Insomnia in palliative care: Information for patients and carers

Sleep problems are common in people with advanced illness and are important to address. Difficulty sleeping can be caused by a combination of many factors such as pain, needing to go to the toilet too frequently or depression. If physical symptoms are affecting sleep, or if the practical tips on this page do not help, it is important to discuss sleep problems with a doctor.

Each person needs a different amount of sleep. The aim is to feel alert most of the the daytime.

Practical tips for good quality sleep

Environment

Try to remove distractions from the bedroom. 

Ideally stop the bright displays of computers, phones and TVs an hour or two before sleep as these suppress melatonin production – the hormone that helps sleep. 

Consider an eye mask or ear plugs.

The temperature of the room is also important as being too cold or too hot can disrupt sleep. 

Anxiety about sleep

Worrying about sleeping can keep people awake. Relaxation techniques can help.

If unable to sleep it is better to get up, try a warm drink (no sugar or caffeine), and go back to bed when feeling sleepier.

If sleep problems persist for more than a month Cognitive Behavioural Therapy (CBT) may help. Please see 'Related Services' on this page for psychological therapy services in your area.

Lifestyle

Napping may be unavoidable but can reduce night time sleep requirements.

Food and drink containing caffeine or sugar can worsen insomnia and should be avoided in the evening.

Alcohol often impairs the quality of sleep.

Medication

Sedative medications for sleep work better if not taken every night.

Melatonin is particularly helpful to reset the body clock (i.e. asleep all day and awake all night).

Some people find various herbal remedies such as lavender helpful- these are always worth a try.

Resources

Dr Michael Mosley's website Fast Asleep has some great tips, with a book by the same name

Recommended Resources

Fast Asleep

Published 9th June 2024

The mental health foundation: how to sleep better

Published 1st August 2022

Marie Curie - Sleep problems in palliative care

Published 1st March 2022

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Related Services

Wellbeing services

Age UK
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Age UK

T. 0800 678 1602

W. https://www.ageuk.org.uk/

Age UK provide information and support on financial, legal, health and wellbeing for older people. They support via their advice line, befriending service and day centres.

Compassionate Hillingdon
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Compassionate Hillingdon is a collaborative project that supports people who might need support in Hillingdon. Their work revolves around a commitment to those living with a life limiting illness, older people and those suffering from isolation. They do this by facilitating reciprocal friendships between like minded people who live close to one another across Hillingdon.

This project is part of the ‘Compassionate Communities’ movement. Compassionate Communities is built on a combined ethos of a Public Health Approach to Community Development, Palliative and End of Life Care.

H4ALL
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H4ALL supports Hillingdon residents to better manage long term conditions and brings residents into greater contact with their local community.

Referral criteria: Adults over the age of 18 who are registered with a Hillingdon GP and who are isolated/ lonely and who have one or more long term condition. 

Services offered: Social prescribing, wellbeing services, counselling and advice.

Wellbeing services referrals email nhsnwl.h4allwellbeing@nhs.net

Counselling services via Hillingdon Mind email h4allcounselling@hillingdonmind.org.uk

Harlington Hospice
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Harlington Hospice

T. 020 8759 0453

W. https://www.harlingtonhospice.org/

Harlington Hospice provides a wide range of palliative care services to the residents of Hillingdon and surrounding areas.

The Hospice hosts a Wellbeing Service (shared with Michael Sobell Hospice), complementary therapies, counselling, lymphoedema service and the CABS team supporting children and adolescents.

The Hospice also hosts Harlington Hospice@Home team, mainly providing night sits, plus inpatient beds based at Michael Sobell Hospice (MSH) in Northwood.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Marie Curie
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Marie Curie

T. 0800 090 2309

W. https://www.mariecurie.org.uk/

Marie Curie provide support for patients and carers through terminal illness.

Find information and support through the telephone helpline and online chat via their website.

Other services include Marie Curie nurses, Hospice care, helper and companion services.

Wellbeing Hub
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The Wellbeing Hub is an online tool and resource hub developed to empower Hillingdon residents’ and improve overall feelings of wellbeing. 

It provides modern, hospice wellbeing information alongside other types of wellbeing support. The wellbeing hub empowers people to enhance feelings of wellbeing in a holistic way. The online tool provides support with information to better support each person's own, unique wellbeing journey, by encouraging the setting of personal goals and accomplish tasks that align with individual wellbeing aspirations. Goals such as completing tasks (by creating and sharing a bucket list) and documenting wishes such as an advance care plan can take place.

