Category: Tiredness

Medication for epilepsy

On By KennethIn Medication, Seizures, Sodium valproate, Tiredness4 Comments
Photo by Anna Shvets on Pexels.com

Epilepsy cannot be cured with medication. However, with the right type and strength of medication, the majority of people with epilepsy do not have seizures. The medicines work by stabilising the electrical activity of the brain. You need to take medication every day to prevent seizures.

Medicines used to treat epilepsy

These include:
Carbamazepine, clobazam, clonazepam, eslicarbazepine, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital, phenytoin, pregabalin, primidone, rufinamide, sodium valproate, tiagabine, topiramate, vigabatrin and zonisamide. They all come with different brand names.

Sodium valproate is commonly used as a treatment for epilepsy. In April 2018, the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK recommended that valproate must no longer be used for any women or girl who could become pregnant unless a Pregnancy Prevention Programme is in place. The Pregnancy Prevention Programme is a system of ensuring all female patients taking valproate medicines:

  • Have been told and understand the risks of use in pregnancy and have signed a Risk Acknowledgement Form.
  • Are on highly effective contraception if necessary.
  • See their specialist at least every year.

How effective is medication used for epilepsy?

The success in controlling seizures by medication varies depending on the type of epilepsy. For example, if no underlying cause can be found for your seizures (idiopathic epilepsy), you have a very good chance that medication can fully control your seizures. Seizures caused by some underlying brain problems may be more difficult to control.

The overall outlook is better than many people realise. The following figures are based on studies of people with epilepsy, which looked back over a five-year period. These figures are based on grouping together people with all types of epilepsy, which gives an overall picture:

  • About 5 in 10 people with epilepsy will have no seizures at all over a five-year period. Many of these people will be taking medication to control seizures. Some will have stopped treatment having had two or more years without a seizure whilst taking medication.
  • About 3 in 10 people with epilepsy will have some seizures in this five-year period but far fewer than if they had not taken medication.
  • So, in total, with medication about 8 in 10 people with epilepsy are well controlled with either no, or few, seizures.
  • The remaining 2 in 10 people experience seizures, despite medication.

Which medicine is the most suitable?

Deciding on which medicine to prescribe depends on such things as:

  • Your type of epilepsy.
  • Your age.
  • Other medicines that you may take for other conditions.
  • Possible side-effects.
  • Whether you are pregnant or planning a pregnancy.

There are popular first-choice medicines for each type of epilepsy. However, if one medicine does not suit, another may be better.

A low dose is usually started. The aim is to control seizures at the lowest dose possible. If you have further seizures, the dose is usually increased. There is a maximum dose allowed for each medicine. In about 7 in 10 cases, one medicine can control all, or most, seizures. Medicines may come as tablets, soluble tablets, capsules or liquids to suit all ages.

What if seizures still occur?

In about 3 in 10 cases, seizures are not controlled despite taking one medicine. This may be because the dosage or timing of the medication needs re-assessing. A common reason why seizures continue to occur is because medication is not taken correctly. If in doubt, your doctor or pharmacist can offer advice.

If you have taken a medicine correctly up to its maximum allowed dose but it has not worked well to control your seizures, you may be advised to try a different medicine. If that does not work alone, taking two medicines together may be advised. However, in about 2 in 10 cases, seizures are not well controlled even with two medicines.

When is medication started?

The decision when to start medication may be difficult. A first seizure may not mean that you have ongoing epilepsy. A second seizure may never happen, or occur years after the first. For many people, it is difficult to predict if seizures will recur.

Another factor to consider is how severe seizures are. If the first seizure was severe, you may opt to start medication immediately. In contrast, some people have seizures with relatively mild symptoms. Even if the seizures occur quite often, they might not cause much problem and some people in this situation opt not to take any medication.

The decision to start medication should be made by weighing up all the pros and cons of starting, or not starting, treatment. A popular option is to wait and see after a first seizure. If you have a second seizure within a few months, more are likely. Medication is commonly started after a second seizure that occurs within 12 months of the first. However, there are no definite rules and the decision to start medication should be made after a full discussion with your doctor.

