If you live with generalised anxiety disorder (GAD), you probably know the 2am spiral well. Your body is exhausted, but your mind won't stop running through tomorrow, last week and every “what if” in between. The NHS lists difficulty sleeping as a common sign of GAD (NHS, 2024a), so if this is you, you're far from alone.
This guide covers everyday habits, talking therapies, free NHS services, prescribed medicines, pharmacy sleep aids and herbal remedies, and which types of sleep problem each one is most likely to help.
Key insight: break the loop
One person quoted on Mind's sleep pages sums it up: poor sleep leads to worrying, and worrying leads to poor sleep (Mind, 2024b). Breaking the loop at either end helps both.
Please note
This page is general information, not medical advice. Never start, stop or change a medicine without talking to your GP, pharmacist or prescriber.
What kind of sleep problem do you have?
Insomnia isn't one thing. Knowing your main problem can help you and your GP choose what to try first.
| Your main problem | What may help most |
|---|---|
| Trouble falling asleep | A wind-down routine, a worry list, relaxation and breathing exercises, sleep restriction therapy (with a later bedtime), CBT for insomnia |
| Waking up in the night | The 20-minute rule (get up if you can't sleep), CBT for insomnia, avoiding tea, coffee, alcohol and smoking in the evening |
| Waking too early | Sleep restriction therapy (with an earlier wake time), CBT for insomnia |
| A racing, worried mind | CBT for anxiety through NHS Talking Therapies, writing worries down, meditation |
| Insomnia lasting 3 months or more | CBT for insomnia first. If that's not enough, your GP may discuss medicine |
Sources: NHS (2024b); NHS Every Mind Matters (n.d.a; n.d.b); Sleepstation (2023); Riemann et al. (2023).
1. Sleep habits that help
“Sleep hygiene” simply means the daily habits and bedroom set-up that make good sleep more likely. Together, they teach your body when it's time to switch off (NHS, 2024b; NHS Every Mind Matters, n.d.a).
Your routine
| Try this | Why it helps |
|---|---|
| Get up at the same time every day, weekends included | Sets your body clock, so sleepiness arrives at a predictable time |
| Only go to bed when you feel sleepy | Lying awake in bed can turn it into a place for worrying |
| Awake for about 20 minutes? Get up and do something calm, then go back when sleepy | Breaks the link between your bed and tossing and turning |
| Skip daytime naps | Saves your sleepiness for the night |
Your evening
| Try this | Why it helps |
|---|---|
| Relax for at least an hour before bed, and put phones, tablets and computers away | Screen light and scrolling keep your brain alert |
| Write down worries and tomorrow's to-do list | Gets them out of your head and onto paper, so you don't have to “hold” them all night |
| Avoid tea, coffee, alcohol and smoking for at least 6 hours before bed | All of these can make it harder to get to sleep and stay asleep |
| Avoid big meals late at night | A full stomach can keep you awake |
| Be active during the day, but avoid exercise in the 4 hours before bed | Builds natural tiredness without leaving you wired at bedtime |
Your bedroom
| Try this | Why it helps |
|---|---|
| Keep your bedroom dark, quiet and cool | Makes it easier to fall asleep and stay asleep |
| Try blackout curtains, an eye mask, earplugs or white noise | Blocks light and noise you can't control, such as streetlights or traffic |
Sources: NHS (2024b); NHS Every Mind Matters (n.d.a).
2. Therapies that can help
Cognitive behavioural therapy for insomnia (CBT-I) is recommended as the first treatment for long-term insomnia in adults, including people with anxiety. It can be done in person or online (Riemann et al., 2023). GPs now rarely prescribe sleeping pills to treat insomnia (NHS, 2024b).
