What Are the Treatment Options for Insomnia?

Though there are many different treatment options, the first step in any case is to understand the issue. The recommended way to do this is to keep a sleep journal, which is a record of information about your sleep habits. Your sleep journal should include:

  • What time you went to bed
  • How long it took you to fall asleep
  • How many times you woke up in the middle of the night
  • How long you spent awake at night total
  • The time you woke up
  • How long you spent in bed after waking up

An important thing to keep in mind about a sleep journal is not to "clock watch" after you get into bed. Clock watching is when you keep looking at the clock to see what time it is, and can distract you from falling asleep. Instead it's okay to estimate the times, the sleep journal is not meant to be exact but is more of an informational tool to help you see what your sleep habits are. The sleep journal can also help with the next step, talking to your doctor about the issues you're having with your sleep. The information in the sleep journal can help a doctor decide what steps they think you should take next. The following sections will describe what the common treatments are

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is a set of lessons and exercises for changes you can make to your sleep habits (doctors call them sleep hygiene) that will help you sleep more and hopefully overcome your insomnia. It is the number one recommendation for treating insomnia according to the European Sleep Foundation, and has the most evidence supporting it, with over 15 studies showing good effects and increased sleep in subjects who tried it. CBT-I can be done with a doctor, usually a  psychiatrist, who gives the lessons and guides you through the exercises to improve your sleep, but can also be done using a computer.

Pharmacological Treatments

In addition to CBT-I, doctors may prescribe various medicines that can help with insomnia. These medicines include benzodiazepines and sedating antidepressants, which are commonly referred to as sleeping pills because they can help you sleep. Though these medications have been shown to help with insomnia in the short term, they are not recommended because they have side effects and can cause people to become dependent on them to sleep. A study in the American Journal of Psychiatry found that over 50% of benzodiazepine users returned to using benzodiazepines within 2-5 years of stopping.

Other Treatments

Some additional recommendations include exercise, supplements, and light therapy. Light therapy uses light bulbs that mimic sunlight to help regulate the sleep cycle, while supplements like melatonin aim to increase the amount of certain chemicals in the brain that are linked to sleep. Though these approaches can be helpful, there is little evidence to show they are effective in treating insomnia

Citations

https://www.ncbi.nlm.nih.gov/pubmed/2035717 https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.12594