I can't sleep: what to do and when to get help

Most bad patches of sleep are not a medical problem and do not need a product. They need a fortnight of boring, unglamorous changes to your routine — and, above all, a decision about how long you let it run before you ask someone for help.

Two or three weeks of poor nights already justify real changes. When the pattern drags on for months, or arrives with symptoms that are not only about sleep, self-management stops being the right tool and a conversation with a professional starts being the right one. None of these three situations is fixed by willpower.

Why can't I sleep at night?

The most frequent reasons are not mysterious. Your bedtime and waking time drift, and the body stops knowing when night begins. The bedroom is too warm, too bright, or full of screens. Caffeine after lunch, alcohol with dinner, a heavy meal late. And then there is stress, which rarely shows up the way we picture it: plenty of people do not feel anxious during the day, yet the moment the light goes off the head starts reviewing everything still unresolved. That is not a character flaw. It is the first silence of the day.

Notice what is useful about that list. Almost every item on it is something you control, at least partly. Which is why it is worth starting there before you go looking for an outside solution.

What you can change this week

Start with the measures that carry the most support and are simplest to apply. Do not try to change everything at once. People who overhaul five habits in one night are usually back where they started within four days.

The first is a fixed waking time. Yes, even after a bad night. Pick an hour you can genuinely keep seven days a week, and hold it for two weeks before you judge the result.

The second is light. In practice: get outside or open the curtains soon after waking, and dim the house in the last hour before bed.

The third is caffeine. If falling asleep is your difficulty, try cutting coffee, black tea and caffeinated soft drinks after lunch.

The fourth is reserving the bed for sleep. If you have been rolling around for more than twenty minutes without drowsiness, get up, go to another room with low light, and come back when you feel sleepy again.

A fifth, which costs nothing and helps a lot of people: spend five minutes before bed writing down whatever is still pending for tomorrow. It does not solve the problems. It takes them out of your head for the night.

What tends not to help, even though everyone recommends it

A glass of wine with dinner is the most widely shared advice and one of the most misleading. Alcohol may make you fall asleep faster; it does not give you the night you are hoping for.

Lying there frustrated is the other trap. If you are awake and getting irritated, fifteen minutes out of bed beats insisting.

Then there is the temptation of whatever the internet serves up in a hurry: tablets sold as natural with no directions at all, several products stacked at once, devices that promise to regulate your sleep. Sleep does not work like that, and no product replaces the hours your body needs.

If a solution promises to fix your problem while asking nothing of you in return, the likeliest outcome is that it fixes nothing.

Where supplements honestly fit

The answer here is narrower than the advertising suggests. Melatonin is a hormone that regulates the circadian rhythm and is widely used as a food supplement in support of sleep. That part is factual. What is not factual is the claim that melatonin resolves insomnia across the adult population in general — the available evidence does not support it. Existing studies focus mainly on specific clinical populations, and results are mixed.

What holds up better are systematic reviews suggesting a possible improvement in subjective sleep quality in adults with various health conditions. Not in any healthy person going through a rough patch. Read those two sentences carefully before you spend money.

On valerian and ashwagandha: in the material we hold, there is no peer-reviewed evidence that would let us say they help you fall asleep. We are not going to invent it. If you are thinking of trying them, speak to your pharmacist first and check the label of any product, dose and warnings included.

That is a modest sentence, and it is precisely why it is the only one we can use. If you do want to try, TuttiBear makes Sleep Well Gummies, with 1 mg of melatonin per two gummies, for adults, chewed shortly before bedtime. Do not exceed the recommended daily dose. Not recommended for children, pregnant or breastfeeding women; in case of illness or use of medication, consult a healthcare professional before use. May cause drowsiness; avoid driving or operating machinery after taking. Contains polyols; excessive consumption may produce laxative effects.

One safety note worth more than any promise: melatonin is a hormone that acts on several systems in the body. Using it as a supplement is something to weigh, not something to assume is harmless. And to be plain, the idea that melatonin cures or prevents diseases such as cancer or Alzheimer's has no support in the available evidence.

When this stops being normal

Some signals do not belong in the ordinary category and call for a conversation with your doctor or pharmacist rather than another week of trying.

Seek help if difficulty sleeping has dragged on for more than three months, if it happens almost every night, if daytime tiredness is starting to affect work, driving or mood, or if someone tells you that you snore loudly and pause in your breathing. Speak up too if you fall asleep involuntarily during the day, if pain wakes you, if anxiety or low mood now fill much of your days, or if you take medication and do not know whether it might be interfering with sleep.

None of that means you have something serious. It means the likely cause has moved out of the things you can change alone, and it is worth having someone look at the whole picture.

How long until you know whether it is working

Give routine changes two weeks before you assess them. If nothing has shifted by then, do not give up yet: adjust one variable at a time rather than adding another item to the list.

With supplements the logic is similar. Do not judge by the first tablet or the first gummy. And above all, do not treat them as replacements for the hours of sleep your body needs — no supplement does that job for you.

If, after three to four weeks of consistent changes, you still cannot sleep, the next step is not another product. It is booking an appointment and taking a plain note with you: what time you went to bed, what time you woke, what happened during the day. That sheet is worth more in a consultation than any bottle.