Insomnia
Insomnia explained: symptoms, causes, short-term vs chronic, CBT-I and when sleep medication helps.
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Insomnia
What insomnia is, what drives it, why the three-month mark changes everything, and which treatments actually hold up.
Part of our Sleep conditions guide.
Key fact: Insomnia is defined by its daytime consequences, not by hours slept. And for insomnia lasting three months or more, the first-line treatment in UK guidance is not a tablet — it is cognitive behavioural therapy for insomnia (CBT-I), which is the only approach whose benefit reliably outlasts the treatment itself.
What insomnia actually is
Insomnia is a persistent difficulty with getting to sleep, staying asleep, or the quality of sleep, which happens despite having adequate opportunity and circumstances to sleep, and which leaves daytime functioning impaired.
Two parts of that definition do most of the work, and both are routinely overlooked.
The first is adequate opportunity. Someone working night shifts, or a new parent woken four times, is sleep-deprived rather than insomniac. The distinction matters because sleep deprivation is solved by creating the opportunity to sleep, whereas insomnia is the inability to use an opportunity that is already there.
The second is impaired daytime functioning. This is the part that turns unsatisfactory sleep into a clinical condition. Fatigue, low mood, irritability, general malaise and difficulty concentrating are the daytime symptoms clinicians look for. Sleep disturbance without any daytime impairment is not insomnia disorder — it may simply be a shorter sleep requirement than expected.
Why this matters: A great deal of distress about sleep comes from measuring the wrong thing. If you wake feeling reasonably rested and get through the day well, six hours is enough sleep for you, whatever a sleep tracker says.
Short-term vs chronic insomnia
Three months is the dividing line, and it changes the entire approach. This is the single most useful thing to understand about insomnia.
| Short-term insomnia | Chronic insomnia | |
|---|---|---|
| Duration | Less than 3 months, often days to weeks | 3 months or more |
| Usual trigger | An identifiable stressor or change | Trigger often long gone |
| What keeps it going | The stressor itself | Learned responses to poor sleep |
| Natural course | Usually resolves when the trigger passes | Self-sustaining without treatment |
| First-line treatment | Address the stressor; sleep hygiene advice | CBT-I |
| Role of medication | Very short course, only if severely distressing | Adjunct at most, never the main plan |
The reason chronic insomnia becomes self-sustaining is worth spelling out, because it explains why treatment looks counter-intuitive.
A bad patch of sleep prompts sensible-sounding compensations: going to bed earlier to catch up, lying in at weekends, napping, staying in bed hoping sleep will come, checking the clock. Each of these weakens the biological pressure to sleep and strengthens the association between the bed and being awake. Layered on top is anxiety about sleep, which is itself arousing. Within a few weeks the original trigger has resolved and the compensations have become the problem.
That is why treatment for chronic insomnia is not about trying harder to sleep. It is about dismantling those patterns. Our guide to the physiology of sleep and the harms of chronic insomnia explains the mechanism in more detail, and what sustained sleep loss does to the body and brain.
Symptoms of insomnia
Night-time symptoms
- Difficulty falling asleep — lying awake at the start of the night
- Difficulty staying asleep — repeated awakenings, or long periods awake in the small hours
- Early morning waking — waking well before you intended, unable to get back to sleep
- Non-restorative sleep — sleep that happens but does not refresh
Daytime symptoms — the part that defines it
- Fatigue and low energy that does not lift with rest
- Low or depressed mood, and irritability
- Difficulty concentrating, poor memory, more mistakes than usual
- General malaise — feeling unwell in a way that is hard to pin down
- Reduced performance at work, in study, or socially
- Preoccupation with sleep and anxiety as bedtime approaches
Worth distinguishing: Fatigue is not the same as sleepiness. People with insomnia are usually exhausted but paradoxically unable to nap. Genuine sleepiness — nodding off in meetings, in front of the television, or at the wheel — points more towards obstructive sleep apnoea or another sleep disorder than towards insomnia, and needs different assessment.
