At a glance: Sleep and insomnia

Getting enough sleep is important for our health and wellbeing. It is not possible to say how much sleep is normal because that depends on individual factors and people’s age. It is common for children above the age of five to sleep for eight or nine hours a night. Adults sleep about seven hours a night. People sleep less as they get older: over 80-year-olds sleep around six hours a night. But these are only average times. Different people need different amounts of sleep.

When we talk about the amount of sleep people get, we mean the total sleep time – from when we turn off the light, close our eyes and try to sleep, until we wake up fully and get up in the morning. We do not need seven or eight hours of deep sleep every night. About half the time is spent in lighter sleep stages. There is no need to worry if it takes half an hour for you to fall into slightly deeper sleep after turning off the light. That is absolutely normal. You can read more about the different stages of sleep here.

Things that can disrupt sleep

Sleep problems are common: it is thought that 20 out of 100 people (20 percent) are affected. Things that can interfere with sleep include:

• alcohol, drugs and medication
• physical and mental illness
• pauses in breathing at night (sleep apnoea)
• going to the toilet at night
• shift work
• noise
• sleepwalking
• stress
• an urge to move your legs (restless legs syndrome)
• grinding your teeth (bruxism)

People are considered to have chronic insomnia if they have problems sleeping on more than three nights a week for at least a month. There is often a medical reason for this, such as depression, pain or certain medications. If that is the case, it makes sense to address the cause directly rather than only treating the insomnia.

Sleeping pills are not a long-term solution

Sleeping pills are only available on prescription and are only meant to be used for a limited amount of time. That means for a few days or at the most a few weeks, but not months or years. They can be useful if you are hardly getting any sleep at all. Medication can help you sleep a little more so that you are able to try out other approaches.

Sleeping pills are not a long-term solution for insomnia. They can have many adverse effects, lead to addiction and affect your reaction time during the day too. Driving a car or operating machinery can be particularly dangerous. Medicine for insomnia can increase the risk of falling in older people too, and interact with other medicines or alcohol.

What you can do against insomnia

One of the main things to do is avoid the things that might be interfering with your sleep, especially drinking too much alcohol. Although alcohol can help you fall asleep more quickly, it actually lowers the quality of your sleep and makes it harder for you to sleep through the night.

Changing your sleep habits can help too. The following basics could help you to sleep more peacefully and wake up less often at night:

• do not use alcohol, coffee, tea or other stimulants for four to six hours before you go to bed
• avoid smoking before bedtime or during the night
• avoid large or very spicy meals just before going to bed
• get exercise, but do not exercise strenuously just before you go to bed
• try to make sure your bedroom is quiet, dark and a comfortable temperature

It can also be helpful if you only associate your bed with sleeping and nothing else. Having a consistent schedule and certain bedtime habits can be useful here. For example:

• only going to bed when you feel tired
• getting out of bed if you are unable to sleep
• using the bed and bedroom for sleeping (and sex) only - not for reading, watching television or eating
• getting up at the same time every morning
• not having naps during the day
• getting out of bed as soon as you wake up

There are many other things you can do to try to improve your sleep – such as exercising more, doing yoga or trying phototherapy. You can read about the research on various approaches in our fact sheet.

Relaxation techniques could help you sleep more

Autogenic training and progressive muscle relaxation (also called the Jacobson method) are two relaxation techniques that are widely used to treat sleep problems. You can either learn them in a class or teach yourself how to do them, for example with the help of an audio recording. Biofeedback is another relaxation technique. You can read more about these approaches here. Research has shown that people who use relaxation techniques fall asleep a bit faster. But they do not help everyone.

Cognitive therapy: Changing your thinking patterns

"If I can’t get to sleep now, I will never get through the day tomorrow." This is a common thought that can stop people from falling asleep. In cognitive therapy people learn to recognise thoughts like this and replace them with more realistic thoughts like, “It’s normal to wake up at night. I might fall asleep again. And if I don't, then it won't be the end of the world."

In cognitive-behavioural therapy, cognitive therapy is generally combined with some of the other techniques and therapies that are described here.


Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)