The main treatment options for alleviating insomnia symptoms are 1. Cognitive Behavioral Treatment for Insomnia (CBT-I), 2. Medication, or 3. Combined CBT-I and Medication. Head-to-head studies comparing CBT-I to medication show that both work equally well in the short run but in the long run CBT-I works best because you stop taking medication and it stops working! Also, many patients complain about side effects for medications commonly used for insomnia.
To elaborate on CBT-I, it is typically a 5-8 week treatment administered by a trained Behavioral Sleep Medicine Specialist. The work involves filling out weekly sleep logs, making changes to your sleep schedule and learning strategies for dealing with thoughts, behaviors and emotions interfering with sleep. Research shows this treatment is effective in 75% of those who follow treatment guidelines. In clinic, almost all patients see at least some alleviation of insomnia symptoms. Patients with moderate to severe psychological or medical comorbidities may not respond as well to treatment as those who have "pure" insomnia. However, even patients with secondary insomnia (i.e., insomnia caused by mental or medical issues) can benefit from CBT-I.