How much sleep do you actually need?
There is no standard definition of normal sleep. The amount needed for good health varies between individuals and changes across a lifetime, and the familiar seven-to-nine-hour figure for adults is an average, not a prescription.
The practical test is simpler: it is reasonable to assume you are getting the right amount of sleep if you wake feeling well-rested and can perform well during the day.
Two age-related changes cause a lot of avoidable worry:
More awakenings
The number of night-time awakenings rises with age. Waking two or three times and settling again is a normal older sleep pattern, not a disorder.
Less total sleep
Total sleep time falls with age, and sleep becomes lighter. Melatonin production also declines, which is part of why sleep gets shallower.
Expecting the sleep you had at twenty-five to continue at sixty-five sets up a target you will keep missing. Correcting that expectation is a legitimate part of treatment, and it is one of the things CBT-I addresses directly.
What causes insomnia
Short-term insomnia
Transient insomnia is common and usually traceable to something specific:
- Stressful events — bereavement, illness, job changes, exams, deadlines, financial difficulty
- Changed sleeping patterns — a new baby, a house move, a new partner
- Environmental disturbance — noise, light, extremes of temperature
- Shift work and jet lag — a circadian problem rather than a sleep-generation problem, and treated differently
Chronic insomnia
What maintains chronic insomnia is not fully understood, but the current understanding centres on maladaptive behaviours and cognitive processes — the compensations described above, plus beliefs about sleep that raise arousal at exactly the wrong moment. The original stressor may still be present, but frequently it is not.
Substances that disrupt sleep
| Substance | Effect on sleep | Practical guidance |
|---|---|---|
| Caffeine | Delays sleep onset; half-life means an afternoon coffee is still active at bedtime | Avoid after midday |
| Alcohol | Shortens sleep onset but fragments the second half of the night and suppresses restorative sleep | Avoid within 2 hours of bed; a common and counterproductive self-treatment |
| Nicotine | Stimulant; withdrawal overnight causes awakenings | Avoid within 2 hours of bed |
| Large meals | Discomfort and reflux | Avoid within 2 hours of bed |
Alcohol deserves singling out. Using a drink to get to sleep is one of the most common self-treatment strategies for insomnia, and one of the most reliably counterproductive. It helps with sleep onset and then breaks up the rest of the night, which produces exactly the broken, unrefreshing sleep it was meant to fix.
Conditions hiding underneath insomnia
Chronic insomnia very often co-exists with something else, and treating the insomnia in isolation gets nowhere if the driver is untreated. The relationship usually runs in both directions — anxiety worsens sleep, poor sleep worsens anxiety.
Other sleep disorders
- Obstructive sleep apnoea — loud snoring, witnessed pauses in breathing, choking or gasping, heavy daytime sleepiness. Needs specific assessment; sleeping tablets can make it worse.
- Restless legs syndrome — an irresistible urge to move the legs, worse in the evening and at rest.
- Circadian rhythm disorders — shift work, jet lag, and body clocks that run late or early.
Mental health
- Anxiety, depression, PTSD, bipolar disorder, ADHD and autism spectrum conditions all commonly disturb sleep
- Early morning waking with low mood is a classic pattern in depression
- Alcohol and substance misuse
Physical conditions
- Chronic pain and musculoskeletal conditions — the most common physical driver
- Menopause — night sweats and flushing, plus the hormonal changes themselves. See our guide to hormone replacement therapy.
- Night-time acid reflux — often silent, and a frequent cause of unexplained waking. See acid reflux and GORD.
- Poorly controlled asthma — night cough and waking breathless is a marker of inadequate control. See asthma.
- Allergic rhinitis — nasal blockage disturbs sleep and worsens snoring. See hay fever and allergic rhinitis.
- COPD, heart failure, diabetes, thyroid disease, tinnitus, neurological conditions including Parkinson's disease, stroke, epilepsy and migraine
- Prostate problems and other causes of frequent night-time urination
Insomnia is also around 1.5 to 2 times more common in women than men, and both the menopause and ageing independently predispose to it.
