Treatment | Insomnia

Medication
Prevention

Transient and intermittent insomnia usually do not require treatment since episodes last for only a few days at a time. However, the temporary use of low-dose sleeping pills, also known as hypnotics, may improve your sleep and alertness the next day. Learn more about sleeping pills.

Treatments for chronic insomnia include identifying stressors, environmental factors, or behaviors that may trigger or worsen insomnia.  After these potential factors are identified, ways to stop or reduce the impact of these factors, as well as establishing alternatives, may be suggested to improve sleep.  Prescription and over-the-counter medications that assist sleep are not typically used for long-term treatment of insomnia because their safety and effectiveness over long periods are not proven.  Only behavioral or psychological techniques are proven to ease chronic insomnia.

Behavioral techniques used to treat chronic insomnia are:

• Relaxation therapy
  Relaxation therapy is used to reduce or eliminate anxiety and body tension. It focuses on getting the patient's mind to stop racing and the muscles to relax so restful sleep can occur.  Examples of relaxation therapy include progressive muscle relaxation training, imagery training, biofeedback, and hypnosis. 
  Learn some relaxation techniques.  

• Sleep restriction
  When suffering from poor sleep, it is often a natural response for an individual to increase the time spent in bed in order to provide more sleep opportunities.  This can cause sleep that is often interrupted or fragmented, and it becomes counterproductive for an insomnia sufferer.  So, when a patient begins this therapy, he or she is only permitted a very short period of sleep during the night.  The amount of time allotted for sleeping during the night is gradually increased until a normal length of sleeping time is achieved. 

• Reconditioning or Stimulus Control Therapy
  Some experts believe that the bedtime and the bedroom are associated in the brain with repeated unsuccessful attempts of sleeping. Reconditioning is a treatment that re-teaches the patient to associate the bed and bedtime with sleep by establishing rules like a standard wake up time, avoiding napping, curtailing non-sleep related activities, and others.

• Cognitive Therapy
  Those suffering from insomnia will often increase the severity of the problem by obsessing on missed sleep. This type of therapy seeks to adjust the expectations of the patient with respect to sleep. 

• Sleep Hygiene Education
  In many cases, simply modifying behaviors can significantly contribute to sleep quantity and quality.  For example, reducing the amount of caffeine or alcohol consumed can improve sleep.  This therapy addresses these behaviors.

Medication

Prescription medications help to improve transient and intermittent insomnia by reducing the amount of time it takes to fall asleep, increasing sleep duration, and reducing the number of awakenings during sleep.  Medications are often used along with the behavioral techniques described above. 

Over-the-counter medications may help you sleep, but if your insomnia is caused by a different disorder, such as a sleep-related breathing disorder, taking the over-the-counter medication could be life-threatening.  Always consult your doctor before taking any over-the-counter sleep medications.

If insomnia persists after treatment, your doctor may suggest that you visit a sleep disorders center.  It is recommended that patients ensure that the sleep disorders center of their choice offer comprehensive sleep studies and is accredited by the American Academy of Sleep Medicine. 

Prevention

Avoid behaviors that lead to poor sleep, including:

• Drinking caffeine
• Using nicotine
• Drinking alcohol
• Napping in the late afternoon and evening

It's best to exercise regularly and establish a bedtime routine that will allow you to unwind and send a signal to your brain that it's time to sleep. Make your sleep environment as pleasant, comfortable, dark, and quiet as possible. If you can't go to sleep after 30 minutes, involve yourself in a relaxing activity.  Don't toss and turn.