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Mental health

Sleeping better without reaching for a tablet

Sleeping tablets work for a week or two and cause problems after that — here is what actually fixes long-term poor sleep.

Why sleeping tablets are a short-term tool

Medicines such as zolpidem (Stilnox) and zopiclone (Imovane) genuinely help someone sleep, and for a short, specific crisis — a bereavement, a few nights in hospital — they have a place.

The difficulty is what happens after a few weeks. The body adapts, the same dose stops working, and stopping produces rebound insomnia that is worse than the original problem — which feels like proof that the tablets were necessary. They also increase the risk of falls and next-day impairment, particularly in older people.

The rules that actually work

  • Get up at the same time every day, including weekends. Fixing the wake time is more powerful than fixing the bedtime, because it sets the whole rhythm.
  • Only go to bed when sleepy. Going early to 'catch up' means lying awake, which teaches your brain that bed is where you lie awake.
  • If you are awake for around twenty minutes, get up and do something quiet and dim until you feel sleepy, then go back. Repeat as often as needed.
  • Keep the bed for sleep and sex only. No working, scrolling or watching in bed.
  • Cut caffeine after midday. It has a long half-life and affects sleep quality even when you fall asleep fine.
  • Avoid alcohol as a sleep aid. It gets you to sleep and fragments the second half of the night badly.
  • Get daylight early in the morning. This anchors your body clock more effectively than anything you do at night.
  • Do not nap late in the day if you are struggling at night.

These work slowly — expect a couple of weeks, and expect the first few nights to be worse rather than better as your sleep consolidates. That dip is part of it, not a sign of failure.

When poor sleep is a symptom of something else

Treating insomnia as a standalone problem misses a lot. Waking in the early hours and being unable to return to sleep is a classic feature of depression. Anxiety commonly makes falling asleep difficult. Untreated pain, an overactive thyroid, and some medicines all disturb sleep.

Common questions

Is melatonin safer than a sleeping tablet?
It works differently — it shifts the body clock rather than sedating — and is most useful for jet lag or a delayed sleep pattern rather than classic insomnia. Discuss it with a pharmacist or doctor, particularly if you take other medicines or have a long-term condition.
How many hours should I be getting?
Most adults need somewhere around seven to nine, but there is real variation, and how you function during the day is a better guide than the number. Anxiously counting hours tends to make sleep worse.
I have been on sleeping tablets for years — should I just stop?
Not abruptly. Long-term use needs a planned, gradual reduction with clinical support, because stopping suddenly can cause severe rebound insomnia and, with some medicines, dangerous withdrawal. It is very doable with a plan.

Sources

Last reviewed 4 August 2026.