Get Insomnia Treatment Online
Access Doctor offers treatment for insomnia following a confidential online consultation with our GPhC-registered pharmacist independent prescribers. No GP appointment needed, and no treatment is issued without clinical assessment.
View Insomnia Treatments →When to get it looked at properly
Seek urgent medical advice if insomnia comes with thoughts of self-harm or suicide, or if you are falling asleep involuntarily during the day — particularly at the wheel. Do not drive if you feel sleepy.
Arrange an assessment rather than continuing to self-manage if:
- Sleep problems have persisted for three months or more
- Insomnia is significantly affecting your work, relationships, mood or safety
- There is loud snoring, choking, gasping or witnessed pauses in breathing
- You have excessive daytime sleepiness rather than fatigue — nodding off unintentionally
- There is unusual behaviour during sleep — sleepwalking, acting out dreams, night terrors
- You have been using sleeping tablets, prescribed or over-the-counter, for more than a couple of weeks
- You are using alcohol to get to sleep
- Insomnia started alongside a new medicine
How insomnia is assessed
There is no test for insomnia. Diagnosis is clinical, and a good assessment covers considerably more than "how are you sleeping".
The symptoms and their duration
Which of the four patterns is present — onset, maintenance, early waking, non-restorative sleep — how long it has gone on, and how many nights a week. Three months and three nights a week are the thresholds that shape treatment options.
Daytime impact
Effect on quality of life, mood, work, relationships and the ability to drive. Without daytime impairment the diagnostic criteria are not met, so this is not a soft question.
The sleep schedule itself
Bedtime, how long sleep takes to arrive, number and length of awakenings, rise time, naps. A sleep diary kept for one to two weeks is far more reliable than recall, and often reveals more time in bed than expected.
Behaviour during sleep
Snoring, witnessed apnoeas, restless legs, sleepwalking. A partner's account is often the most valuable part of the history. Where sleep apnoea is suspected, a screening tool such as STOP-Bang is used.
Beliefs about sleep
What the person thinks normal sleep should look like. Unsatisfactory sleep without functional impairment does not meet the criteria for insomnia, and correcting an unrealistic expectation is sometimes the whole intervention.
Medical history, mental health and medicines
Comorbidities, current and previous treatments, caffeine, alcohol, nicotine and any medicine that can disturb sleep. Untreated depression, anxiety, pain or reflux underneath insomnia has to be dealt with in its own right.
CBT-I: the first-line treatment
Cognitive behavioural therapy for insomnia is the first-line treatment for chronic insomnia in adults of any age. Not a tablet, and not sleep hygiene advice on its own. Our full guide to CBT-I covers the programme session by session, and how to access it on the NHS.
CBT-I is not general counselling, and it is not relaxation with a clinical label. It is a structured programme, usually four to eight sessions, built from components that each target a specific mechanism:
Stimulus control
Rebuilds the association between bed and sleep. Bed is for sleep and intimacy only; if you are awake and frustrated, you get up until sleepy.
Sleep restriction
Temporarily limits time in bed to match actual sleep time, concentrating sleep and rebuilding sleep pressure. Counter-intuitive, uncomfortable at first, and the most powerful single component.
Cognitive therapy
Targets the catastrophic thinking about sleep loss that keeps arousal high at bedtime.
Relaxation training
Reduces the physical and mental arousal that prevents sleep onset.
It can be delivered face to face or digitally. Sleepio, a digital CBT-I programme, is recommended by NICE for treating insomnia and insomnia symptoms, which makes structured CBT-I accessible without waiting for a therapy appointment.
The distinguishing feature: the benefits of CBT-I tend to persist after treatment ends, because the mechanisms maintaining the insomnia have been changed. When a sleeping tablet is stopped, the insomnia is generally still there.