What about side-effects?

All medicines have possible side-effects that affect some people. All known possible side-effects are listed in the leaflet which comes in the medicine packet. If you read this it may appear alarming. However, in practice, most people have few or no side-effects, or just minor ones. Many side-effects listed are rare. Each medicine has its own set of possible side-effects. Therefore, if you are troubled with a side-effect, a change of medication may resolve the problem.

When you start a medicine, ask your doctor about any problems which may arise for your particular medicine. Two groups of problems may be mentioned:

  • Side-effects which are relatively common but are not usually serious. For example, sleepiness is a common side-effect of some medicines. This tends to be worse when first started. This problem often eases or goes once the body gets used to the medicine. Other minor side-effects may settle down after a few weeks of treatment. If you become unsteady, it may indicate the dose is too high.
  • Side-effects which are serious but rare. Your doctor may advise what to look out for. For example, it is important to report any rashes or bruising whilst taking some types of medicine.

Note: you should not stop taking a medicine suddenly. If you notice a side-effect, you should ask your doctor for advice.

Taking your medication correctly

It is important to take your medicine as prescribed. Try to get into a daily routine. Forgetting an occasional dose is not a problem for some people; however, for others this would lead to breakthrough seizures. One of the reasons why seizures recur is due to medication not having been taken properly. A pharmacist can be a good source of advice if you have any queries about medication.

Prescription medicines are free if you have epilepsy

You will need an exemption certificate. Ask your pharmacist for details.

Some medicines taken for other conditions may interfere with medication for epilepsy. If you are prescribed or buy another medicine, always remind your doctor or pharmacist that you take medication for epilepsy. Even preparations such as indigestion medicines may interact with your epilepsy medication, which may increase your chance of having a seizure.

Some epilepsy treatments interfere with the contraceptive pill. You may need a higher-dose pill or an alternative method of contraception. For reliable contraception, it is best to seek advice from a doctor or nurse. They will be able to tell you if your epilepsy treatment affects any methods of contraception.

For women with epilepsy, the risk of complications during pregnancy and labour is slightly higher than for women without epilepsy. The small increase in risk is due to the small risk of harm coming to a baby if you have a serious seizure whilst pregnant. There is also a small risk of harm to an unborn baby from anti-epilepsy medicines.

Before becoming pregnant it is important to seek advice from your doctor. Any potential risks can be discussed. For example, to go over your current medication and to see if it should be changed to minimise the risk of harm to a developing baby. One important point is that you should take extra folic acid (folate) before becoming pregnant and continue it until you are 12 weeks pregnant.

If you have an unplanned pregnancy, you should not stop epilepsy medication, which may risk a seizure occurring. Continue your medication and see a doctor as soon as possible. See the separate leaflet called Epilepsy and Planning Pregnancy for more details.

You may wish to consider stopping medication if you have not had any seizures for two or more years. It is important to discuss this with a doctor. The chance of seizures recurring is higher for some types of epilepsy than others. Overall, if you have not had any seizures for 2-3 years and you then stop medication:

  • About 6 in 10 people will remain free of seizures two years after stopping medication. If seizures do not return within two years after stopping medication, the long-term outlook is good. However, there is still a small chance of a recurrence in the future.
  • About 4 in 10 people will have a recurrence within two years.

There are many different types of epilepsy, some of which are age-dependent but some that will need medication for life. Your epilepsy specialist should be able to offer you more advice about the long-term outlook for your particular type of epilepsy.

Your life circumstances may influence the decision about stopping medication. For example, if you have recently regained your driving licence, the risk of losing it again for a year if a seizure occurs may affect your decision. However, if you are a teenager who has been free of seizures for some years, you may be happy to take the risk.

If a decision is made to stop medication, it is best done gradually, reducing the dose over a period of several weeks or months. It is important to follow the advice given by your doctor.

