Sleep & Insomnia

A deep dive into how sleep works, why insomnia sticks, and the tools that actually shift things — including CBT-I, 3 am rescue steps, and guides for shift workers, teens, menopause, chronic pain, PTSD/nightmares, and sleep apnoea. UK & Scotland support links included.

1) How Sleep Works (the useful science)

Notebook sketch of sleep stages with a bedside clock glowing faintly — You cycle every ~90 minutes: N1→N2→N3 (deep)→REM. Later cycles = more REM.

Two-process model

Sleep pressure (adenosine): builds while awake; caffeine blocks its receptors temporarily.
Circadian rhythm: the body clock sets a “sleep gate” at your usual time; morning light advances, late light delays.

Key chemicals

Melatonin: darkness signal; rises 1–2 h before habitual sleep. It nudges timing, it doesn’t “knock you out”.
Orexin (hypocretin): wake drive; steadies alertness. Loss = narcolepsy.
GABA: main calming transmitter (enhanced by many sleep meds).
Cortisol: should peak in the morning; chronic stress can keep it high at night.

Why insomnia sticks

Conditioning: bed becomes linked with struggling instead of sleep.
Hyperarousal: worry and body tension keep the “threat” system up.
Catch-up naps/lie-ins reduce pressure → another bad night → loop.

Overlapping line graphs labelled sleep pressure and circadian rhythm beside a mug — Aim to align high sleep pressure with your circadian “sleep gate”.

2) Wind-Down (30–90 min, your way)

Warm evening scene with chamomile tea, closed laptop and a book — Make a dimmer-switch routine: power-down → soothe body → quiet mind.

Power-down: set an alarm to stop tasks; park tomorrow’s 3 bullets.
Light: warm/dim; enable night-shift; avoid bright overheads.
Body: warm bath/shower, light stretches, 4-6 breathing.
Mind: paper reading, craft, slow playlist, gratitude/done list.
Environment: 16–18 °C; blackout or mask; steady sound if helpful.

3) CBT-I (gold-standard for chronic insomnia)

Stimulus control: re-pair bed = sleep

Notebook on a bed with rules: bed = sleep, up if awake >20 min — If you’re awake ~20 min, get up (dim light). Return when sleepy.

Use bed only for sleep/sex. No doom-scrolling or email.
Consistent wake-time daily (anchors the clock).
Naps: avoid for 2–3 weeks while you’re resetting, or keep ≤20 min before 2 pm.

Sleep restriction (sleep consolidation)

Clock and journal page with marked sleep window — Match time in bed to actual sleep, then expand slowly.

Track actual sleep for 7 days (use the diary).
Set a fixed wake time (e.g., 07:00). If you average 5 h sleep, bedtime = 02:00.
Hold that window for a week. When sleep efficiency >85%, move bedtime earlier by 15–20 min.
Stop if bipolar (mania risk) or if excessive sleepiness makes driving unsafe — speak to your GP.

CBT-I add-ons

Paradoxical intention: if trying harder makes it worse, “try to stay awake peacefully” — pressure drops, sleep comes.
Worry window: 15 min early evening to write worries + next tiny step → trains the brain not to deliver them at 2 am.
Safety behaviours audit: note things you do “to cope” that keep the loop going (e.g., clock-watching, long lie-ins) and taper them.

4) Cognitive Tools (when thoughts rev)

Defusion line: “I’m having the thought that I’ll be useless tomorrow.” (Creates distance.)
Reframe: “I can function on less than perfect sleep; rest still helps.”
Constructive capture: one-line note for a useful idea → back to sleep.
Clock rules: turn the display away; no 3 am time-maths.
Belief reset: aim for “good enough sleep” most nights; perfection beliefs fuel insomnia.

5) Relaxation Set (rotate weekly)

Breathing: 4-in / 6-out for 2–5 min; or box 4-4-4-4.
PMR: tense–release muscle groups toes→brow.
Body scan: slow attention sweep; note “warm/heavy/soft”.
Imagery: safe place, include 3 senses; keep it the same each night.
Audio: steady fan/brown noise; low volume, no surprises.

6) Light & Timing (big results, low effort)

Morning light: 15–30 min outside within 1–2 h of waking (even cloudy UK light counts).
Evening dim: last 60–90 min low light; shift screens to warm colour.
Caffeine half-life ~5–8 h: keep last dose 6–8 h pre-bed; watch hidden sources (cola, energy drinks, pre-workout, green tea).
Alcohol: may knock you out but fragments sleep/REM; finish drinking 3+ h before bed.
Exercise: great for sleep; avoid intense sessions within ~3 h of bedtime.
Meal timing: heavy meals 3+ h pre-bed; protein-rich breakfast helps circadian anchoring.

7) Bedroom Set-Up (quietly powerful)

Cool, dark, quiet: 16–18 °C; blackout/mask; earplugs/white-noise.
Mattress & pillows: neutral spine; side-sleepers often need thicker pillow.
Declutter the sightline: fewer “work cues” reduces arousal.
Phones: charge out of reach; use a dumb alarm or Do-Not-Disturb.