Sleep hygiene: what it can and cannot do
Sleep hygiene is the set of behavioural and environmental habits that support sleep. It is worth being precise about its role, because it is widely oversold.
In short-term insomnia, sleep hygiene advice is genuinely useful — largely because it heads off the maladaptive coping strategies that turn a bad fortnight into a chronic problem.
In chronic insomnia, sleep hygiene on its own is not recommended as a standalone treatment. It is more effective delivered inside the broader framework of CBT-I. It remains useful for people who cannot access CBT-I, or do not want it.
The environment
- Comfortable and consistent: not too hot, cold, noisy or bright
- The bedroom for sleep and intimacy only
- No clock-watching through the night — turn the clock away
- Minimise bright light in the evening; blue light from screens suppresses melatonin, so avoid devices for at least an hour before bed
The schedule
- Go to bed when sleepy, not at a fixed early hour to "catch up"
- Get up at the same time every morning — including weekends, and including after a bad night
- Get bright light in the morning
- Avoid daytime naps
- Wind down before bed: reading, a bath, music
Substances and exercise
- No caffeine after midday
- No nicotine, alcohol or large meals within two hours of bed
- Exercise is beneficial earlier in the day; avoid vigorous exercise within an hour of bedtime
The one rule people break most: a fixed wake-up time, kept after a bad night. Lying in to recover feels sensible and reliably prolongs insomnia, because it drains the sleep pressure needed for the following night.
Sleep medication: where it fits
Medication has a place in insomnia, but a narrower one than most people expect. UK guidance is explicit that hypnotics should not be prescribed routinely.
Z-drugs: zopiclone, zolpidem
See our full zopiclone guide for the dose, the metallic taste, driving rules, rebound insomnia and coming off it.
These are the standard short-term hypnotics. They may be considered where sleep hygiene has failed, daytime impairment is severe and causing significant distress, and either the insomnia is expected to resolve soon or a hypnotic is needed as a temporary adjunct alongside CBT-I.
The prescribing rules are tight, and they exist for good reason:
- Lowest effective dose, shortest possible period — no longer than two weeks, preferably less than one
- For short-term insomnia with a passing trigger, a course of three to seven days
- Avoid in older people — increased risk of falls and fractures
- Avoid in pregnancy and breastfeeding
- If the first hypnotic does not work, a second is not prescribed
- Further prescriptions are not usually given, and not without review in person
Z-drugs are contraindicated in severe obstructive sleep apnoea, respiratory failure, marked neuromuscular respiratory weakness, myasthenia gravis, severe liver impairment, and in anyone who has previously had complex sleep behaviours such as sleepwalking on zopiclone. They also carry next-day impairment: at least eight hours should pass between zolpidem and driving or any skilled task.
Prolonged-release melatonin
Melatonin is a prescription-only medicine in the UK, which surprises people familiar with the American supplement aisle. Prolonged-release melatonin 2mg is licensed for the short-term treatment of primary insomnia characterised by poor quality of sleep, in adults aged 55 and over, for a maximum of 13 weeks.
It suits sleep that is poor in quality or broken in the small hours, rather than a body clock that needs shifting. It comes as Circadin, the originator brand, and as a generic modified-release melatonin 2mg that is the same medicine at a lower price. Take it one to two hours before bedtime, after food, and swallow it whole — crushing or chewing a prolonged-release tablet releases the whole dose at once and turns it into a different medicine.
Immediate-release melatonin 3mg is a different proposition altogether — licensed for jet lag, and designed to produce the sharp evening peak that moves the body clock rather than the low sustained level that supports sleep quality. The two are not interchangeable. Our guides on melatonin for sleep, Circadin and melatonin vs Circadin cover the difference in full.
Daridorexant (Quviviq)
Covered in full in our Quviviq guide.
Daridorexant is a newer option that works by blocking orexin, one of the brain's wake-promoting signals, rather than by sedating broadly. NICE recommends it for adults whose insomnia symptoms occur on three or more nights per week for at least three months and whose daytime functioning is considerably affected — but only where CBT-I has been tried and not worked, or is unavailable or unsuitable.
