For more information on keeping active, and suggestions about ways to exercise, visit our Keeping active section.

Section 14 of 14

14. Next steps

Urgent help

This self-help guide is intended for people with mild-to-moderate mental health issues.

If you're feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

For an emergency ambulance phone 999.

Keep using the techniques you found helpful from this guide – they should continue to benefit you. If there are some things that you didn’t find helpful to begin with, stick with them for a few weeks – it can take time to improve your sleep routine and get used to the changes.

Further help

If you’re feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

If you feel you need more help with your mental health, try speaking to your GP, or search for mental health and wellbeing services in your area.

For information and advice when you’re feeling down, you can phone Breathing Space on 0800 83 85 87.

The Breathing Space phoneline is available:

  • 24 hours at weekends (6pm Friday to 6am Monday)
  • 6pm to 2am on weekdays (Monday to Thursday)

If you found this guide helpful and would like to do more work like this, Living Life offers a range of structured psychological interventions and therapies to improve mental health and wellbeing. This service is appointment-based and specifically for low mood, or mild/moderate depression or anxiety. Living Life are open Monday to Friday, from 1pm to 9pm, and you can phone them on 0800 328 9655 for an assessment appointment.

Learn more

For advice on things that can affect your sleep, visit some other parts of NHS inform:

Last updated:
27 May 2021