Sleep when you are unwell

What is breaking your sleep

• Physical: pain, breathlessness, itching, needing to pass urine, hot flushes, cramps.
• Medication: steroids taken late, diuretics, some antidepressants, opioid withdrawal at night.
• Mental: worry that only surfaces when the house goes quiet.
• Habit: napping long into the afternoon, then lying awake at 2am.
• Environment: hospital lights, monitors, a partner's disturbed sleep.

The changes that actually move the needle

1. 1Fix the wake time, not the bedtime. Get up at the same hour every day, including weekends.
2. 2Cap naps at 30 minutes and take them before 3pm.
3. 3Ask for steroids and diuretics to be scheduled earlier in the day where clinically possible.
4. 4Get daylight on your face within an hour of waking — even through a window.
5. 5If you are awake more than 20 minutes, get out of bed, sit in low light and do something dull. Return when sleepy.
6. 6Keep the bed for sleep and intimacy. Scrolling in bed teaches the brain that bed is for alertness.

Worry at 3am

Keep a notepad by the bed. Write the thought in a single line and put the pen down — you are not solving it now, you are parking it for the morning.

If pain wakes you regularly, that is a treatment problem, not a sleep problem. Tell your team the time of night it happens; background pain relief may need adjusting.