Sleep problems mean you have trouble falling asleep, wake often or too early, or wake unrefreshed despite enough hours in bed. Almost everyone has them at times; when they go on at least three nights a week for more than three months it is called chronic insomnia, and then cognitive behavioural therapy for insomnia (CBT-i) is the treatment that works best, better than sleeping pills in the long run. The most common causes of ordinary sleep problems are stress that is not wound down, irregular hours, light from screens late, caffeine after lunch, alcohol in the evening, pain, snoring and hormonal changes. What helps is morning daylight, the same wake-up time every day, an evening that winds down, and a bodily routine that tells the nervous system the day is over. Here are the causes, the warning signs, what has evidence and an evening routine step by step.
Common causes of sleep problems
| Cause | Recognised by | What helps |
|---|---|---|
| Stress and worry | Thoughts racing at bedtime, waking at three and starting to plan | A wound-down evening, "worry time" earlier in the evening with pen and paper, breathing with a long exhale. See the guide to stress |
| Irregular circadian rhythm | Sleeping in at weekends, different bedtimes, shift work, jet lag | Same wake-up time every day, daylight within an hour of waking, no long naps |
| Screens and light | Phone in bed, light in the room, "just one more episode" | Screen-free last hour, dim warm light in the evening, dark bedroom |
| Caffeine, alcohol, nicotine | Coffee after lunch, wine to fall asleep (gives shallow sleep and awakenings), nicotine in the evening | Caffeine before 2 pm, alcohol sparingly and not as a sleep aid |
| Pain and a stiff body | Waking from pain in the back, hip, shoulder; hard to find a position | Treat the pain, evening routine with heat and cupping, a good pillow. See the complaint guides, e.g. back pain |
| Hormones | Menopause (sweats, awakenings), pregnancy, periods | Cool bedroom, self-care and treatment when needed. See cupping during menopause |
| Snoring and sleep apnoea | Loud snoring, pauses in breathing a partner notices, tired in the day despite sleep, morning headache | Investigation by a doctor; treatment exists and makes a big difference |
| Restless legs | Crawling sensations and a need to move the legs in the evening and at night | See the guide to restless legs; iron tests with a doctor |
| Too much time in bed | Lying awake for long, "trying" to sleep, sleeping in to catch up | Sleep restriction: get up if you do not fall asleep in 20 minutes, less time in bed until sleep becomes continuous |
Seek help if
Contact your doctor if the sleep problems have gone on for more than three months at least three nights a week, if you are so tired in the day that it affects work or driving, if you snore loudly or have pauses in breathing, if you wake from pain or shortness of breath, if the insomnia comes with low mood, anxiety or thoughts of not wanting to live (then seek urgent care), or if you need alcohol or pills to sleep. Sleep problems can also be due to the thyroid, anaemia, medication or depression, which need tests and assessment.
What has the best evidence
- The same wake-up time, every day. It is the wake-up time, not the bedtime, that governs the circadian rhythm. Get up at the same time even after a bad night, and go to bed when you are sleepy.
- Morning daylight and movement in the day. Out into the light within an hour of waking, 20–30 minutes, and a walk or training during the day (not hard training in the last two hours). That is the strongest signal to the internal clock.
- Sleep restriction. If you lie awake for long: shorten the time in bed to about the time you actually sleep (but never under five and a half hours), and extend by a quarter of an hour at a time when you sleep continuously. It builds sleep pressure and is the core of CBT-i.
- Get up if you do not fall asleep. After about 20 minutes awake: get up, do something calm in dim light, go back when you are sleepy. The bed should be linked to sleep, not to wakefulness and frustration.
- A wound-down evening. The last hour without screens, work and difficult conversations; dim light; a fixed order of things that always leads to sleep (see the routine below).
- Caffeine, alcohol, food. Caffeine before 2 pm, alcohol sparingly and not in the last hours, no large meal late but not hungry either.
- Cool, dark, quiet. Around 17–19 degrees Celsius, blackout or an eye mask, earplugs if needed.
