How Is Insomnia Treated?
Lifestyle changes often can help relieve acute
(short-term) insomnia. These changes may make it easier to fall asleep and stay
asleep.
A type of counseling called cognitive-behavioral
therapy (CBT) can help relieve the anxiety linked to chronic (ongoing)
insomnia. Anxiety tends to prolong insomnia.
Several medicines also can help relieve insomnia and
re-establish a regular sleep schedule. However, if your insomnia is the symptom
or side effect of another problem, it's important to treat the underlying cause
(if possible). Your doctor also may prescribe medicine to help treat your
insomnia.
Lifestyle Changes
If you have insomnia, avoid substances that make it
worse, such as:
- Caffeine, tobacco, and other stimulants taken
too close to bedtime. Their effects can last as long as 8 hours.
- Certain over-the-counter and prescription
medicines that can disrupt sleep (for example, some cold and allergy
medicines). Talk to your doctor about which medicines won't disrupt your
sleep.
- Alcohol. An alcoholic drink before bedtime may
make it easier for you to fall asleep. However, alcohol triggers sleep that
tends to be lighter than normal. This makes it more likely that you will wake
up during the night.
Try to adopt good bedtime habits that make it easier
to fall asleep and stay asleep. Follow a routine that helps you wind down and
relax before bed. For example, read a book, listen to soothing music, or take a
hot bath.
Try to schedule your daily exercise at least 5 to 6
hours before going to bed. Don't eat heavy meals or drink a lot before
bedtime.
Make your bedroom sleep-friendly. Avoid bright
lighting while winding down. Try to limit possible distractions, such as a TV,
computer, or pet. Make sure the temperature of your bedroom is cool and
comfortable. Your bedroom also should be dark and quiet.
Go to sleep around the same time each night and wake
up around the same time each morning, even on weekends. If you can, avoid night
shifts, alternating schedules, or other things that may disrupt your sleep
schedule.
Cognitive-Behavioral Therapy
CBT for insomnia targets the thoughts and actions
that can disrupt sleep. This therapy encourages good sleep habits and uses
several methods to relieve sleep anxiety.
For example, relaxation training and biofeedback at
bedtime are used to reduce anxiety. These strategies help you better control
your breathing, heart rate, muscles, and mood.
CBT also works on replacing sleep anxiety with more
positive thinking that links being in bed with being asleep. This method also
teaches you what to do if you're unable to fall asleep within a reasonable
time.
CBT also may involve talking with a therapist
one-on-one or in group sessions to help you consider your thoughts and feelings
about sleep. This method may encourage you to describe thoughts racing through
your mind in terms of how they look, feel, and sound. The goal is for your mind
to settle down and stop racing.
CBT also focuses on limiting the time you spend in
bed while awake. This method involves setting a sleep schedule. At first, you
will limit your total time in bed to the typical short length of time you're
usually asleep.
This schedule may make you even more tired because
some of the allotted time in bed will be taken up by problems falling asleep.
However, the resulting tiredness is intended to help you get to sleep more
quickly. Over time, the length of time spent in bed is increased until you get
a full night of sleep.
For success with CBT, you may need to see a
therapist who is skilled in this approach weekly over 2 to 3 months. CBT works
as well as prescription medicine for many people who have chronic insomnia. It
also may provide better long-term relief than medicine alone.
For people who have insomnia and major depressive
disorder, CBT combined with antidepression medicines has shown promise in
relieving both conditions.
Medicines
Prescription Medicines
Many prescription medicines are used to treat
insomnia. Some are meant for short-term use, while others are meant for longer
use.
Talk to your doctor about the benefits and side
effects of insomnia medicines. For instance, insomnia medicines can help you
fall asleep, but some people may feel groggy in the morning after taking them.
Rare side effects may include sleep eating, sleep
walking, or driving while asleep. If you have side effects from an insomnia
medicine, or if it doesn't work well, tell your doctor. He or she may prescribe
a different medicine.
Some insomnia medicines may be habit forming. Talk
to your doctor about the benefits and risks of insomnia medicines.
Over-the-Counter Products
Some over-the-counter (OTC) products claim to treat
insomnia. These products include melatonin, L-tryptophan supplements, and
valerian teas or extracts.
The Food and Drug Administration doesn't regulate
natural products and some food supplements. Thus, the dose and
purity of these products can vary. How well these products work and how safe
they are isn't well understood.
Some OTC products that contain antihistamines are
marketed as sleep aids. Although these products may make you sleepy, talk to
your doctor before taking them.
Antihistamines pose risks for some people. Also,
these products may not offer the best treatment for your insomnia. Your doctor
can advise you whether these products can benefit you. |