| Therapy | What it involves | Most helpful for |
|---|---|---|
| CBT for insomnia (CBT-I) | A short, structured course that changes the thoughts and habits keeping you awake. It usually includes several of the techniques below. | Long-term insomnia of any kind (Riemann et al., 2023) |
| Sleep restriction therapy | Cutting your time in bed to match the sleep you actually get, then slowly adding time back. You may feel sleepier during the day at first, so it's best done with a trained therapist. | Trouble falling asleep and waking too early (Sleepstation, 2023) |
| Stimulus control | Going to bed only when sleepy, and getting up if you're awake for around 20 minutes | Breaking the habit of lying awake in bed (NHS, 2024b; NHS Every Mind Matters, n.d.a) |
| Relaxation and meditation | Guided meditation, 4-7-8 breathing (breathe in for 4, hold for 7, out for 8) and progressive muscle relaxation (tensing then relaxing each muscle group) | Falling asleep when your mind is racing (NHS Every Mind Matters, n.d.b) |
| CBT for anxiety | Talking therapy or guided self-help for anxiety, alone or in a group | When worry is the main thing keeping you awake (NHS, 2024c) |
| Exercise and light therapy | Regular physical activity, and planned exposure to bright light | Useful add-ons alongside CBT-I (Riemann et al., 2023) |
3. Free NHS services
These services offer CBT-I or anxiety support. Availability varies by area, so check before you sign up.
| Service | What it is | How to get it |
|---|---|---|
| Sleepstation | Online CBT-I course with support from sleep coaches | NHS-funded in some areas of England, but not everywhere. Search for your GP surgery on its website to see if you can apply yourself, or ask your GP. Not recommended if you have epilepsy, psychosis, bipolar disorder or schizophrenia, are at high risk of falls, or are in a mental health crisis (Sleepstation, n.d.). |
| Sleepio | App-based CBT-I course recommended by NICE (NICE, 2022) | Free for everyone in Scotland and in some parts of England, with no prescription or referral needed (Big Health, n.d.; Right Decisions, n.d.). |
| NHS Talking Therapies | Talking therapy for anxiety and depression | In England, refer yourself without seeing a GP. You need to be registered with a GP and aged 18 or over (16 or over in some areas) (NHS, 2025d). |
| NHS sleep clinics | Specialist assessment and CBT-I, usually in small groups, such as UCLH's insomnia clinic in London | Referral from your GP or a hospital service. There may be a wait for a place (UCLH, n.d.). |
4. Prescribed sleep medicines
If CBT-I hasn't worked well enough, a doctor may offer medicine. European guidance says sleeping pills are mainly for short-term use, usually 4 weeks or less, because your body gets used to them and some can cause dependence. Longer-term use is sometimes considered, weighing up the benefits and risks (Riemann et al., 2023). Sleeping pills can ease symptoms, but they can't cure insomnia or anxiety because they don't treat the cause (Mind, 2021).
Short-term medicines
| Medicine | Most helpful for | Things to know |
|---|---|---|
| Zopiclone (a “Z-drug”) | Falling asleep, waking in the night and waking too early | Usually prescribed for a few days to a few weeks, and not usually for more than 4 weeks. It's possible to become addicted, so don't stop suddenly without advice (NHS, 2026a). |
| Zolpidem (a “Z-drug”) | Falling asleep faster and waking less in the night | Takes around 1 hour to work. Usually prescribed for up to 4 weeks. Don't drink alcohol with it (NHS, 2023b). |
| Benzodiazepines, such as temazepam, loprazolam, lormetazepam and nitrazepam | Short-term relief of severe insomnia | Mind advises taking sleeping pills for no longer than 3 weeks (ideally no longer than 1 week), and trying not to take them every day, because of the risk of dependence (Mind, 2021). |
| Low-dose sedating antidepressants, such as trazodone or mirtazapine | Short-term help with sleep (Riemann et al., 2023) | Mainly used to treat depression (and, for trazodone, anxiety). Both can make you sleepy, so they're often taken at bedtime (NHS, 2026b; NHS, 2026c). Mirtazapine can make you hungrier, so you may put on weight (NHS, 2022). |
Medicines that may be used for longer
These can be used for longer in some cases, with regular reviews.
| Medicine | Who it's for | Things to know |
|---|---|---|
| Daridorexant (Quviviq) | Adults whose insomnia happens at least 3 nights a week for at least 3 months and badly affects their daytime life, if CBT-I hasn't worked or isn't available or suitable | Blocks orexin, a chemical messenger that keeps your brain awake. Should be reviewed within 3 months and stopped if it isn't helping enough (NICE, 2023; The Sleep Charity, 2023). |
| Slow-release melatonin (such as Circadin) | Mainly short-term sleep problems in people aged 55 and over | Prescription-only in the UK. Usually one 2mg slow-release tablet taken 1 to 2 hours before bed, for up to 13 weeks (NHS, 2023a; NHS, 2023c). |
Tips from the daridorexant patient leaflet (Idorsia, n.d.):
- Take it in the half hour before bed.
