Before any treatment is recommended, our pharmacist or pharmacist independent prescriber will work through a structured sleep history with you. This is in line with NICE Clinical Knowledge Summary guidance on insomnia and is the same approach a GP would use.
What we ask about
Your sleep pattern
- How long the problem has been going on (acute, <3 months, or chronic).
- How long it takes you to fall asleep, how often you wake, and total sleep.
- Whether your difficulty is falling asleep, staying asleep, or both.
- Whether you wake too early or feel unrefreshed.
- Daytime impact — tiredness, concentration, mood, safety.
Lifestyle factors
- Caffeine, alcohol, nicotine and recreational drug use.
- Shift work, jet lag, irregular routine.
- Screen time, exercise timing, evening eating.
- Bedroom environment — light, noise, temperature.
Health and medicines
- Pain, breathing problems, frequent waking to pass urine, restless legs.
- Mental health — anxiety, low mood, recent stressful events.
- Possible sleep apnoea (loud snoring, witnessed pauses, gasping).
- Current medicines — many can affect sleep (e.g. some antidepressants, beta blockers, steroids, decongestants).
What we may suggest
- Sleep hygiene changes as the first step.
- Cognitive behavioural therapy for insomnia (CBT-I) via NHS Talking Therapies — the NICE-recommended first-line treatment for chronic insomnia.
- A medication review — if a current medicine is affecting your sleep, we may suggest discussing the timing or alternatives with your GP.
- Onward referral if we suspect a sleep disorder such as sleep apnoea, or if a mental health condition is the main driver.
Where medication fits in
For most adults, sleep medication is not the right first step. Where it is considered, it should be at the lowest effective dose, for the shortest possible time, alongside non-medication strategies, and only after a full clinical assessment. Our Sleep Clinic follows this approach.