Sleep

The NHS advises that most adults need 7 to 9 hours of sleep a night. Persistently sleeping less is associated with weight gain, type 2 diabetes, hypertension, cardiovascular disease, low mood and impaired daytime functioning.^[1]NHS

The Mental Health Foundation's Sleep Matters report and subsequent UK surveys find that around one in three adults reports symptoms of insomnia, with prevalence higher in women, shift workers and people with long-term physical or mental health conditions.^{[5]Mental Health Foundation}

Cappuccio et al.'s meta-analysis (16 cohorts, 1,382,999 participants) found a U-shaped relationship between sleep duration and mortality: ~12% higher mortality in short sleepers (≤5–6 h) and ~30% higher in long sleepers (≥9 h) versus a 7–8 h reference.^{[3]Cappuccio 2010}

A 2017 meta-analysis in Sleep Medicine linked short sleep to significantly higher risk of diabetes, hypertension, cardiovascular disease, coronary heart disease and obesity.^{[4]Itani 2017}

NICE Clinical Knowledge Summaries recommend cognitive behavioural therapy for insomnia (CBT-I) as the first-line treatment for chronic insomnia in adults. Hypnotic medication is reserved for short-term use only, due to dependence, tolerance and rebound insomnia.^{[2]NICE CKS}

In 2022, NICE issued medical technologies guidance recommending Sleepio, a digital CBT-I programme developed with Oxford researchers, for use in the NHS as a cost-saving alternative to usual GP care for adults with insomnia symptoms.^{[7]NICE MTG70} The underlying randomised trial (DIALS) in The Lancet showed clinically meaningful improvements in sleep, mental wellbeing and quality of life.^{[6]Espie 2019}

• Keep a consistent wake time, including at weekends, to anchor your circadian rhythm.
• Get bright daylight in the first hour of waking; dim the lights in the 1–2 hours before bed.
• Avoid caffeine within 8–10 hours of bedtime; its half-life is 5–6 hours.
• Keep the bedroom cool (around 18 °C), dark and quiet.
• If sleep doesn't come within ~20 minutes, get up and do something calm in dim light.

Summarised from NHS sleep guidance.^[1]NHS