*Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS* website.**
	Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the NHS website, or view any of our Previous A to Z Features.

You should also know that OutUK has produced a special report about: Coronavirus Covid-19.

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This Week - Z : ZZZ... Trouble Getting to Sleep

Check if you have insomnia

You have insomnia if you regularly:

find it hard to go to sleep
wake up several times during the night
lie awake at night
wake up early and cannot go back to sleep
still feel tired after waking up
find it hard to nap during the day even though you're tired
feel tired and irritable during the day
find it difficult to concentrate during the day because you're tired

If you have insomnia for a short time (less than 3 months) it's called short-term insomnia. Insomnia that lasts 3 months or longer is called long-term insomnia.

How much sleep you need

Everyone needs different amounts of sleep.

On average:

adults need 7 to 9 hours
children need 9 to 13 hours
toddlers and babies need 12 to 17 hours

You probably do not get enough sleep if you're constantly tired during the day.

What causes insomnia

The most common causes of insomnia are:

stress, anxiety or depression
noise
a room that's too hot or cold
uncomfortable beds
alcohol, caffeine or nicotine
illegal drugs like cocaine or ecstasy
jet lag
shift work

How you can treat insomnia yourself

Insomnia usually gets better by changing your sleeping habits.

Do

go to bed and wake up at the same time every day
relax at least 1 hour before bed, for example, take a bath or read a book
make sure your bedroom is dark and quiet - use curtains, blinds, an eye mask or ear plugs if needed
exercise regularly during the day
make sure your mattress, pillows and covers are comfortable

Don't

do not smoke or drink alcohol, tea or coffee at least 6 hours before going to bed
do not eat a big meal late at night
do not exercise at least 4 hours before bed
do not watch television or use devices, like smartphones, right before going to bed, because the blue light makes you more awake
do not nap during the day
do not drive when you feel sleepy
do not sleep in after a bad night's sleep and stick to your regular sleeping hours instead

How a pharmacist can help with insomnia

You can buy tablets or liquids (sometimes called sleeping aids) from a pharmacy that may help you sleep better.

Some contain natural ingredients such as valerian or lavender, while others contain an antihistamine.

They cannot cure insomnia but may help you sleep better for 1 to 2 weeks. They should not be taken for any longer.

Some of these products can have side effects, for instance, they may make you drowsy. This could make it difficult for you to do certain things like drive.

Check with your doctor before taking anything for your sleep problems.

See a GP if:

changing your sleeping habits has not helped your insomnia
you've had trouble sleeping for months
your insomnia is affecting your daily life in a way that makes it hard for you to cope

Treatment from a GP for insomnia

A GP will try to find out what's causing your insomnia so you get the right treatment.

Sometimes you'll be offered cognitive behavioural therapy (CBT). This may be face-to-face with a therapist, or through an online self-help programme.

This can help you change the thoughts and behaviours that keep you from sleeping.

You may be referred to a sleep clinic if you have symptoms of another sleep disorder such as sleep apnoea.

GPs now rarely prescribe sleeping pills to treat insomnia. Sleeping pills can have serious side effects and you can become dependent on them.

Sleeping pills are only prescribed for a few days, or weeks at the most, if:

your insomnia is very bad
other treatments have not worked

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We'll have more information and advice next week on another topic in our A to Z of Gay Health. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features. If you want to find out more about this week's subject you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.
Photos: LightFieldStudios and one of VladOrlov, Stockcube, darak77, ajr_images or rawpixel.com.