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Trusted NHS and government information about sleep and mental health.
Why sleep matters for mental health
Sleep and mental health are closely connected, and difficulties with either can affect the other.
Poor sleep may contribute to
Mental health difficulties can also disturb sleep, creating a cycle where poor sleep worsens emotional wellbeing and emotional distress makes sleep harder.
Insomnia
Insomnia means regularly having difficulty sleeping or not feeling refreshed after sleep.
Difficulty falling asleep
Lying awake for a long time despite feeling tired.
Frequent waking
Waking repeatedly during the night or struggling to return to sleep.
Waking too early
Waking much earlier than intended and being unable to sleep again.
Unrefreshing sleep
Sleeping but still feeling tired, drained or unable to function well.
Poor concentration
Difficulty thinking clearly, remembering things or making decisions.
Mood changes
Irritability, low mood, anxiety or reduced patience during the day.
Possible causes of insomnia
- Anxiety, depression, stress or trauma
- Chronic pain or other physical health conditions
- Medication side effects
- Shift work, irregular hours or jet lag
- Caffeine, nicotine, alcohol or other substances
- Noise, temperature, unsuitable bedding or an uncomfortable environment
Treatment and support
- Improving sleep habits and daily routines
- Cognitive Behavioural Therapy for Insomnia, often called CBT-I
- Support for anxiety, depression, pain or trauma
- Reviewing medicines with a qualified healthcare professional
- GP assessment where sleep problems continue or affect daily life
Sleep anxiety
Worrying about sleep can increase alertness and make falling asleep more difficult.
Common worries
- “I will not get enough sleep.”
- “I will not cope tomorrow.”
- “My work, study or caring responsibilities will suffer.”
- “Poor sleep will damage my health.”
- “I have to fall asleep right now.”
Helpful approaches
- Write worries down earlier in the evening
- Set aside a short, planned “worry time”
- Use breathing or relaxation exercises
- Reduce clock-checking and pressure to sleep
- Seek support for underlying anxiety
When anxiety becomes stronger at night
Thoughts can feel louder at night when daytime distractions reduce.
Racing thoughts
Thoughts may move quickly between problems, memories and future concerns.
Physical anxiety
Increased heart rate, tension, sweating or restlessness may make sleep difficult.
Overthinking
Replaying conversations, decisions or events can keep the mind alert.
Catastrophic thinking
Worries may feel more serious or threatening during the night.
Panic symptoms
Some people experience panic attacks when falling asleep or waking suddenly.
Feeling unsafe
Trauma, intrusive thoughts or fear may make it difficult to relax.
If night-time anxiety regularly affects sleep, work, education, caring responsibilities or daily functioning, consider speaking to a GP or using NHS Talking Therapies.
Poor sleep and depression
Depression can affect sleep in different ways, and ongoing sleep problems may make low mood harder to manage.
Sleep changes linked to depression may include
- Difficulty falling asleep
- Broken or restless sleep
- Waking very early
- Sleeping much longer than usual
- Difficulty getting out of bed
Poor sleep may increase
- Low mood and irritability
- Fatigue and reduced motivation
- Feelings of hopelessness
- Difficulty concentrating
- Reduced ability to cope
When to seek help
Speak to a GP or mental health professional if low mood lasts more than two weeks, sleep problems are persistent, or daily life is becoming difficult.
Building a healthy sleep routine
A regular routine can help the body recognise when it is time to be awake and when it is time to rest.
Keep regular times
Try to wake up at a similar time each day and keep bedtime reasonably consistent.
Create a wind-down period
Spend 30 to 60 minutes doing calm activities before bed.
Reduce stimulation
Dim bright screens and avoid stressful work or conversations shortly before bed.
Review caffeine and nicotine
Stimulants later in the day may delay sleep or make sleep lighter.
Avoid heavy late meals
Allow time to digest before going to bed where possible.
Improve the environment
Aim for comfortable bedding, lower noise, darkness and a suitable temperature.
Relaxation techniques
Relaxation does not guarantee sleep, but it can help reduce physical tension and mental alertness.
Slow breathing
- Breathe in gently through your nose.
