1) How Sleep Works (the useful science)

Diagram showing sleep cycle stages (N1, N2, N3, REM) with clock illustration

You cycle roughly every 90 minutes: N1 → N2 → N3 (deep) → REM. Later cycles contain more REM.

Two-process model

  • Sleep pressure (adenosine): builds while awake; caffeine blocks its receptors temporarily.
  • Circadian rhythm: your body clock creates 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. Nudges timing rather than “knocking you out”.
  • Orexin (hypocretin): wake drive; stabilises alertness. Loss = narcolepsy.
  • GABA: main calming transmitter (enhanced by many sleep medicines).
  • Cortisol: should peak in the morning; chronic stress can keep it high at night.

Why insomnia sticks

  • Conditioning: bed becomes linked with struggling rather than sleep.
  • Hyperarousal: worry + body tension keep the “threat” system up.
  • Catch-up naps/lie-ins reduce pressure → another bad night → loop.
Graph showing interaction of sleep pressure and circadian rhythm

Aim to align high sleep pressure with your circadian “sleep gate”.

2) Wind-Down (30–90 min, your way)

  • 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 rules: bed equals sleep, up if awake over 20 minutes

If you’re awake ~20 min, get up (dim light). Return only 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.

  1. Track actual sleep for 7 days (use the diary).
  2. Set a fixed wake time (e.g., 07:00). If you average 5 h sleep, bedtime = 02:00.
  3. Hold that window for a week. When sleep efficiency >85%, move bedtime earlier by 15–20 min.
  4. 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”.
  • 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 coping behaviours (clock-watching, long lie-ins) and taper them.

4) Cognitive tools (when thoughts rev)

5) Relaxation set (rotate weekly)

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

7) Bedroom set-up (quietly powerful)

8) Naps & jet lag

Smart naps

  • Power-nap 10–20 min (set an alarm). Longer → sleep inertia.
  • Keep naps pre-2 pm while fixing 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

Example: 3 × night shifts

  1. Pre-shift: 20–30 min nap late afternoon; caffeine early on shift only.
  2. During: brightest light first half; dimmer late.
  3. Post-shift: sunglasses home; wind-down; 4–5 h core sleep; optional 20 min top-up mid-afternoon.
  4. 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.

11) Menopause & perimenopause

12) Chronic pain

13) PTSD: Nightmares & flashbacks

Imagery Rehearsal Therapy (IRT) — DIY starter

  1. Choose a recurrent nightmare; write a new, safe ending (even if unrealistic).
  2. Rehearse the new version for 10 min in the daytime (eyes open, steady breath) daily for 2 weeks.
  3. 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

15) 3 am emergency toolkit

Decision tree (5–10 min)

  1. Turn clock away. Long exhale × 10.
  2. Still wired? Leave bed: dim light, quiet chair.
  3. Do one calming loop: breath/scan/reading.
  4. Brain dump or 3-bullet “tomorrow” if worries persist.
  5. 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

Support (UK & Scotland)

If you need urgent help

  • Call 999 (UK) if there is immediate danger.
  • Samaritans — 116 123 (free, 24/7, UK & ROI)
  • Shout — text SHOUT to 85258 (24/7, UK)

When to seek medical help

Important Note

The information on this page is for general understanding and support. It is not a substitute for professional medical or psychological 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.

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