Drug treatments

If your sleep problems carry on, you should speak to your doctor, specialist nurse or therapist, who’ll be able to offer more advice and prescribe suitable medications if you need them.

There are 4 main groups of drugs that can be helpful. They’re most likely to have an effect when just one factor is causing your sleep disturbance. You may benefit from a combination of drugs from more than one of these groups. Your GP or hospital specialist will be able to advise on which drugs are most likely to help you.

• Painkillers (analgesics) – Taking paracetamol (with or without codeine) just before going to sleep can relieve pain to allow you to get to sleep, but it’s unlikely to last all night. Non-drowsy painkillers that include caffeine are unlikely to help you sleep.
• Anti-inflammatory drugs – Slow-release formulations of anti-inflammatory drugs such as ibuprofen or naproxen reduce pain and stiffness throughout the night. Although these drugs have potential side-effects, they can be very useful.
• Sedating antidepressant drugs – Some antidepressants such as amitriptyline, dosulepin and trazodone have sedative effects, which means they make people feel sleepy, and may also reduce chronic pain. These drugs aren’t given as sleeping tablets but may improve your sleep as an added benefit. It’s often advisable to take them a few hours before going to bed so that the effect has worn off by the morning.
• Sedatives (hypnotics) – Temazepam, zolpidem and zopiclone are given specifically to help people sleep. They’re sometimes called hypnotics. They help people to go to sleep but may not keep you asleep through the night. Doctors are often very reluctant to prescribe these drugs because of the risk of dependence, but they can be very helpful for short-term use. In some cases long-term use of these drugs may be better than going without sleep for a long time.

Many people experience painful muscle cramps during the night. Quinine sulphate can be a useful drug to reduce these pains, though it doesn’t work on other types of pain.