"Sleep hygiene' is a non-medication way of improving your sleep by making some changes to your lifestyle and bedtime habits:
- Get more exercise during the day (but not just before bedtime).
- Get out in the sunshine during the day. This will suppress your melatonin (your brain's natural sleep hormone) during the day so that it can bounce back after dark.
- Avoid caffeine-containing drinks (tea, coffee, coke, pepsi, energy drinks) in the afternoon or evening, or consider cutting them out completely.
- Drink alcohol in moderation only, and don't use alcohol as a way of getting to sleep.
- Avoid using electronic screens (TV, computers, tablets) for a couple of hours before bedtime. This is because the light from screens suppresses your brain's melatonin.
- Get into a routine with a specific bedtime at the same time every night.
- Do something a bit dull and calming in the hour before bedtime (like reading a book, and having a bath).
- Avoid a big meal just before bedtime.
- Use your bed only for sleep (and cuddling), not for watching TV, playing computer games, reading emails, doing homework etc. The aim is to train your brain into the habit that bed = sleep.
- Breathing exercises for relaxation at bedtime can be useful, for example the 4-7-8 technique. Here is another bedtime relaxation technique.
- There are also some dietary, nutritional and herbal interventions that can help with sleep.
It is best to avoid medication if at all possible, but if you have tried the 'sleep hygiene' approach and you still have severe insomnia, then there are some medication options.
Melatonin seems to be safe with long term use but us generally only effective with children or elderly people.
Phenergan or similar antihistamines (used for allergies) are also safe options.
Some antidepressant or anti-anxiety medications have sedation as a side effect and this may influence the voice of medication for depression or anxiety.
'Benzodiazepines' such as temazepam and nitrazepam are best avoided because of the risk of dependence. If they are used, this should be for no longer than a couple of weeks. Zopiclone and Zimovane are similar drugs which are also only for short term use.