  • Surgery to remove a small part of the brain, which is the underlying cause of the epilepsy. Surgery is only possible for a minority of people with epilepsy and it may be considered when medication fails to prevent seizures, especially focal seizures (used to be called partial seizures). Only a small number of people with epilepsy are suitable for surgery and, even for those that are, there are no guarantees of success. Also, there are risks from operations. However, surgical techniques continue to improve and surgery may become an option for more and more people in the future.
  • Vagal nerve stimulation is a treatment for epilepsy where a small generator is implanted under the skin below the left collarbone. The vagus nerve is stimulated to reduce the frequency and intensity of seizures. This can be suitable for some people with seizures that are difficult to control with medication.
  • The ketogenic diet is a diet very high in fat, low in protein and almost carbohydrate-free. This can be effective in the treatment of difficult-to-control seizures in some children.
  • Complementary therapies such as aromatherapy may help with relaxation and relieve stress but have no proven effect on preventing seizures.
  • Counselling. Some people with epilepsy become anxious or depressed about their condition. A doctor may be able to arrange counselling with the aim of overcoming such feelings. Genetic counselling may be appropriate if the type of epilepsy is thought to have an hereditary pattern.

Some people with epilepsy are prescribed a medicine that a relative or friend can administer in emergencies to stop a prolonged seizure. In most people with epilepsy, seizures do not last more than a few minutes. However, in some cases a seizure lasts longer and a medicine can be used to stop it. A doctor or nurse should give instruction on how and when to administer the medicine.

The most commonly used medicine for this is diazepam. This can be squirted from a tube into the person’s anus (rectal diazepam). This is absorbed quickly into the bloodstream from the rectum and so works quickly. More recently, a medicine called midazolam has been used which is easier to administer. It is squirted into the sides of the mouth where it is absorbed directly into the bloodstream.

There is often no apparent reason why a seizure occurs at one time and not another. However, some people with epilepsy find that certain triggers make a seizure more likely. These are not the cause of epilepsy but may trigger a seizure on some occasions.

Possible triggers may include:

  • Stress or anxiety.
  • Heavy drinking.
  • Street drugs.
  • Some medicines such as antidepressants, antipsychotic medication.
  • Lack of sleep, or tiredness.
  • Irregular meals which cause a low blood sugar level.
  • Flickering lights such as from strobe lighting.
  • Periods (menstruation).
  • Illnesses which cause a high temperature (fever), such as flu or other infections.

If you suspect a trigger it may be worth keeping a diary to see if there is any pattern to the seizures. Some are unavoidable but treatment may be able to be tailored to some triggers. For example:

  • Keeping to regular mealtimes and bedtimes may be helpful for some people.
  • Learning to relax may help. Your doctor may be able to advise about relaxation techniques.
  • A small number of people with epilepsy have photosensitive seizures. This means that seizures may be triggered by flickering lights from the TV, video games, disco lights, etc. Avoiding these may be an important part of treatment for some people. (Photosensitive epilepsy can be confirmed by hospital tests. Most people with epilepsy do not have photosensitive seizures and do not have to avoid TVs, videos, discos, etc.)

Clinical Depression

On By KennethIn Angry, Anxiety, Sadness, Tiredness, Uncategorized1 Comment
Photo by Du01b0u01a1ng Nhu00e2n on Pexels.com

Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression. Clinical depression is the more-severe form of depression, also known as major depression or major depressive disorder. It isn’t the same as depression caused by a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder.

To diagnose clinical depression, many doctors use the symptom criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Signs and symptoms of clinical depression may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

Symptoms are usually severe enough to cause noticeable problems in relationships with others or in day-to-day activities, such as work, school or social activities.

Clinical depression can affect people of any age, including children. However, clinical depression symptoms, even if severe, usually improve with psychological counseling, antidepressant medications or a combination of the two.

Type 2 diabetes Symptoms

On By KennethIn Healthy Diet, Tiredness, Weight LossLeave a comment

Check if you have type 2 diabetes

Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

  • peeing more than usual, particularly at night
  • feeling thirsty all the time
  • feeling very tired
  • losing weight without trying to
  • itching around your penis or vagina, or repeatedly getting thrush
  • cuts or wounds taking longer to heal
  • blurred vision

You’re more at risk of developing type 2 diabetes if you:

  • are over 40 (or 25 for south Asian people)
  • have a close relative with diabetes (such as a parent, brother or sister)
  • are overweight or obese
  • are of Asian, African-Caribbean or black African origin (even if you were born in the UK)

Type 2 diabetes is often diagnosed following blood or urine tests for something else.

