Feedback

We appreciate and encourage feedback. If you need advice or

are concerned about any aspect of care or treatment please
speak to a member of staff or contact the Patient Advice and
Liaison Service (PALS):
Freephone: 0800 183 0204
From a mobile or abroad: 0115 924 9924 ext 65412 or 62301
E-mail: [email protected]
Letter: NUH NHS Trust, c/o PALS,
How to sleep well
Freepost NEA 14614,
Nottingham, NG7 1BR Information for patients
www.nuh.nhs.uk
Epilepsy service

If you require a full list of references for this leaflet please email
This document can be provided in different languages and
[email protected] or phone 0115 924 9924
ext. 67184. formats. For more information please contact:

Epilepsy Service Nurse Advice Line

The Trust endeavours to ensure that the information given here QMC/City
is accurate and impartial.
Tel: 0115 970 9030

Sarah Pashley, Epilepsy Service © October 2018. All rights reserved. Nottingham
University Hospitals NHS Trust. Review October 2020. Ref: 1953/v2/1018/AH
This leaflet provides information to help reduce sleep problems Melatonin is sometimes given (usually as Circadin®) to treat
and ideas to deal effectively with sleep difficulties when they insomnia as part of a sleep hygiene plan when behavioural
occur. methods alone haven’t worked. It is not a sedative as such,
although it can make you feel a little drowsy. It is sometimes
Sleep used to help people with a learning disability and those with
challenging behaviour who have disturbed or disrupted sleep.
Sleep is essential for good health and wellbeing. The amount of Treatment response should be recorded in a sleep diary and
sleep people need varies widely and usually reduces with age. reviewed regularly.
Most people have difficulty sleeping at some point in their life. Further information
Poor quality sleep has a harmful effect on mood, memory and
performance. The following resources may be helpful. The web links and
some examples of sleep diaries can be accessed through the
This booklet contains information to help people who have sleep page on our epilepsy service website.
trouble sleeping. It will help you to think about your current sleep
habits and suggests ideas to help you sleep better. Epilepsy Service
www.nuh.nhs.uk/epilepsy
What causes poor sleep? The Sleep Council
Poor sleep can be caused by many things including, poor sleep www.sleepcouncil.org.uk
habits, stress, anxiety, depression, alcohol, substance misuse,
pain or certain medicines. Insomnia Therapy Workshops
thesleepschool.org
Insomnia is when a person has difficulty falling or staying
Insomnia and sleep resources and advice
asleep, wakes too early, or feels unrefreshed in the morning.
www.nottinghamshirehealthcare.nhs.uk/resources-
It is not uncommon for people to experience these symptoms Royal College of Psychiatrists
every now and then. Insomnia is when these symptoms have www.rcpsych.ac.uk/mentalhealthinformation/
been present for at least a month (a chronic problem) and are mentalhealthproblems/sleepproblems/sleepingwell
interfering with the ability to function during the day.
NHS website
How age influences sleep www.nhs.uk/LiveWell/Insomnia/Pages/insomniahome.aspx
The amount and quality of our sleep is affected by age. Sleep
Nottinghamshire Healthcare NHS Foundation Trust
becomes shorter and lighter as we get older. This is quite
www.choiceandmedication.org.uk/nottinghamshirehealthcare
normal but means older adults are more likely to naturally wake
during the night and be disturbed by noise, discomfort or pain. National Institute for Health and Care Excellence
www.nice.org.uk/guidance/