- Treatment length should be as short as possible
- It should be reviewed within three months of starting
- It should be stopped if long-term insomnia has not responded adequately
- If continued, it is reassessed at regular intervals
Note the sequence. Both daridorexant and prolonged-release melatonin sit after CBT-I in UK guidance, not instead of it. A prescriber who reaches for either without asking what has been tried behaviourally is skipping the step with the best evidence.
Over-the-counter sleep aids
UK pharmacy sleep aids fall into two groups, and it is worth being straightforward about both. For every option side by side, prescription and pharmacy, see our guide to sleeping tablets in the UK.
| Type | Examples | What to know |
|---|---|---|
| Sedating antihistamines | Diphenhydramine (Nytol One-A-Night, Nytol Original), promethazine (Sominex) | Sedation is a side effect, not a designed mechanism. Tolerance develops within days. Next-day grogginess, dry mouth, constipation. Avoid in older adults. |
| Herbal preparations | Valerian (Kalms Night) | Traditional herbal use; evidence for insomnia is weak. Generally well tolerated. Can interact with other sedatives. |
NICE guidance does not recommend over-the-counter treatments as a management strategy for insomnia. That does not make an occasional tablet before a difficult night unreasonable — but it does mean these products are not a solution to a sleep problem that has lasted weeks.
A useful signal: if you have been buying over-the-counter sleep aids for more than two weeks, that is a reason to have the insomnia assessed rather than a reason to buy more. Tolerance to the sedative effect means you will be getting progressively less from them anyway.
Insomnia, driving and the DVLA
This section matters more than its length suggests, because the legal position catches people out.
- Do not drive if you feel sleepy. Tiredness is a factor in a substantial share of serious road collisions.
- Sleeping tablets impair driving into the next day. With zolpidem, allow at least eight hours before driving or any skilled task.
- Driving while impaired by a prescribed medicine is an offence in Great Britain, even when the medicine was legitimately prescribed for you.
- The DVLA must be informed if excessive sleepiness is having, or is likely to have, an adverse effect on driving. This includes obstructive sleep apnoea of any severity, primary hypersomnias such as narcolepsy, and any other condition or medication causing excessive sleepiness.
Insomnia in itself, without excessive daytime sleepiness, is not notifiable. Excessive daytime sleepiness is a different matter, and it is also a reason to look for sleep apnoea rather than to treat insomnia.
Getting insomnia treatment in the UK
There are three routes, and the right one depends on how long this has been going on.
Self-management, for a short-term problem
An identifiable trigger, a few bad weeks, no daytime crisis: sleep hygiene, protecting a fixed wake time, and avoiding the compensations that entrench the problem. Most short-term insomnia resolves.
CBT-I, for anything lasting three months
The first-line treatment. Available through the NHS face to face, and digitally through NICE-recommended programmes. If sleep has been a problem for months, this is the intervention that changes the trajectory.
Prescription treatment, where it is clinically appropriate
Short-course hypnotics for severe short-term insomnia, prolonged-release melatonin for adults over 55, or daridorexant where CBT-I has been tried and has not worked. Each requires clinical assessment.
Access Doctor is a GPhC-registered online pharmacy (#9011198). Treatment for insomnia is issued only after an online consultation reviewed by a pharmacist independent prescriber, who will decline to prescribe where a hypnotic is not appropriate — including where the history points to sleep apnoea, or where the pattern calls for CBT-I rather than a tablet.
Speak to a Prescriber About Your Sleep
Complete a confidential online consultation and a GPhC-registered pharmacist independent prescriber will review it. Regulated UK pharmacy #9011198, discreet delivery, and no treatment issued without clinical assessment.
Start Your Consultation →Frequently Asked Questions
What is insomnia?