However, you should see a GP straight away if you have any symptoms of diabetes.

To find out if you have type 2 diabetes, you usually have to go through the following steps:

  1. See a GP about your symptoms.
  2. The GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back.
  3. If you have diabetes, the GP will explain the test results and what will happen next.

If you’re diagnosed with diabetes

What the GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

Generally, they’ll talk to you about:

  • what diabetes is
  • what high blood sugar means for your health
  • whether you need to take medicine
  • your diet and exercise
  • your lifestyle – for example, alcohol and smoking

If you have questions about your diagnosis

It’s usually difficult to take in everything the GP tells you during the appointment.

Talk to family and friends about what the GP told you, and write down any questions you have.

Then make another GP appointment and take your list of questions with you.

There’s also a lot of information on diabetes available.

What happens after the diagnosis

Usually, the following things happen after your diagnosis:

  1. The GP may prescribe medicine. It might take time for you to get used to the medicine and to find the right doses for you.
  2. You will usually need to make changes to your diet and be more active.
  3. You’ll have to go for regular type 2 diabetes check-ups.
  4. You’ll have to look out for certain signs to avoid other health problems.

A free education course for type 2 diabetes can help you manage your condition.

Most people need medicine to control their type 2 diabetes.

This helps keep your blood sugar level as normal as possible to prevent health problems.

You may have to take it for the rest of your life, although your medicine or dose may need to change over time.

Adjusting your diet and being active is usually also necessary to keep your blood sugar level down.

Medicines for type 2 diabetes

There are many types of medicine for type 2 diabetes. It can take time to find a medicine and dose that’s right for you.

You’ll usually be offered a medicine called metformin first.

You may need to take extra medicines, or a different medicine such as insulin, if:

  • treatment is not keeping your blood sugar levels within a healthy range
  • you have heart problems or need to lose weight

Your GP or diabetes nurse will recommend the medicines most suitable for you.

Your medicine might not make you feel any different, but this does not mean it’s not working. It’s important to keep taking it to help prevent future health problems.

Metformin

Metformin is the most common medicine for type 2 diabetes. It can help keep your blood sugar at a healthy level.

It comes as tablets you take with or after meals.

Common side effects of metformin include feeling or being sick and diarrhoea. If this happens to you, your doctor may suggest trying a different type called slow-release metformin.

Type two Diabetes

On By KennethIn blurred vision, Thirsy, Tiredness, Type 2 Diabetes, Weight LossLeave a comment

What is type 2 diabetes?-Type 2 diabetes

    • Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high.
    • It can cause symptoms like excessive thirst, needing to pee a lot and tiredness. It can also increase your risk of getting serious problems with your eyes, heart and nerves.
    • It’s a lifelong condition that can affect your everyday life. You may need to change your diet, take medicines and have regular check-ups.
    • It’s caused by problems with a chemical in the body (hormone) called insulin. It’s often linked to being overweight or inactive, or having a family history of type 2 diabetes.

        Check if you have type 2 diabetes

        Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

        Symptoms of type 2 diabetes include:

        • peeing more than usual, particularly at night
        • feeling thirsty all the time
        • feeling very tired
        • losing weight without trying to
        • itching around your penis or vagina, or repeatedly getting thrush
        • cuts or wounds taking longer to heal
        • blurred vision

        You’re more at risk of developing type 2 diabetes if you:

        • are over 40 (or 25 for south Asian people)
        • have a close relative with diabetes (such as a parent, brother or sister)
        • are overweight or obese
        • are of Asian, African-Caribbean or black African origin (even if you were born in the UK)

        Type 2 diabetes is often diagnosed following blood or urine tests for something else.

        However, you should see a GP straight away if you have any symptoms of diabetes.

