Treatment for Insomnia

Once diagnosed, insomnia is a very treatable condition. When insomnia is caused by other problems like stress or pain, treatment of these causes will help. However, if the insomnia is the primary problem, then standard treatments include sleep hygiene education, cognitive behavioral therapy (CBT), phototherapy, chronotherapy and/or medication.

Sleep hygiene: This means practicing good sleeping habits and these include:

• Avoiding nicotine, caffeine, and alcohol for at least several hours before going to bed.
• Avoiding naps during the day.
• Eating on a regular schedule and avoiding large meals late in the day but not going to bed hungry.
• Exercising at least three hours before bedtime.
• Having a set sleeping schedule every night.
• Making sure you are comfortable with your sleep environment (light, noise, temperature).
• Getting rid of any anxiety or worries before bedtime by distracting yourself or making a list for the next day. You may want to keep a notepad or journal next to your bed.
• Doing relaxing things before bedtime, like taking a bath or reading.
• Not trying to force sleep – if you still haven’t fallen asleep after half an hour, get out of bed and go to another room where you can do something quiet until you get tired.

If these recommendations don’t help your insomnia, you might want to try over-the -counter medications such as melatonnin or diphenhydramine (contained in Tylenol PM and Unisom, among others).

Keep in mind that you don’t have to worry about your health too much if you get at least six hours of sleep a day. Everyone has different requirements when it comes to sleep, though, so some people might thrive on just four hours of sleep, while others might feel better with getting ten hours of sleep.

Your sleep requirements will also change the older you get. So, make sure you listen to the sleep signals in your body and don’t try to get more sleep or less sleep than you need to awaken refreshed in the morning.

Cognitive behavioral therapy (CBT):

People who have problems sleeping at night often worry that the will not be able to function well the next day and this can start a cycle of worry that only increases the sleeplessness. Staying awake causes anziety which makes it harder to sleep and people sometimes begin to blame all their problems on not being able to sleep. Working with a therapist helps deal with the anxiety of insomnia and the negative thinking that worsens the problem.

CBT for insomnia is usually done over an 8-10 week period and focusses on sleep hygiene education, stimulus control, sleep restriction and cognitive therapy. It may also address stress and relapse prevention.

Phototherapy: This is also called light therapy and is used for people who have a specific type of insomnia called delayed sleep phase syndrome. Their body’s “clock” is set so that they have a difficult time falling asleep until much later than they want to and therefore wake up later than they want to in the morning. Phototherapy is done by sitting in front of a special light box for 30-40 minutes after waking up to reset the body’s sleep clock.

Chronotherapy: This is used for people who have a circadian sleep disorder and involves intentially delaying sleep by 2-3 hours more each day until the person is able to fall asleep at the desired time. This can be very difficult to do and must be followed up with a strict sleep schedule.