Sleep problems

Difficulty sleeping is one of the most common reasons people consult a complementary practitioner and many report that they get benefits. Complementary therapies are not widely available through the NHS, so a typical session could cost you from £40 to £80.

You should always look for a practitioner who is properly trained and registered with the relevant professional body.

Summary
Acupuncture is a traditional form of treatment that began in China thousands of years ago. Thin needles are inserted into the skin at special points on the body, which practitioners believe will help restore health. The treatment sometimes also involves heat, pressure, electrical currents or soft-laser light. In the UK, acupuncture is most commonly used for pain relief.

Evidence
Some small studies suggest that acupuncture may help with sleep problems but because of different methods the studies overall have not been convincing.

Safety
Acupuncture is generally safe if practised by a trained acupuncturist. The most common side-effects are slight discomfort (common) and bruising (occasionally).

Cost
A session may cost £40-£60. Frequency of treatment will depend on you and your practitioner.

Find out more
The following professional organisations can help you find a qualified practitioner:
Acupuncture Association of Chartered Physiotherapists
British Academy of Western Medical Acupuncture
British Acupuncture Council
British Medical Acupuncture Society

Summary
If sleeplessness has been a long-term problem you might have started to feel that it will never get better. Hypnotherapy (the therapeutic application of hypnosis) might help you overcome this sort of negative thinking. It can help you learn to relax too. Whether or not it is safe and effective depends on the skill of the practitioner and how you feel about working with them. At present, it is hard to find out whether a hypnotherapist has been appropriately trained because the field of hypnotherapy is not well regulated.

Autogenic training (AT) is a type of self-hypnosis. It involves simple phrases that you repeat to yourself silently as you release tension from each part of your body. These phrases suggest particular sensations that calm negative thoughts and reduce tensions in the body. It begins by encouraging you to find a relaxing place and position, and allow the out-breath to get softer, longer and slower. AT can train you to reach very deep states of relaxation.

Using a guided imagery recording can help you slip into a calm, dreamy state of mind. Like AT, this technique can help you imagine a safe, comfortable place where you are able to feel yourself relaxing more and more deeply

Evidence
Some research has been carried out on all of these techniques for sleep problems. The results are promising but more studies are needed.

Safety
These techniques are safe for most people if carried out by or under the guidance of a qualified practitioner. If you have a long-term mental health problem you should ask your GP whether these methods would be appropriate for you.

Cost
You can buy guided imagery CDs in shops and pharmacies and some libraries keep them in stock.

Further information
Hypnotherapists who are also doctors or psychologists have strong regulatory organisations. See The British Association of Medical Hypnosis

The British Autogenic Society (BAS) is the professional and educational organisation for autogenic therapists in the UK.

Summary
There are many different types of massage, some more vigorous and going deeper into the muscles than others. Massage has traditionally been used for relaxation. It may be just on one part of the body (for example, the back and shoulders), or it can be done on the whole body. Aromatherapy massage uses pleasant-smelling essential oils.

Evidence
Few trials have been carried out to test the effectiveness of massage in easing sleep problems.

Safety
Massage is safe if carried out by qualified massage therapists, and it rarely causes problems. Vigorous massage should be avoided if you have blood disorders, some forms of cancer, skin problems or are on blood-thinning medications (such as warfarin). Allergies or skin irritation can occur with some essential oils used in massage.

Cost
Monthly cost will depend on how regularly you receive treatments.

Further information
It is important to find a qualified practitioner such as one registered with The General Council for Soft Tissue Therapies.

Summary
Counselling and psychotherapy aim to help people change thoughts, feelings and attitudes. Counsellors help you talk about difficult feelings and understand conflict. It can be helpful just to have time alone with a counsellor to talk in confidence about how you feel. Spending time reflecting on problems often brings insight and puts things into perspective. Psychotherapy helps people learn better ways of thinking or behaving that can reduce their symptoms, disability and distress. Some psychotherapists are trained to help you explore possible causes of distress or symptoms in your past. Cognitive behavioural therapy (CBT) is the type of psychotherapy that is currently most widely available in the NHS.

Instead of exploring causes of distress or symptoms in the past (like many other types of therapy), CBT looks for ways to improve your state of mind right now. The therapist does this by helping you spot unhelpful thought processes and change them. The Royal College of Psychiatrists says “CBT can help you to change how you think (‘cognitive’) and what you do (‘behavioural’)”. For instance, CBT can help you make sense of what seem like overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you.

During CBT sessions to address sleep problems, people learn how to improve sleep problems by using sleep hygiene and relaxation methods, and by changing unhelpful beliefs about sleep. If sleeplessness has been a long-term problem you might have started to feel that it will ever get better. CBT might help you overcome thoughts like these.

Evidence
A number of good studies have shown that CBT can improve sleep problems.

Safety
CBT techniques are generally safe if carried out by or under the guidance of a qualified counsellor or psychologist.

Cost
In most areas your GP can refer you for CBT or a psychological therapist in the NHS. There are often long waiting lists. A session of CBT or psychological therapy may cost between £20-£50. Frequency will depend on you and your therapist. A typical course of CBT lasts between 6-12 weekly sessions

Further information
It is important to find a qualified counsellor or psychologist. Contact The British Psychological Society.

Summary
Tai chi is also known as ‘moving meditation’ It is a series of slow, graceful, controlled movements, which develop strength, balance, posture and inner peace. It is a discipline that has to be learned in a class from a teacher and can then be practised at home

Evidence
Several studies suggest that tai chi may improve sleep quality, particularly in elderly people.

Safety
Supervised exercise programmes are safe for most people. Anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should avoid strenuous exercise, though most tai chi classes are not strenuous.

Cost
Once you have learned the movements, you can do this at home, at no cost.

Further information
Classes are run in most areas by both private tutors and by adult education services or you can contact the The Tai Chi Union.

Summary
Yoga, as taught in the UK, generally includes physical postures or stretches, breathing techniques, meditation and relaxation. There are several different types of yoga. Some of them are mainly based on the physical exercises (some types are much more strenuous than others). Others focus more on meditation.

Evidence
Several small studies have found that practising yoga can help with sleep problems although one trial found it did not help.

Safety
Yoga is generally safe when practised appropriately and at the right level. Classes are run for different ability levels so look for one that is right for you. Yoga stretches should be increased slowly. If in doubt, check with your doctor, osteopath or physiotherapist. Avoid with severe osteoporosis or acute joint or back pain, or recent injuries.

Cost
You will have to pay for the classes but once you have learned this technique you can practise it at home at no cost.

Further information
Classes are run in most areas by both private tutors and by adult education services. To find a qualified teacher near you see also the The Yoga Alliance
and the The British Wheel of Yoga.