        To find out if you have type 2 diabetes, you usually have to go through the following steps:

        1. See a GP about your symptoms.
        2. The GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back.
        3. If you have diabetes, the GP will explain the test results and what will happen next.

        If you’re diagnosed with diabetes

        What the GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

        Generally, they’ll talk to you about:

        • what diabetes is
        • what high blood sugar means for your health
        • whether you need to take medicine
        • your diet and exercise
        • your lifestyle – for example, alcohol and smoking

        Important:Important

        The GP will do their best to discuss the diagnosis with you, but this first appointment might only be 10 to 15 minutes.

        If you have questions about your diagnosis

        It’s usually difficult to take in everything the GP tells you during the appointment.

        Talk to family and friends about what the GP told you, and write down any questions you have.

        Then make another GP appointment and take your list of questions with you.

        There’s also a lot of information on diabetes available.

        What happens after the diagnosis

        Usually, the following things happen after your diagnosis:

        1. The GP may prescribe medicine. It might take time for you to get used to the medicine and to find the right doses for you.
        2. You will usually need to make changes to your diet and be more active.
        3. You’ll have to go for regular type 2 diabetes check-ups.
        4. You’ll have to look out for certain signs to avoid other health problems.

        A free education course for type 2 diabetes can help you manage your condition.

        Sign yourself up online to Healthy living for people with type 2 diabetes. The GP may refer you to Diabetes education and self management for ongoing and newly diagnosed (DESMOND).

        How to manage stress

        On By KennethIn Anxiety, Depression, Pressure, Stress, TirednessLeave a comment

        Explains what stress is, what might cause it and how it can affect you. Includes information about ways you can help yourself and how to get support.

        What is stress?

        We all know what it’s like to feel stressed, but it’s not easy to pin down exactly what stress means. When we say things like “this is stressful” or “I’m stressed”, we might be talking about:

        • Situations or events that put pressure on us – for example, times where we have lots to do and think about, or don’t have much control over what happens.
        • Our reaction to being placed under pressure – the feelings we get when we have demands placed on us that we find difficult to cope with.

        “It’s overwhelming. Sometimes you can’t see beyond the thick fog of stress.”

        There’s no medical definition of stress, and health care professionals often disagree over whether stress is the cause of problems or the result of them. This can make it difficult for you to work out what causes your feelings of stress, or how to deal with them. But whatever your personal definition of stress is, it’s likely that you can learn to manage your stress better by:

        • managing external pressures, so stressful situations don’t seem to happen to you quite so often
        • developing your emotional resilience, so you’re better at coping with tough situations when they do happen and don’t feel quite so stressed

        Is stress a mental health problem?

        Being under pressure is a normal part of life. It can help you take action, feel more energised and get results. But if you often become overwhelmed by stress, these feelings could start to be a problem for you.

        Stress isn’t a psychiatric diagnosis, but it’s closely linked to your mental health in two important ways:

        • Stress can cause mental health problems, and make existing problems worse. For example, if you often struggle to manage feelings of stress, you might develop a mental health problem like anxiety or depression.
        • Mental health problems can cause stress. You might find coping with the day-to-day symptoms of your mental health problem, as well as potentially needing to manage medication, heath care appointments or treatments, can become extra sources of stress.

        This can start to feel like a vicious circle, and it might be hard to see where stress ends and your mental health problem begins.

        “[When I’m stressed] I feel like I’m on the verge of a breakdown.”

        Why does stress affect me physically?

        You might find that your first clues about being stressed are physical signs, such as tiredness, headaches or an upset stomach.

        There could be many reasons for this, as when we feel stressed we often find it hard to sleep or eat well, and poor diet and lack of sleep can both affect our physical health. This in turn can make us feel more stressed emotionally.

        Also, when we feel anxious, our bodies release hormones called cortisol and adrenaline. (This is the body’s automatic way of preparing to respond to a threat, sometimes called the ‘fight, flight or freeze’ response). If you’re often stressed then you’re probably producing high levels of these hormones, which can make you feel physically unwell and could affect your health in the longer term.