- It may take longer to work if taken with or soon after a large meal.
- Avoid grapefruit and grapefruit juice in the evening.
- Leave about 9 hours between taking it and driving.
- It can be stopped without gradually cutting down the dose.
5. Over-the-counter sleep aids
You can buy some sleep aids from a pharmacy without a prescription. Most contain a drowsy (sedating) antihistamine. They're only meant for short spells of poor sleep.
| Product | Most helpful for | Things to know |
|---|---|---|
| Diphenhydramine: Nytol Original (25mg), Nytol One-A-Night (50mg), Boots Sleepeaze | Short-term trouble sleeping | Take about 20 minutes before bed. It can make you dizzy or unsteady, and you can become dependent on it. Speak to your doctor if you need it for more than 2 weeks. Avoid alcohol (NHS, 2025c; Nytol, n.d.). |
| Promethazine: Sominex (20mg) from pharmacies. Also sold as Phenergan, and sometimes used as a sleeping pill (Mind, 2024a) | Difficulty falling or staying asleep. Sominex can be taken up to an hour after going to bed if you can't sleep | Don't take Sominex for more than 7 days. You may feel drowsy the next morning, so don't drive until you know how it affects you. Not for under-16s unless a doctor advises it (Sominex, n.d.). Best taken only for a very short time (NHS, 2025a). |
Key insight: not a long-term fix
European sleep experts don't recommend antihistamine sleep aids for treating insomnia (Riemann et al., 2023). If you've needed one for more than a couple of weeks, it's time to talk to your GP.
Watch out for double doses
Some night-time cold and flu remedies, such as Night Nurse, contain promethazine, the same drowsy antihistamine found in Sominex (Mind, 2024a). Taking both could mean a double dose. Check the labels, and ask your pharmacist before combining them.
6. Herbal remedies and supplements
Look for the “THR” (Traditional Herbal Registration) mark on herbal remedies. It means the product meets UK standards for quality and safety and has been used traditionally for at least 30 years. It doesn't mean clinical trials have proved it works (MHRA, n.d.).
| Remedy | What the evidence says | Watch out for |
|---|---|---|
| Valerian: Nytol Herbal, Nytol Herbal One-A-Night | Mostly used for trouble falling asleep. Some people feel they sleep better, but a 2024 review found no evidence that it works as a treatment for insomnia (Valente et al., 2024). | Generally well tolerated (Valente et al., 2024). |
| Lavender oil capsules (80mg): Kalms Lavender One-A-Day | Registered as a traditional herbal medicine for the temporary relief of mild anxiety (Kalms, n.d.; BHMA, n.d.). Trials of an 80mg lavender oil preparation (Silexan) found it eased anxiety, including GAD (Dold et al., 2023; Bartova et al., 2023). One of the researchers worked for the company that makes Silexan. | Not recommended for under-18s. If you're pregnant or breastfeeding, ask your doctor first (Kalms, n.d.). |
| Other herbs, such as hops, passionflower and chamomile | European sleep experts don't recommend herbal remedies for treating insomnia (Riemann et al., 2023). | Often sold in combination products, so check the label. |
| Magnesium | A review of 3 small trials found older adults fell asleep about 17 minutes faster, but the evidence was too weak for firm advice (Mah and Pitre, 2021). | Check your multivitamin so you don't double up. |
| Ashwagandha | Popular for stress, but it has no authorised health claims in the UK (Carter, 2026). | The Food Standards Agency is reviewing its safety, including possible liver harm. Meanwhile, it advises people with liver conditions and pregnant women to avoid it (Carter, 2026; Food Standards Agency, 2026). |
| St John's wort | Often sold for low mood and anxiety. | Don't take it with sertraline, a common anxiety medicine (NHS, 2025b). |
Key insight: natural isn't the same as risk-free
“Natural” doesn't mean “no side effects” or “no interactions”. Tell your pharmacist or GP about any herbal remedy or supplement before you start it, especially if you take other medicines.
When to talk to your GP
See your GP if changing your sleep habits hasn't helped, if you've had trouble sleeping for months, or if poor sleep is making it hard to cope with daily life (NHS, 2024b). Poor sleep is a health issue, not a personal failing.
Need help now?