Insomnia is persistent difficulty getting to sleep, staying asleep, or getting sleep that feels restorative, despite having adequate opportunity and circumstances to sleep, and it causes impaired daytime functioning. That last part is the piece people most often miss. Sleep that is short or broken but leaves you feeling well and working normally the next day is not insomnia disorder. It is the daytime consequences, the fatigue, low mood, irritability and difficulty concentrating, that make it a clinical problem rather than a preference about sleep.
What is the difference between short-term and chronic insomnia?
The dividing line is three months. Short-term insomnia lasts less than three months, typically a few days or weeks, and usually has an identifiable trigger such as bereavement, illness, a work crisis, a new baby or a change in environment. It commonly resolves when the trigger passes. Chronic insomnia means symptoms lasting three months or more. By that point the original trigger is often no longer the problem, and what keeps the insomnia going is a set of learned responses to it, spending longer in bed to compensate, anxiety about sleeping, checking the clock. That is why the two need different treatment: short-term insomnia often needs the stressor addressed, while chronic insomnia needs those maintaining patterns unpicked, which is what cognitive behavioural therapy for insomnia does.
How much sleep do I actually need?
There is no standard figure. The amount of sleep needed for good health varies from person to person and changes with age, and general guidance of seven to nine hours for adults is an average rather than a target. A more useful test than counting hours is how you feel and function: if you wake feeling reasonably rested and can perform well during the day, you are getting the right amount of sleep for you. It is also normal for sleep to become lighter and more broken with age, with more awakenings and less total sleep time. Expecting the sleep you had at twenty-five is a common source of unnecessary worry about sleep.
What is the most effective treatment for insomnia?
Cognitive behavioural therapy for insomnia, usually shortened to CBT-I, is the first-line treatment for chronic insomnia in adults of any age. It is not general counselling or relaxation. It is a structured programme that typically combines stimulus control, which rebuilds the association between bed and sleep, sleep restriction, which concentrates your sleep by temporarily limiting time in bed, cognitive work on unhelpful beliefs about sleep, and relaxation training. It can be delivered face to face or digitally. Sleepio, a digital CBT-I programme, is recommended by NICE. Unlike sleeping tablets, the benefits of CBT-I tend to persist after the treatment ends.
Do sleeping tablets work, and are they safe?
Z-drugs such as zopiclone and zolpidem do shorten the time it takes to fall asleep, but they are intended for very short-term use only. UK guidance is that a hypnotic should be used at the lowest effective dose for no longer than two weeks, and preferably less than one week. Beyond that, tolerance develops, the benefit shrinks and the risk of dependence grows. They also carry real risks: next-day drowsiness that affects driving, falls and fractures in older people, and complex sleep behaviours such as sleepwalking. Guidance advises avoiding them in older people and in pregnancy or breastfeeding, and not prescribing a second hypnotic if the first has not worked. They are a short bridge, not a treatment for the underlying problem.
Can I buy melatonin over the counter in the UK?
No. Melatonin is a prescription-only medicine in the UK, unlike in the United States where it is sold as a food supplement. Prolonged-release melatonin 2mg, sold as Circadin or as a generic modified-release tablet, is licensed for the short-term treatment of primary insomnia characterised by poor quality of sleep in adults aged 55 and over, for a maximum of 13 weeks. Immediate-release melatonin 3mg is licensed for jet lag rather than insomnia, and the two are not interchangeable, because one is designed to release slowly across the night and the other to produce a sharp evening peak that shifts the body clock. Melatonin bought from overseas websites is not a UK-regulated medicine and its actual content can differ substantially from the label.
Do over-the-counter sleep aids like Nytol work?
Their effect is modest and short-lived. Most over-the-counter sleep aids sold in the UK contain a sedating antihistamine, either diphenhydramine or promethazine, and their sedative effect is a side effect of the antihistamine rather than a mechanism designed for sleep. Tolerance to that sedation develops within a few days of regular use, so they are not suited to anything beyond occasional use. They commonly cause next-day grogginess, dry mouth and constipation, and they should be avoided in older adults, in whom sedating antihistamines are associated with confusion and falls. NICE guidance does not recommend over-the-counter treatments as a management strategy for insomnia. If you have been reaching for them for weeks, that is a signal to have the insomnia properly assessed rather than a reason to keep buying them.
