Non-Drug / First-Line Treatments
Before medicines are considered, the UK favours psychological and behavioural treatments. These often have fewer side effects and better long-term outcomes than relying on drugs alone.
Cognitive Behavioural Therapy (CBT)
For anxiety disorders (including Generalised Anxiety Disorder (GAD), panic disorder, social anxiety etc.), CBT is first-line. Evidence shows it is as effective as medication for many people and often has more durable benefits.
For insomnia, CBT for insomnia (CBT-I) is the gold standard first choice. In cases of chronic insomnia (e.g. lasting ≥ 3 months, affecting daytime functioning), NICE recommends trying CBT-I before using pharmacologic treatments.
Self-help / Digital Interventions
NICE has approved the Sleepio app, a digital CBT-I programme, for treating insomnia symptoms in primary care. It’s cost-saving, reduces need for sleeping pills, and better than just sleep hygiene advice.
For anxiety, low-intensity guided self-help (books, internet, apps) or psychoeducational groups may be offered, especially early in the treatment pathway.
Sleep Hygiene and Lifestyle Changes
Common advice includes regular sleep schedule, avoiding screens before bed, reducing caffeine/alcohol, ensuring a comfortable sleep environment. These are usually combined with CBT-I or before medicines.
For anxiety: relaxation techniques, mindfulness, breathing exercises, physical activity, sometimes worry scheduling etc.
When Medicines Are Considered
If non-drug treatments are not sufficient, or symptoms are severe, medically supervised treatments may be used. If you’re exploring medication options for anxiety or insomnia disorders, you can also see a curated selection at our Anxiety & Insomnia category, where we cover many of the medicines discussed below.
Medicines Used for Anxiety
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Medicines / Treatments for Insomnia
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Summary
For both anxiety and insomnia, UK practice and guidelines emphasise:
Non-drug treatments first – CBT, CBT-I, self-help, lifestyle change.
Use medicines only when necessary, selecting the class/agent based on severity, speed required, side-effects, and patient preference.
Limit duration of drugs that have higher risk of dependency (benzodiazepines, z-drugs).
New medications and digital tools are expanding options (e.g. daridorexant, Sleepio).
If you’re considering treatment options, you may also want to visit our Anxiety & Insomnia product collection to see available medicines and compare what might be right for you.