        Insomnia

        On By KennethIn Blood Pressure, Concentration, Diabetes, Heart disease, Menopause, TirednessLeave a comment

        Insomnia is when you find it difficult getting to sleep or staying asleep for long enough to feel refreshed the next morning. It can affect your quality of life if you feel tired and find it hard to concentrate during the day.

        man looking out window

        About insomnia

        It’s important to have enough good quality sleep in order to function properly – it helps to rest and repair your body and mind. Most adults need around seven to nine hours’ sleep each night.

        Insomnia is thought to affect about a third of people in the UK. You’re more likely to have difficulty sleeping as you get older because your sleep pattern changes – half of people over 65 have insomnia at some point.

        Symptoms of insomnia

        If you have insomnia, it means that despite having the time and opportunity to get enough sleep, you may:

        • have difficulty getting to sleep
        • difficulty staying asleep (waking up often and finding it hard to get back to sleep)
        • wake up early in the morning
        • feel tired, irritable and unable to concentrate the next day

        You might have such problems for a few weeks (short-term insomnia) or they may carry on for longer (long-term insomnia). If you continue to have trouble sleeping over a long time, it can really start to affect all aspects of your life – including work or school, and your social and home life. It can also make you more likely to develop various health problems such as obesity, diabetes, high blood pressure, heart problems and depression.

        Causes of insomnia

        There can be many things that contribute to insomnia. Here are just some of the potential causes. 

        • Environmental factors such as noise, light seeping through your blinds, an uncomfortable bed or feeling too hot or cold can all affect your ability to sleep.
        • Lifestyle habits such as an irregular sleep routine, eating late at night, not getting enough exercise, or exercising too late at night can make it difficult to sleep.
        • Something causing you temporary stress or worry such as a new job, work stress, financial concerns or a bereavement in the family may keep you awake.
        • Having a mental health condition such as stress, anxiety or depression may cause insomnia.
        • Jet lag and shift work can disturb your sleep patterns.
        • Drinking alcohol can have a significant impact on your quality of sleep. Many people see alcohol as a way to help with sleep problems; but the effect it has on your sleep can make the situation worse.
        • Too much caffeine – for instance, drinking lots of tea and coffee – can keep you awake.
        • Certain medicines including antidepressants and medicines for high blood pressure and epilepsy can affect how well you sleep.
        • Certain health conditions such as an overactive thyroid, asthma, acid reflux or heart disease can make it hard to sleep. Night sweats due to the menopause may cause insomnia. For more information on this, see our FAQ: Can the menopause cause insomnia?

        Self help for insomnia

        It’s worth thinking about ways to improve your sleep habits and routines to help you to sleep well. This is often referred to as ‘sleep hygiene’. Here are some do’s and don’ts to try.

        Dos

        • Establish a regular bedtime routine by going to bed and getting up at roughly the same times every day. Try not to sleep in late to compensate for a bad night’s sleep.
        • Make sure you get some regular exercise, but don’t do any strenuous activity within four hours of going to bed because this might disturb your sleep.
        • Try to relax before bedtime. You could try having a warm bath, a warm milky drink, reading or listening to soothing music to help you relax. Some people find meditation or mindfulness techniques helpful. There are guides available online that you can try for free.
        • If you can’t sleep within half an hour or so, get up and do something relaxing like reading until you feel tired enough to sleep. If something is on your mind, write it down and aim to deal with it the next day.
        • Make sure your bedroom is comfortable – not too hot, cold, noisy or bright – and you have a supportive, comfy mattress on your bed.
        • Where possible, try to avoid using your bedroom for work.

        Don’ts

        • Don’t have any drinks that contain caffeine or alcohol within six hours of going to bed.
        • Don’t smoke before you go to bed.
        • Don’t eat a heavy or rich meal late at night.
        • Try not to clock-watch. It might make you feel more frustrated about being awake and stop you getting back to sleep.
        • Try to have a break from screen time, including phones and tablets before bed. Using these devices at bedtime is associated with inadequate sleep – particularly in children.
        • Don’t take naps during the day. It can make it difficult for you to sleep at night.

