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How is insomnia treated?

Dr. Jeanne Morrison, PhD
Family Practitioner

There are several treatment options for short-term insomnia. If the cause of your insomnia is an underlying medical condition, a doctor might be able to treat the condition and get rid of the insomnia by doing so. If the cause is stress or anxiety, cognitive-behavioral therapy might help offer relief. Lifestyle changes such as keeping regular hours or not drinking caffeine may also help. Your doctor may also prescribe sleep medication.

Studies suggest that treatments that help you modify the behaviors and thoughts that interfere with sleep are more effective in the long run than sleep medications. Here are four common approaches:

Relaxation therapy uses methods such as progressive muscle relaxation, deep-breathing exercises, biofeedback, and meditation or another attention-focusing activity to help you relax your mind and body.

Sleep-restriction therapy involves limiting the time you spend in bed to the average number of hours you actually sleep each night over a 2-week period. That does not include the time you spend tossing and turning. If you typically get only 5 hours of good shut-eye and feel tired and out of sorts the next day, you'll begin by being in bed for only 5 hours. Eventually, as your sleep improves, you'll increase your time in bed by 30-minute increments until you're getting enough of the high quality sleep you need to feel rested.

Sleep hygiene involves practicing healthy sleep habits, including limiting bedroom activities to sleep and sex—not working, not watching TV, not reading in bed—to retrain yourself to associate the bed only with those two activities. For many people, reconditioning by following the principles of good sleep hygiene allows them to fall asleep more quickly.

Cognitive-behavioral therapy (CBT) is done with a therapist in order to help you learn to overcome the stressful attitudes or specific beliefs that undermine your efforts to get to sleep. CBT often accompanies another approach, such as sleep-restriction therapy.

Transient and intermittent insomnia may not require treatment because episodes only last a few days. Some people who experience daytime sleepiness and impaired performance from transient insomnia can find relief with short-acting sleeping pills. However, over-the-counter sleep medicines, if used at all, should be used on a short-term basis and are not recommended for chronic insomnia.

Lifestyle changes and consultation with a healthcare professional are your best options for persistent insomnia. These include identifying and treating any underlying medical or psychological problems, and reducing sleep-impairing activities, such as limiting caffeine consumption or managing stress. Behavioral modification can also be undertaken through special behavioral techniques, such as:

  • Relaxation therapy. Specific techniques to reduce or eliminate anxiety and body tension, such as yoga, meditation or guided imagery. Ideally, your mind is able to stop racing, your muscles can relax, and you can get some restful sleep. You typically have to practice these techniques for a few weeks before they're effective.
  • Sleep restriction. Some people suffering from insomnia spend too much time in bed trying to sleep. They may benefit from a program that initially allows only a few hours of sleep during the night, gradually increasing sleep time until a more normal night's sleep is achieved.
  • Reconditioning. Another treatment is to recondition yourself so you learn to associate the bed and bedtime with sleep. For most people, this means not using the bed or bedroom for any activities other than sleep and sex; this is also referred to as stimulus control. As part of the reconditioning process, you should only go to bed when you're sleepy. If you're not able to fall asleep, get up, stay up until you're sleepy and then return to bed. Throughout this process, you should avoid naps, and wake up and go to bed at the same time each day. Eventually your body and mind begin to associate the bed and bedtime with sleep.
  • Using medications that aid in insomnia treatment. These include zaleplon (Sonata), eszopiclone (Lunesta), zolpidem (Ambien), ramelteon (Rozerem), hypnotic medications, antidepressants and antihistamines. Don't drink alcohol if you're taking any sleep medications because it can intensify their effects.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.