- Count slowly to four.
- Pause briefly without straining.
- Breathe out slowly and comfortably.
- Repeat several times.
Progressive muscle relaxation
Gently tense one muscle group, then release it and notice the difference. Work gradually from the feet towards the face without causing pain.
Mindfulness and grounding
Focus attention on the present moment rather than trying to force thoughts away.
- Notice the feeling of breathing
- Listen to sounds without judging them
- Use a guided body scan
- Name things you can see, hear and feel
Gentle stretching
Light, comfortable stretching may reduce physical tension. Stop if anything causes pain, dizziness or discomfort.
Guided relaxation audio
Some people find meditation, relaxation recordings or sleep stories useful. Keep the screen dim or turned off and use a comfortable volume.
Other factors that can disturb sleep
Sleep difficulties are not always caused by stress or mental health.
Pain or illness
Long-term pain, breathing problems, reflux and other conditions may affect sleep.
Medicines
Some prescribed or over-the-counter medicines may affect alertness or sleep.
Sleep apnoea
Loud snoring, choking, gasping or severe daytime sleepiness may need medical assessment.
Restless legs
Uncomfortable sensations or an urge to move the legs can interfere with sleep.
Caring responsibilities
Babies, children, disability, illness or night-time caring can interrupt rest.
Shift work
Night work and changing shifts can disrupt the body clock and recovery time.
Do not stop or change prescribed medicine without speaking to a qualified healthcare professional.
When sleep problems need professional support
Seek advice when sleep difficulties continue, worsen or affect safety and daily functioning.
Problems lasting weeks
Persistent symptoms may need assessment rather than relying only on self-help.
Daily life is affected
Sleep is affecting work, education, driving, caring or relationships.
Anxiety is worsening
Night-time anxiety, panic or intrusive thoughts are becoming difficult to manage.
Low mood is worsening
Depression, hopelessness or withdrawal is increasing.
A sleep disorder is suspected
Symptoms such as gasping, severe daytime sleepiness or unusual movements need assessment.
Self-help is not working
A GP can consider physical, psychological, medication and lifestyle factors.
Workplace, education and disability support
Long-term sleep and mental health difficulties may create barriers at work or in education.
Workplace support may include
- Adjusted hours or shift patterns
- Additional breaks
- Temporary changes to duties
- Home or hybrid working where suitable
- Occupational health involvement
- A phased return after sickness absence
Education support may include
- Pastoral or student wellbeing support
- Adjusted deadlines or attendance arrangements
- Quiet rest or study spaces
- Disability or learning support services
- Individual adjustments based on need
Urgent mental health support
Seek urgent support if distress becomes overwhelming, you feel unable to keep yourself safe, or someone is in immediate danger.
Immediate danger
Call 999 or go to A&E if there is an immediate risk to life or safety.
Urgent mental health help
Call NHS 111 and select the mental health option.
Speak to someone
Samaritans can be contacted free at any time on 116 123.
Frequently asked questions
How much sleep should I get?
Sleep needs vary between people and across different ages. How refreshed and able to function you feel is also important.
Should I stay in bed when I cannot sleep?
If you remain awake and frustrated, some people find it helpful to get up briefly and do something quiet in low light before returning when sleepy.
Can anxiety cause insomnia?
Yes. Worry, physical tension, panic and increased alertness can all make falling asleep or staying asleep harder.
Should I use sleeping tablets?
Discuss medicines with a GP or pharmacist. Sleeping medicines are not suitable for everyone and may only be used for limited periods.
When should I see a GP?
Seek help when sleep problems last several weeks, affect daily life, or may be connected to depression, anxiety, medication or a physical sleep disorder.
Can poor sleep affect driving?
Yes. Fatigue can reduce concentration and reaction time. Do not drive when too tired to do so safely.
Key message
Sleep problems are common and treatable. Difficulties may be linked to anxiety, depression, stress, trauma, physical health, medication, caring responsibilities or life pressures.
Support is available through GPs, NHS Talking Therapies, mental health services and specialist sleep services where appropriate.
Rest matters. Mental wellbeing matters. Seeking support early matters.
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