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If a person tends to fall asleep too early (e.g. early evening) and How sleep problems become chronic
get up too early, exposure to bright light in the late afternoon
and early evening may be helpful. Delay breakfast for early Some people are more prone to sleep problems than others.
risers until a sensible time. Certain life events can trigger episodes of poor sleep such as
emotional stress, anxiety, low mood, a change in the
Sleep diaries environment or routine and ill health. Alcohol, substance misuse
and some medicines also cause sleep problems.
Improving “sleep hygiene” and sticking to planned changes can
often really help to improve sleep. It may be helpful to keep a Once a sleep problem has developed, common habits or
sleep diary (see page 7) for a short time to help identify the behaviours people adopt to cope with the problem tend to make
problem better and record progress. If you try the tips in this the problem worse. These habits can prevent recovery.
booklet and are still struggling to sleep, see your doctor,
pharmacist, or nurse for further advice. Habits and sleep
Will sleeping pills help? People who sleep poorly at night often develop habits like lying
in later in the morning or napping during the day, drinking lots of
Although sleeping pills (also known as hypnotics) can be very tea, coffee and high energy drinks during the day to stay alert,
effective at relieving insomnia and help in getting back into a which reduce sleepiness at bedtime. These habits help to
good sleep routine, they do not address the underlying cause(s) compensate for the lack of sleep at night but they also help to
of insomnia. Good sleep hygiene is essential. maintain the problem.
Long-term, continuous use of sleeping pills is not generally
If you sleep during the day you are highly likely to wake at night.
recommended as your body may get used to them which makes
If you need a daytime nap because of a particular health issue, it
them less effective over time, and some people can find it
is best to nap early in the day.
difficult to stop taking them. If you have been taking sleeping
pills for a long period of time (more than one month) you should
not stop taking them abruptly but should discuss this first with Taking back control
your doctor. People who develop, or live with someone who has a sleep
problem often say “it has been like this for years”, or “I have tried
Melatonin everything and nothing has helped”.
Melatonin is the brain's regulator of sleep. It is naturally
produced in the brain in the hours of darkness to promote sleep. If sleep is problematic it is important to practice good “sleep
Artificial light from screens (e.g. TVs, iPads, computer screens) hygiene”. This means doing the things which are known to
reduces the amount of melatonin the body releases and improve sleep and avoid those things which are known to
prolongs the time it takes to fall asleep. Cutting those out for a disturb sleep.
few hours before bedtime is important.
Learn more with the Loughborough University self-help
programme on our sleep page at www.nuh.nhs.uk/epilepsy.

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Tips to encourage good sleep Night time walking
 Try to take regular exercise during the day. Consider what might be causing you to wake; an uncomfortable
 Try to spend time in daylight (or bright artificial light) during bed, needing the toilet, being too warm or cold, poorly, or
the day. If you spend a lengthy time sitting, try to sit near a worrying about something. Get up and go to another room if you
window. can’t settle. Don’t watch TV, or use a computer, iPad or mobile
phone. The light from these devices promotes wakefulness.
 Do something relaxing before bedtime e.g. have a warm bath Return to bed when sleepy.
or listen to soft music.
 Keep a regular time for going to bed. This is usually when If you are caring for someone with a sleep problem try to let
you feel sleepy. them resettle on their own, if possible. If you have to intervene
 Try a hot, milky or decaffeinated drink near bedtime. Cherry keep contact to a minimum. If they need a drink offer a few sips
juice and bananas are also good. of water only. Avoid eye contact, guide them back to bed and
use a set bedtime phrase such as “sleep well, see you in the
 Keep the bedroom cool, quiet, and dark at night. Make the morning”.
bed as comfy as possible.
 Try wearing earplugs at night to block out external noises. Bedtime routine
 Put any worries to one side until morning. A “worry journal” Develop a good routine and stick to it. This is particularly
next to the bed can be helpful. important when caring for someone else with a sleep problem,
 Get up at the same time each morning regardless of how for example someone with a learning disability.
long you slept.
Establish a set order of events which lead to bedtime. Provide a
peaceful, calm atmosphere. Try to choose a short routine; have
Things to avoid
a bath, pyjamas on, warm milky drink, brush teeth, listen to soft
 Bright light in the evening. music in a dimly lit room. The routine should always have a clear
 Watching TV, listening to radio, or eating in the bedroom. end point that signals it is now time to go to sleep, such as
Keep the bedroom mainly for sleeping. turning the light off and having a set goodnight phrase, “sleep
well, see you in the morning”.
 Artificial light from computer screens, iPads, mobile phones
in the evenings before bed. People who don’t fall asleep until late tend to sleep-in later in the
 Heavy meals, sugary foods and drinks, alcohol, caffeine and morning when they get chance. This is not a good idea as it
energy drinks (e.g. coffee, tea, chocolate, cola) in the makes it likely they won’t go to sleep until later the following
evening. Sensitivity to caffeine increases with age. night, reinforcing a bad habit. Try to have a fixed time for getting
 Snacks if you wake in the night. up and stick to it during the week and weekends.
 Smoking around bedtime and first thing in the morning. Exposure to bright light in the morning may be helpful and avoid
 Napping or long periods of inactivity during the day. day time napping. The length of time a person sleeps during the
day will usually reduce night time sleep by a similar amount.
 Vigorous exercise within 2 hours of the usual bedtime.
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