What is daridorexant (Quviviq)?
Daridorexant is a newer prescription medicine that works differently from traditional sleeping tablets. Rather than sedating the brain broadly, it blocks orexin, one of the signals that keeps you awake. NICE recommends it for adults whose insomnia symptoms occur on three or more nights a week, have lasted at least three months and considerably affect daytime functioning, but only where CBT-I has been tried and has not worked, or where CBT-I is unavailable or unsuitable. Treatment should be as short as possible, should be reviewed within three months of starting, and should be stopped if long-term insomnia has not responded adequately. It is a prescription-only medicine and needs a clinical assessment.
When should insomnia be investigated for another cause?
When there are signs pointing to a different sleep disorder or an untreated condition underneath. Loud snoring, choking or gasping at night, witnessed pauses in breathing and heavy daytime sleepiness suggest obstructive sleep apnoea, which needs specific assessment and is not treated with sleeping tablets. An irresistible urge to move the legs in the evening suggests restless legs syndrome. Insomnia that arrives alongside low mood, anxiety, night sweats and flushing around the menopause, night-time heartburn, poorly controlled asthma, chronic pain or a thyroid problem is usually best addressed by treating that condition. Insomnia that does not improve with treatment, or that comes with unusual behaviour during sleep, warrants referral to a sleep clinic or neurology.
Can I drive if insomnia is making me sleepy?
Not while you feel sleepy. Do not drive if you are affected by sleepiness, and be aware that sleeping tablets can impair driving into the following day. With zolpidem, for example, at least eight hours should pass between taking it and doing anything requiring alertness. Driving while impaired by a prescribed medicine is an offence in Great Britain, even when the medicine has been legitimately prescribed. The DVLA must be told if excessive sleepiness is having, or is likely to have, an adverse effect on your driving, which includes obstructive sleep apnoea of any severity, conditions such as narcolepsy, and any other condition or medication causing excessive sleepiness. Insomnia alone, without excessive daytime sleepiness, is not in itself notifiable.
If a prescription treatment is appropriate for you, these are the sleep treatments available through Access Doctor following a clinical assessment.
Quviviq (Daridorexant) 50mg
Orexin receptor antagonist, NICE-recommended for long-term insomnia where CBT-I has not worked.
View product →Circadin 2mg Prolonged-Release Melatonin
The originator brand of prolonged-release melatonin, for primary insomnia in adults aged 55 and over.
View product →Melatonin 2mg Modified-Release
The same medicine as Circadin in generic form, at a lower cost over a 13-week course.
View product →Nytol One-A-Night 50mg
Diphenhydramine for occasional short-term sleep disturbance. Not for continuous use.
View product →Sominex 20mg
Promethazine for temporary sleep disturbance. Tolerance develops with regular use.
View product →Kalms Night One-A-Night 385mg
Traditional herbal valerian preparation for temporary sleep disturbance.
View product →References
- NICE Clinical Knowledge Summaries. Insomnia. Last revised June 2026. cks.nice.org.uk
- National Institute for Health and Care Excellence. Daridorexant for treating long-term insomnia (TA922). 18 October 2023. nice.org.uk
- National Institute for Health and Care Excellence. Sleepio to treat insomnia and insomnia symptoms (MTG70). 20 May 2022. nice.org.uk
- National Institute for Health and Care Excellence. Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia (TA77). 2004. nice.org.uk
- NHS. Insomnia. nhs.uk
- Joint Formulary Committee. British National Formulary: zopiclone. bnf.nice.org.uk
- Joint Formulary Committee. British National Formulary: melatonin. bnf.nice.org.uk
- Driver and Vehicle Licensing Agency. Assessing fitness to drive: a guide for medical professionals. gov.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.