        Seeking help for insomnia

        If you’ve tried the self-help measures and you’re still having trouble sleeping, it’s worth seeing your GP for advice. Your GP will ask you about your sleep patterns and how lack of sleep might be impacting your life. They may also examine you to look for any signs of a physical condition that could affect your sleep. Most of the time, your GP will be able to tell if you’re having sleep problems and what might be causing them just from talking to you.

        If there doesn’t seem to be an obvious cause for your insomnia, they may suggest keeping a sleep diary for a couple of weeks. It can be a good idea to do this before your appointment. Record things like:

        • the time you go to bed
        • how long it takes you to get to sleep
        • how often you wake up during the night and for how long
        • what time you wake up in the morning
        • if you feel tired during the day or have any naps
        • your mealtimes and how much alcohol and caffeine you drink during the day
        • how much exercise you do or any significant events during the day

        Devices that track your sleep can often give you an estimate of the amount of sleep you’re getting. But they’re not always very accurate, so you shouldn’t rely on them. If your GP thinks you might have a specific sleep disorder, they may refer you to a sleep specialist for more tests. For more information, see our FAQ, What do tests for insomnia involve?

        If you need help now

        This page is designed to provide general health information. If you need help now, please use the following services.

        If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999 or go to your local accident and emergency department.

        Treatment of insomnia

        If you have any health conditions that could be affecting your sleep, your GP will make sure you’re receiving the right treatment for these. For instance, if you’re waking up due to pain or hot flushes, your GP can prescribe treatment. They will also go through the sleep hygiene measures listed in the section, Self-help for insomnia. They may suggest some of the following treatment options.  

        Behavioural therapies

        If you’ve been having trouble sleeping for several weeks or more, your GP may suggest referring you to psychological services to try a behavioural therapy. These may include the following.

        • Cognitive behavioural therapy (CBT) can help you to recognise and deal with any negative thoughts and habits around your sleep. CBT is often combined with one of the other methods.
        • Stimulus-control therapy can help you to re-associate your bed and bedroom with going to sleep and to create a regular sleep routine.
        • Relaxation therapy can help you relax your muscles and clear your mind of distracting thoughts.
        • Sleep-restriction therapy limits the amount of time you spend in bed to the time when you actually go to sleep. You can then gradually increase the time you spend in bed as your sleep improves.

        Your GP may refer you to an appropriate specialist who can provide these therapies, or they may provide you with self-help materials. In some areas, your GP may be able to give you access to online CBT-based self-help tools, such as Sleepio.

        Medicines

        Doctors only recommend medicines for insomnia (sleeping pills) as a last resort, if you’re unable to function during the day because of insomnia. These medicines are often associated with side-effects such as making you feel sleepy the next day. They also become gradually less effective the longer you take them, and you can become dependent on them if you take them for a long time. If you take them, you should only use them for as short a time as possible.

        The main types of sleeping tablets include the following.

        • Antihistamines, which you can buy over-the-counter from your pharmacy without a prescription. Examples are Nytol, Phenergan and Sominex. These aren’t suitable if you’re pregnant, breastfeeding or have certain health conditions. If you’re in any doubt, check with your pharmacist or doctor before taking them.
        • Hypnotic medicines, which your GP may prescribe for a limited time if your insomnia is having a really severe effect on your day-to-day life. Examples include benzodiazepines, such as temazepam or loprazolam, and non-benzodiazepine ‘z-drugs’, such as zopiclone, zaleplon or zolpidem.
        • Melatonin, which your doctor may prescribe for up to 13 weeks, if you’re over 55 and are having ongoing problems with insomnia. Melatonin is a hormone that your body produces, which helps to control your sleep pattern. It’s worth bearing in mind that it can cause some side-effects like headaches and joint pain.

        If you take sleeping pills, be sure to follow any advice from your doctor or pharmacist, and take note of any warnings in the information leaflet. These may include not driving or operating machinery during the day after using them, for example.