If anxiety feels overwhelming, call 111 and choose the mental health option, or call Samaritans free on 116 123 at any time. If someone's life is at risk, call 999 or go to A&E (NHS, 2023d).
References
Bartova, L., Dold, M., Volz, H.-P., Seifritz, E., Möller, H.-J. and Kasper, S. (2023) ‘Beneficial effects of Silexan on co-occurring depressive symptoms in patients with subthreshold anxiety and anxiety disorders: randomized, placebo-controlled trials revisited’, European Archives of Psychiatry and Clinical Neuroscience, 273(1), pp. 51–63. Available at: https://doi.org/10.1007/s00406-022-01390-z (Accessed: 27 September 2026).
Big Health (n.d.) NHS: provide instant access to insomnia and anxiety treatments. Available at: https://www.bighealth.co.uk/nhs (Accessed: 27 September 2026).
British Herbal Medicine Association (BHMA) (n.d.) Kalms Lavender One-A-Day. Available at: https://bhma.info/kalms-lavender-one-day/ (Accessed: 27 September 2026).
Carter, K. (2026) ‘Ashwagandha: stress buster or health risk?’, Which?, 1 June. Available at: https://www.which.co.uk/news/article/ashwagandha-stress-buster-or-health-risk-aw2Ik4l90Kpv (Accessed: 27 September 2026).
Dold, M., Bartova, L., Volz, H.-P., Seifritz, E., Möller, H.-J., Schläfke, S. and Kasper, S. (2023) ‘Efficacy of Silexan in patients with anxiety disorders: a meta-analysis of randomized, placebo-controlled trials’, European Archives of Psychiatry and Clinical Neuroscience, 273(7), pp. 1615–1628. Available at: https://doi.org/10.1007/s00406-022-01547-w (Accessed: 27 September 2026).
Food Standards Agency (2026) Summary of responses to call for evidence on ashwagandha. Available at: https://www.gov.uk/government/consultations/summary-of-responses-to-call-for-evidence-on-ashwagandha (Accessed: 27 September 2026).
Idorsia (n.d.) QUVIVIQ 50 mg film-coated tablets: patient information leaflet. Available at: https://www.medicines.org.uk/emc/product/15360/pil (Accessed: 27 September 2026).
Kalms (n.d.) Kalms Lavender One-A-Day Capsules. Available at: https://www.kalmsrange.com/kalms-lavender-one-a-day-capsules/p2 (Accessed: 27 September 2026).
Mah, J. and Pitre, T. (2021) ‘Oral magnesium supplementation for insomnia in older adults: a systematic review and meta-analysis’, BMC Complementary Medicine and Therapies, 21(1), article 125. Available at: https://doi.org/10.1186/s12906-021-03297-z (Accessed: 27 September 2026).
MHRA (n.d.) Apply for a traditional herbal registration (THR). Available at: https://www.gov.uk/guidance/apply-for-a-traditional-herbal-registration-thr (Accessed: 27 September 2026).
Mind (2021) About sleeping pills and minor tranquillisers. Available at: https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers/about-sleeping-pills-and-minor-tranquillisers/ (Accessed: 27 September 2026).
Mind (2024a) Promethazine. Available at: https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers-a-z/promethazine/ (Accessed: 27 September 2026).
Mind (2024b) Sleep problems. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/sleep-problems/ (Accessed: 27 September 2026).
National Institute for Health and Care Excellence (NICE) (2022) Sleepio to treat insomnia and insomnia symptoms (MTG70). Available at: https://www.nice.org.uk/guidance/mtg70/chapter/1-Recommendations (Accessed: 27 September 2026).
National Institute for Health and Care Excellence (NICE) (2023) Daridorexant for treating long-term insomnia (TA922). Available at: https://www.nice.org.uk/guidance/ta922/chapter/1-Recommendations (Accessed: 27 September 2026).
NHS (2022) Common questions about mirtazapine. Available at: https://www.nhs.uk/medicines/mirtazapine/common-questions-about-mirtazapine/ (Accessed: 27 September 2026).
NHS (2023a) About melatonin. Available at: https://www.nhs.uk/medicines/melatonin/about-melatonin/ (Accessed: 27 September 2026).
NHS (2023b) About zolpidem. Available at: https://www.nhs.uk/medicines/zolpidem/about-zolpidem/ (Accessed: 27 September 2026).
