How to cope with sleep problems

Explains sleep and mental health, gives practical suggestions and information about where to get support.

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How does sleep relate to mental health?

There's a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health.

Circular arrows with text explaining five stages in the cycle of sleep problems. The cycle moves from a lack of sleep to tiredness, which leads to difficulty coping with daily life, causing low self esteem which leads to worrying and stress, and these cause a lack of sleep, restarting the cycle.

"Poor sleep leads to worrying. Worrying leads to poor sleep. Worrying about sleep is like your mind trying to fight itself. That's a horrible place to be."

What problems might I have with sleep?

Everyone needs sleep, but many of us have problems with it. You might recognise some of the experiences listed below, or have other difficulties with sleep that aren't mentioned here.

You might:

find it hard to fall asleep, stay asleep or wake up earlier than you'd like to (also known as insomnia – find out more on the NHS website)
have problems that disturb your sleep, such as panic attacks, flashbacks, nightmares or psychosis
find it hard to wake up or get out of bed
often feel tired or sleepy – this could be because you're not sleeping enough, not getting good quality sleep or because of health problems
sleep a lot – which could include sleeping at times when you want, or need, to be awake.

"When I get depressed, I sleep so much – at its worst it was 18 hours a day, because it was the only way that I could stop thinking and stop my mind from saying awful things to me."

If you're having problems sleeping, you might:

be more likely to feel anxious, depressed or suicidal
be more likely to have psychotic episodes – poor sleep can trigger mania, psychosis or paranoia, or make existing symptoms worse
feel lonely or isolated – for example, if you don't have the energy to see people or they don't seem to understand
struggle to concentrate, or make plans and decisions
feel irritable or not have energy to do things
have problems with day to day life – for example, at work or with family and friends
be more affected by other health problems, including mental health problems.

"During the day, my brain is fuzzy, my memory is noticeably affected. I barely have energy to function."

What causes problems with sleep?

The things that affect our sleep differ for everyone. They can include:

stresses or worries – for example, issues with money, housing or work
problems with where you sleep – for example, if you sleep somewhere uncomfortable or you're easily disturbed
health conditions relating to sleep, also known as sleep disorders
being a parent or carer
taking medication, including starting or coming off medication
recreational drugs and alcohol
working at night or being a shift worker
current or past trauma
mental and physical health problems, many of which can affect your sleep.

For more information about sleep disorders, see the Mental Health Foundation and Royal College of Psychiatrists websites, and our list of useful contacts.

"It's not possible to relax if you don't have anywhere comfortable and safe at night. This leads to not sleeping and worrying most of the night."

If problems with sleep are worrying you or affecting your day to day life, it's a good idea to see a doctor who can give you a health check and help you access treatment and support. If you fill in a sleep diary, you could take this to your appointment to show your doctor.

"My sleep problems are [...] more a case of bedtime procrastination than insomnia as such and, as a consequence, being too tired the next morning. I still haven't found out what works for me as I can get to sleep once I do get to bed."

How could mental health problems affect my sleep?

If you live with a mental health problem, this could affect your sleep in lots of ways. For example:

Anxiety can cause racing or repetitive thoughts, and worries that keep you awake. You may also have panic attacks while you're trying to sleep.
Depression and seasonal affective disorder (SAD) can make you sleep more, including staying in bed for longer or sleeping more often. Depression can also cause insomnia.
If you've gone through trauma, this can cause flashbacks, nightmares or night terrors that disturb your sleep. You might feel unsafe or uncomfortable in bed or in the dark.
Paranoia and psychosis may make it difficult to sleep. You may hear voices, or see things you find frightening or disturbing.
Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts can also keep you awake and cause insomnia.
Psychiatric medication can cause side effects including insomnia, disturbed sleep, nightmares and oversleeping. Stopping psychiatric drugs can also cause sleep problems.