Insomnia Treatment

The American Academy of Sleep Medicine (AASM) recommends that creating healthy sleep hygiene and/or partaking in behavioral therapies should be the main treatment for insomnia. Medications should only be prescribed when these methods have failed.

Sleep Hygiene:

Proper sleep hygiene is defined as a program of good habits that ensure quality sleep. The most common habits include:

• Establishing a regular sleep schedule. This means going to bed and getting up at the same time everyday, even on weekends and during vacations.
• Reserving the bed for sleep and sex only. Reading, watching television or working should not be done while in bed.
• Avoiding late afternoon or evening naps.
• Exercising in the afternoon before dinner and at least 4 hours before bedtime.
• Eating light dinners 4 to 5 hours before bedtime. Avoiding spicy, fatty, sugary foods in the evening.
• Avoiding alcohol and caffeine 4 to 6 hours before bedtime.
• Avoiding fluids right before bedtime so that sleep is not interrupted by the need to urinate.
• Taking a hot bath 2 hours before bedtime. This changes the body’s temperature and helps people fall asleep. However, taking a bath right before going to bed increases alertness.
• Partaking in a relaxing activity 30 minutes before bedtime.
• Keeping the bedroom cool and well ventilated.
• Not worrying about what time it is or not being able to sleep.
• Getting enough sunlight by spending half an hour in the sun each day.
• Going into another room if one can’t fall asleep within 15 minutes of going to bed. Try to go back to bed after reading or doing a relaxing activity until very sleepy. Avoid watching television or using bright lights during this time.

Behavioral Therapies:

There are quite a few behavioral therapies available to patients suffering from insomnia. All behavioral approaches aim at reducing the time it takes to fall asleep  and at reducing early waking. Behavioral techniques are known to be very effective in curing insomnia and have long-lasting benefits.

• Stimulus control: Stimulus control is a standard treatment for primary chronic insomnia. The main goal of stimulus control is to reinforce the idea that the bed should be used for sleeping and sex only. Stimulus control requires patients to go to bed only when they ready to sleep or for sex. If patients are unable to sleep within 15 minutes, they should get up and go into another room. Patients need to maintain a regular sleep schedule and should wake up at the same time everyday regardless of how few hours they slept. Patients should also avoid naps.
• Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) emphasizes becoming aware of and changing negative thoughts about sleep. Negative thoughts include obsessing about not being able to fall asleep or about the time. Cognitive behavioral therapy targets sleep anxiety and provides patients with tools to help conquer these negative feelings.
• Relaxation training: Relaxation training includes breathing techniques, guided imagery techniques and progressive muscle relaxation. Progressive muscle relaxation take 10 minutes to do and works by focusing on one specific muscle group at a time.