NHS (2023c) How and when to take melatonin. Available at: https://www.nhs.uk/medicines/melatonin/how-and-when-to-take-melatonin/ (Accessed: 27 September 2026).
NHS (2023d) Where to get urgent help for mental health. Available at: https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/ (Accessed: 27 September 2026).
NHS (2024a) Generalised anxiety disorder (GAD). Available at: https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/ (Accessed: 27 September 2026).
NHS (2024b) Insomnia. Available at: https://www.nhs.uk/conditions/insomnia/ (Accessed: 27 September 2026).
NHS (2024c) Treatment: generalised anxiety disorder (GAD). Available at: https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/treatment/ (Accessed: 27 September 2026).
NHS (2025a) Common questions about promethazine. Available at: https://www.nhs.uk/medicines/promethazine/common-questions-about-promethazine/ (Accessed: 27 September 2026).
NHS (2025b) Common questions about sertraline. Available at: https://www.nhs.uk/medicines/sertraline/common-questions-about-sertraline/ (Accessed: 27 September 2026).
NHS (2025c) Diphenhydramine. Available at: https://www.nhs.uk/medicines/diphenhydramine/about-diphenhydramine/ (Accessed: 27 September 2026).
NHS (2025d) Talking therapies. Available at: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/ (Accessed: 27 September 2026).
NHS (2026a) About zopiclone. Available at: https://www.nhs.uk/medicines/zopiclone/about-zopiclone/ (Accessed: 27 September 2026).
NHS (2026b) Mirtazapine. Available at: https://www.nhs.uk/medicines/mirtazapine/ (Accessed: 27 September 2026).
NHS (2026c) Trazodone. Available at: https://www.nhs.uk/medicines/trazodone/ (Accessed: 27 September 2026).
NHS Every Mind Matters (n.d.a) Fall asleep faster and sleep better. Available at: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-fall-asleep-faster-and-sleep-better/ (Accessed: 27 September 2026).
NHS Every Mind Matters (n.d.b) How can meditation help with sleep?. Available at: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-fall-asleep-faster-and-sleep-better/how-can-meditation-help-with-sleep/ (Accessed: 27 September 2026).
Nytol (n.d.) Nytol sleep aids. Available at: https://www.nytol.co.uk/ (Accessed: 27 September 2026).
Riemann, D. et al. (2023) ‘The European Insomnia Guideline: an update on the diagnosis and treatment of insomnia 2023’, Journal of Sleep Research, 32(6), e14035. Available at: https://doi.org/10.1111/jsr.14035 (Accessed: 27 September 2026).
Right Decisions (n.d.) Sleepio app for insomnia. NHS Scotland. Available at: https://www.rightdecisions.scot.nhs.uk/shared-content/ggc-wellbeing/wellbeing/apps/sleepio-app-for-insomnia/ (Accessed: 27 September 2026).
Sleepstation (2023) Spend less time in bed and sleep better. Available at: https://www.sleepstation.org.uk/articles/sleep-science/sleep-restriction-therapy/ (Accessed: 27 September 2026).
Sleepstation (n.d.) Can you get NHS-funded access to Sleepstation?. Available at: https://www.sleepstation.org.uk/nhs_options/ (Accessed: 27 September 2026).
Sominex (n.d.) Sominex: patient information leaflet. Available at: https://www.medicines.org.uk/emc/product/15888/pil (Accessed: 27 September 2026).
The Sleep Charity (2023) NICE guidelines for new insomnia treatment. Available at: https://thesleepcharity.org.uk/nice-guidelines-for-new-insomnia-treatment/ (Accessed: 27 September 2026).
University College London Hospitals NHS Foundation Trust (UCLH) (n.d.) Insomnia and Behavioural Sleep Medicine Clinic. Available at: https://www.uclh.nhs.uk/our-services/find-service/integrated-medicine/insomnia-service (Accessed: 27 September 2026).
Valente, V., Machado, D., Jorge, S., Drake, C.L. and Marques, D.R. (2024) ‘Does valerian work for insomnia? An umbrella review of the evidence’, European Neuropsychopharmacology, 82, pp. 6–28. Available at: https://doi.org/10.1016/j.euroneuro.2024.01.008 (Accessed: 27 September 2026).
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Important medical disclaimer
The content provided in this blog post is for educational and informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your GP, psychiatrist or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Never start, stop or change a prescribed medicine without speaking to your prescriber first.
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