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
- Mental health support and crisis resourcesSouth African Depression and Anxiety Group (SADAG)
- National Mental Health Policy Framework and Strategic PlanNational Department of Health, South Africa
Last reviewed 4 August 2026.