- CBT-i for chronic insomnia: available as online treatment, in groups and individually. Sleeping pills can help briefly but do not solve the cause; melatonin has weak evidence in adults except for circadian rhythm disorders.
Evening routine with breathing, heat and static cupping
A fixed routine does two things: it winds down the nervous system in the right order, and over time it becomes a signal in itself, so the body starts to get sleepy as soon as the routine begins. This one takes 20–30 minutes and starts an hour before bedtime.
- Warm shower or bath, 10 minutes. The heat widens the blood vessels in the skin so that body temperature then drops, which is one of the body's own sleep signals. A sauna works just as well, see the recovery guide.
- Static cups with breathing, 10 minutes. Lie on your back in dim light. Place two static cups with light suction just below the collarbones and breathe into them: four seconds in, six to eight seconds out. Ten breaths. Move the cups to the sides of the ribs, ten breaths, and lastly one cup on the belly below the navel, ten breaths. The long exhale activates the vagus nerve; the cups give the breath a place to go, so the thoughts get something else to do. The program is in the cupping program for breathwork, and a guided relaxation routine in meditation and relaxation.
- Neck, shoulders and jaw, 3 minutes if you tense up: light dynamic cupping with the mini cup up the neck and out over the shoulders, and light massage of the jaw muscles. See stiff neck and teeth grinding.
- Body scan in bed. Lights off. Go through the body from feet to head and release the tension part by part, with a long exhale. If you wake at night: the same breathing, without looking at the clock. Guidance is in the body scanning program.
Do not cup late if you are sensitive to it (some people get more alert from dynamic cupping; keep the static, calm part in the evening and the dynamic part earlier in the day). Cupping is a tool in the routine, not a treatment for insomnia, sleep apnoea or depression.
The day after a bad night
Get up at the same time, out into the light, move, avoid catching up with a long nap (20 minutes at most before 3 pm) or extra coffee in the afternoon, and do not go to bed earlier than usual. A bad night makes you tired but not ill; it is the worry about sleep that keeps the problem alive. The next night is usually better by itself if sleep pressure is allowed to build.
Frequently asked questions
Why do I wake at three and cannot get back to sleep?
Sleep is lighter after the first hours, and a stressed nervous system, alcohol in the evening, a warm bedroom or a restless bladder is enough to wake you. Do not look at the clock, breathe with a long exhale, and get up for a while if you are awake for 20 minutes. Recurrent early waking with low mood should be assessed by a doctor.
How many hours of sleep do you need?
Most adults seven to nine hours, older people often somewhat less. More important than the number is that you wake refreshed and function in the day. Lying longer in bed to "catch up" often worsens sleep quality.
Does cupping help sleep problems?
As part of an evening routine, yes: static cups with a long exhale help many people wind down, and cupping of the neck and shoulders reduces tension that disturbs falling asleep. There are no large studies showing that cupping cures insomnia; for chronic problems CBT-i is the treatment with evidence.
Is melatonin good for sleep problems?
Melatonin has the best evidence for circadian rhythm disorders (jet lag, shift work, delayed sleep phase) and in children with certain diagnoses. For ordinary insomnia in adults the effect is small. Talk to a pharmacist or doctor, and fix the rhythm with light and fixed times first.
When are sleep problems dangerous?
Rarely in themselves, but sleep apnoea (snoring and pauses in breathing), insomnia with low mood or thoughts of not wanting to live, and tiredness that makes you dangerous in traffic should be assessed, the middle one urgently. Sleep problems that have gone on for more than three months should be investigated.
Sources
- 1177 Vårdguiden (Swedish national health guide), search for "sömnsvårigheter", "sömnapné" and "KBT vid sömnproblem" for medical information, treatment and when to seek care.
- Curam's FAQ and cupping programs, developed with trained massage therapists.
Written by Curam. Last updated 17 October 2026. This is general self-care information and does not replace medical care. For sudden, severe or unusual symptoms, contact your doctor. Talk to your doctor before cupping if you are pregnant, take blood thinners or have a condition affecting skin, blood vessels or blood.