8) Naps & Jet Lag

Smart naps

Power-nap 10–20 min (set an alarm). Longer → sleep inertia grogginess.
Keep naps pre-2 pm if you’re trying to fix insomnia.

Jet lag quick plan

Eastbound (earlier clock): morning light at destination; avoid late light; consider low-dose melatonin early evening for a few nights (ask your pharmacist/GP first).
Westbound (later clock): afternoon/evening light; avoid early-morning bright light.
Shift meals and exercise to destination daytime as soon as you land.

9) Shift Work: survivability templates

Anchor sleep: defend one regular 4–5 h block daily.
Light control: bright light on shift; sunglasses home; blacked-out day-sleep room.
Fuel: main meal before night shift; light, protein-lean snacks overnight; hydrate.

Example: 3 × night shifts

Pre-shift: 20–30 min nap late afternoon; caffeine early on shift only.
During: brightest light first half; dimmer late.
Post-shift: sunglasses home; wind-down; 4–5 h core sleep; optional 20 min top-up mid-afternoon.
After final night: short morning sleep (2–3 h), then stay up; early evening bedtime to reset.

10) Teens & Students

Delayed clocks are biological. Work with it, nudge gently earlier.

Strong morning light + movement.
Regular wake time; weekend drift ≤ 1–2 h.
Wind-down with screens out of reach; use app limits after 22:00.
Power naps ≤ 20 min before late-afternoon; no evening napping.

11) Menopause & Perimenopause

Hot flush care: cool room, breathable bedding, bedside fan/water, moisture-wicking nightwear.
Discuss HRT with your GP if symptoms are significant; CBT-I remains effective alongside.
Reduce evening alcohol and spicy/heavy food; experiment to find triggers.

12) Chronic Pain

Pacing: small regular movement prevents late flares from over-doing.
Positioning: pillows to support joints; side-sleep with pillow between knees.
Meds timing: coordinate analgesia with sleep window (per prescriber).
Relaxation: breath/scan reduce sympathetic tone and pain amplification.

13) PTSD: Nightmares & Flashbacks

Imagery Rehearsal Therapy (IRT) — DIY starter

Choose a recurrent nightmare; write a new, safe ending (even if unrealistic).
Rehearse the new version for 10 min in the daytime (eyes open, steady breath) daily for 2 weeks.
If triggered at night, repeat one line of the new script while exhaling slowly.

If nightmares are severe/frequent, ask for trauma-focused CBT or EMDR.

Grounding at night

Sit up; feet on floor; name 5-4-3-2-1 things you can sense.
Cold water on wrists/face; hold a textured object; long exhale.
Words: “This is a memory, not danger. I’m here, now.”

14) Sleep Apnoea & CPAP

Red flags: loud snoring, breath pauses, gasping, morning headaches, daytime sleepiness.
Ask your GP about a home sleep study; CPAP is highly effective when recommended.
CPAP adherence tips: try the mask daytime while reading; adjust humidity; clean regularly; work with the clinic on mask fit.
Side-sleeping, healthy weight, and reduced evening alcohol help mild OSA.
Do not drive if excessively sleepy.

15) 3 am Emergency Toolkit

Decision tree (5–10 min)

Turn clock away. Long exhale × 10.
Still wired? Leave bed: dim light, quiet chair.
Do one calming loop: breath/scan/reading.
Brain dump or 3-bullet “tomorrow” if worries persist.
Return to bed only when drowsy. Repeat as needed.

Quick resets

4-7-8 breaths × 4 rounds.
Progressive release: hands → shoulders → jaw.
Warm your feet; sip water.
Self-talk: “Rest counts. Good-enough sleep is fine.”

Downloads

Sleep Diary (14 days)
Track true sleep & patterns Sleep Hygiene Checklist
Quick room & routine tune-ups CBT-I Starter
Stimulus control + consolidation Worry List
Evening “park it” sheet 3 am Toolkit
Decision tree + quick resets

Support (UK & Scotland)

Forces & Emergency Responders

Combat Stress — veterans’ mental health (trauma, nightmares, insomnia).
Veterans’ Gateway — 24/7 first point of contact.
NHS Op COURAGE (England) — specialist NHS mental health for serving leavers/reservists/veterans.
Mind — Blue Light Programme — police, fire, ambulance, search & rescue.
Police Care UK — serving & former police and families.
The Fire Fighters Charity — recovery & wellbeing.
TASC — The Ambulance Staff Charity — wellbeing & trauma support.

When to seek medical help

Snoring + breathing pauses, gasping, morning headaches, severe daytime sleepiness.
Insomnia > 3 months despite trying behavioural changes.
Restless legs/periodic limb movements disrupting sleep.
Nightmares/flashbacks linked to trauma that aren’t easing.
Mania history or bipolar disorder (get advice before sleep restriction).
Sleepiness impacting driving/safety — do not drive.

Important Note

The information on this page is for general understanding and support. It is not a substitute for professional medical, psychological, or legal advice. If you feel unable to keep yourself safe or someone else is at risk, call 999 (UK) immediately. If you’re outside the UK, contact your local emergency number.

For non-emergency concerns, consider speaking with a qualified health professional or one of the support services listed on our site.

← Back to Wellbeing