        Complementary therapies

        There isn’t enough good quality research to show whether complementary therapies like acupuncture, homeopathy and herbal remedies help with insomnia, but some people do try them. If you decide to give them a try, make sure you choose a reputable practitioner, registered with the appropriate regulatory body.

        Frequently asked questions

        • Can the menopause cause insomnia? Yes, insomnia is common during the menopause – often because of symptoms such as hot flushes and night sweats. Making a few lifestyle changes can help to reduce hot flushes and night sweats. Try wearing lighter clothing or sleeping in a cooler room. And try to avoid potential triggers, such as spicy food, caffeine, smoking and alcoholic drinks.If you’re finding it difficult to manage symptoms of the menopause, your GP may suggest trying hormone replacement therapy (HRT). This can help to control your symptoms, which in turn, may help you to sleep. There are risks and benefits of taking HRT, so it’s important to talk these through with your GP.
        • How do I know if I’m getting a good night’s sleep?The amount of sleep you need is individual to you, but most adults need about seven to nine hours’ sleep a night. General signs of a good night’s sleep include:
          • it taking you less than half an hour to fall asleep
          • you have fewer than three ‘mini wakes’ (when you briefly wake up for a minute or two) – throughout the night
          • feeling refreshed once you’ve woken up in the morning
            If you’re having trouble getting to sleep and feel that it’s affecting your life, contact your GP for advice.
        • What do tests for insomnia involve? Most people with insomnia can be diagnosed simply by describing their symptoms to their GP. If your GP thinks your insomnia may be caused by a specific sleep disorder, they may refer you to a sleep clinic or a specialist for further tests. Such disorders include sleep apnoea and restless leg syndrome. Specific sleep disorder tests include the following.
          • Actigraphy. This can track your sleep habits over extended periods of several days or more. You wear a small, wristwatch-sized device that monitors your movement in relation to times of day.
          • A polysomnography test can record your brain activity, eye movements, sleep quality, heart rate and blood pressure, and assess your breathing. You’ll usually need to stay overnight at a sleep clinic for this test, although some private clinics offer a service where it can be performed in your own home.
            Your doctor may use these tests alongside sleep diaries to identify any sleep-related problems that you may have.

        A day in the life of a young carer

        On By KennethIn Tiredness, Worry, Young CarerLeave a comment

        Being a young carer has to fit around our everyday activities and our routines. Despite our caring roles, we still attend school, something we juggle five days a week.

        Morning

        The hardest thing about being a young carer can be not getting enough sleep

        I wake up and feel tired and sick

        Before I leave for school I would tell my mum to ring me if needed and I’d ring back at lunch time

        During the school day

        School can make us feel different things…

        School can take our mind off things, and allow a break from the caring role, but throughout the day we can worry about the person we care about.

        My school lets me call at break time from the office

        We really want to be able to call or message to check on them, but unfortunately schools don’t always allow us to use mobile phones on the school premises. Sometimes it feels like no one understands. There aren’t assemblies on being a young carer so it can feel difficult to talk to people about it.

        I just stay quiet, I don’t tell my friends or if they ask questions I make excuses

        We had an assembly for mental health awareness week, it made me think about my mum a lot and I felt sad

        Most of us have support at school – we feel more likely to go talk to a member of staff rather than a classmate, but this isn’t always as thorough as we’d hope for.

        They kind of provide support, but something more than just talking would be better

        After school

        The first thing I do when I finish school is check my phone for messages from my dad

        We usually go straight home. It can be difficult fitting everything in; our caring roles often mean that we aren’t able to see friends, do after school activities or even do our homework.

        After school, I go see my Mum first and see what she needs help with, after checking on her I get on with my chores

        I very rarely go out after school or spend time with friends

        Sometimes I haven’t done my homework in time and I have to copy off my friends or rush it last minute

        On a Wednesday I go play football, I can’t let the team down but it also feels bad leaving my Mum

        Bed

        Before bed, we make sure everything is taken care of and prepare for the next day.

        I get stuff ready for the next day and my stuff for school

        The last thing I do before bed is check that my dad has taken his tablets