Treatment options
Sleep hygiene and CBT
The first step in treating insomnia is to evaluate an individual's sleeping habits and encourage them to adopt good 'sleep hygiene'. Sleep hygiene describes lifestyle changes that help improve both the likelihood of falling asleep and having a night of good quality sleep.
Cognitive behavioural therapy (CBT) may be recommended in severe cases. It involves strategies such as sleep restriction therapy, relaxation training and stimulus control.
OTC medication
OTC sleep aids are based on older style antihistamines that have drowsiness as a side effect. While this may not be desirable for treating hayfever during the day, it can help to promote sleep. Common antihistamines used in OTC products include promethazine (e.g. Sominex) and diphenhydramine (e.g. Nytol). These are useful for short-term relief from temporary sleep disturbances in people aged over 16. However, customers should be warned that they may experience drowsiness the following day and should be cautious if they plan to drive or operate machinery. Such products should not be taken for longer than seven days without medical advice. If any customers are making repeat requests or purchasing multiple packs, refer them to the pharmacist.
Natural and complementary remedies
Herbal sleep products are often based on valerian and passiflora. They are thought to work by promoting calmness and encouraging natural sleep. The effects may not be immediate, so warn customers that some products may need to be taken continuously for two to four weeks. OTC brands include Bonuit Sleep Aid Tablets, Kalms Night, Kira Restful Sleep, Niteherb Tablets, Nytol Herbal Tablets, Potter's Nodoff, Quiet Life and Sominex Herbal.
Sleep hygiene
The following lifestyle tips can help to increase the chance of sleep:
Do:
- Ensure the bedroom is at a comfortable temperature
- Remove any distractions such as bright lights or noise. Use dark curtains or earplugs if necessary
- Check that the mattress is supportive €“ too firm and it puts pressure on the hips and shoulders, too soft and it's bad for the back
- Exercise moderately during the day, but avoid activity close to bedtime
- Make time to relax before bed, e.g. have a warm bath
- Write a list of any worries or errands that need to be done the following day
- Quit smoking €“ smokers take longer to fall asleep and wake more frequently.
Don't:
- Go too long without sleep or wake up too late €“ stick to a regular sleep routine every day
- Stay in bed tossing and turning €“ if you can't sleep, get up and do something relaxing, such as reading or listening to soothing music. Go back to bed when you feel tired
- Drink caffeinated drinks after mid-afternoon €“ opt for warm milky drinks or caffeine-free herbal teas instead. Also, avoid caffeine-containing medication €“ it is sometimes an ingredient in OTC painkillers and cold remedies
- Have a nightcap €“ alcohol may help you fall asleep, but you're more likely to wake during the night
- Eat too close to bedtime €“ meals should be early in the evening, but don't go to bed hungry
- Take naps €“ they make it harder to fall asleep at night.