Counselling services

British Association for Counselling and Psychotherapy (BACP)
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British Association for Counselling and Psychotherapy (BACP)

T. 0145 588 3300

W. https://www.bacp.co.uk/

British Association for Counselling and Psychotherapy signposts people to appropriate counselling services across the UK. Please search for a qualified counsellor on the ‘How to find a therapist’ page. 

H4ALL
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H4ALL supports Hillingdon residents to better manage long term conditions and brings residents into greater contact with their local community.

Referral criteria: Adults over the age of 18 who are registered with a Hillingdon GP and who are isolated/ lonely and who have one or more long term condition. 

Services offered: Social prescribing, wellbeing services, counselling and advice.

Wellbeing services referrals email nhsnwl.h4allwellbeing@nhs.net

Counselling services via Hillingdon Mind email h4allcounselling@hillingdonmind.org.uk

Samaritans
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Samaritans

T. 116 123

W. https://www.samaritans.org/

Samaritans provides a 24 hour, 7 days a week advice line.

Talking therapies

British Association for Counselling and Psychotherapy (BACP)
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British Association for Counselling and Psychotherapy (BACP)

T. 0145 588 3300

W. https://www.bacp.co.uk/

British Association for Counselling and Psychotherapy signposts people to appropriate counselling services across the UK. Please search for a qualified counsellor on the ‘How to find a therapist’ page. 

CNWL Talking Therapies Service
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CNWL Talking Therapies Service

T. 01895 206 800

W. https://talkingtherapies.cnwl.nhs.uk/

CNWL Talking Therapies Service provides psychological therapies. Self-referral accepted via the website for adults who are registered with a Brent, Harrow or Hillingdon GP.

Support is available for a range of difficulties, such as low mood or depression, anxiety, and stress, phobias, physical health anxiety, PTSD and Insomnia.

Hammersmith and Fulham Talking Therapies service
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IAPT stands for improving access to psychological therapies. IAPT offers talking therapies for people over 18 who have a GP in the London Borough of Hammersmith and Fulham.

Hammersmith and Fulham Talking Therapies service can help you with common problems like stress, anxiety and depression and use different talking therapies to help you feel better.

Residents or people who are registered with a GP in Hammersmith and Fulham can self refer:

https://gateway.mayden.co.uk/referral-v2/2272c1b5-29eb-42e0-878f-41959c1452f5

IAPT Ealing
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IAPT stands for improving access to psychological therapies. IAPT offers talking therapies for people over 18 who have a GP in the London Borough of Ealing.
 
IAPT can help you with common problems like stress, anxiety and depression and use different talking therapies to help you feel better.

IAPT Hounslow
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IAPT stands for improving access to psychological therapies. IAPT offers talking therapies for people over 18 who have a GP in the London Borough of Ealing.
 
IAPT can help you with common problems like stress, anxiety and depression.

Ealing IAPT offers Cognitive Behavioural Therapy (CBT) but also works in partnership with a counselling service. 

Mind
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Mind

T. 0300 102 1234

W. https://www.mind.org.uk/

Provides information, advice and support to anyone with a mental health problem through its helpline and website. 

Friendship and support

Compassionate Hillingdon
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Compassionate Hillingdon is a collaborative project that supports people who might need support in Hillingdon. Their work revolves around a commitment to those living with a life limiting illness, older people and those suffering from isolation. They do this by facilitating reciprocal friendships between like minded people who live close to one another across Hillingdon.

This project is part of the ‘Compassionate Communities’ movement. Compassionate Communities is built on a combined ethos of a Public Health Approach to Community Development, Palliative and End of Life Care.

Compassionate Neighbours
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Compassionate Neighbours can support by:

  • Visiting weekly for a cup of tea and a chat, offering friendship and a listening ear
  • Helping you do the things you like doing
  • Helping you stay connected to your friends and the community
Wellbeing Hub
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The Wellbeing Hub is an online tool and resource hub developed to empower Hillingdon residents’ and improve overall feelings of wellbeing. 

It provides modern, hospice wellbeing information alongside other types of wellbeing support. The wellbeing hub empowers people to enhance feelings of wellbeing in a holistic way. The online tool provides support with information to better support each person's own, unique wellbeing journey, by encouraging the setting of personal goals and accomplish tasks that align with individual wellbeing aspirations. Goals such as completing tasks (by creating and sharing a bucket list) and documenting wishes such as an advance care plan can take place.

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