Overcoming Insomnia: Treatment and Medication Options

People with insomnia might feel there’s no hope for relief, but it can be overcome, and current treatment therapies are highly effective. While tried-and-true sleep hygiene strategies can be helpful, more comprehensive approaches are often needed for chronic cases.

Sleep Hygiene: A Foundation for Better Sleep

Sleep hygiene strategies, like keeping consistent sleep and wake times, avoiding stimulating activities before bed, and shutting down electronic devices 30 to 60 minutes before bed, usually help sleep problems and often alleviate them completely. These strategies are too recommended for insomnia prevention. However, once sleep problems become chronic, these strategies aren’t as effective in reversing sleep difficulties—though they’re often still recommended to keep insomnia from becoming worse and help make other treatments more effective.

Cognitive Behavioral Therapy for Insomnia (CBTi)

Cognitive behavioral therapy for insomnia (CBTi) – a type of psychotherapy or talk therapy – is now considered the gold standard for chronic insomnia treatment. “CBTi is generally recommended as first-line therapy for chronic insomnia,” says Sheila Tsai, MD, pulmonologist and section head of sleep medicine at National Jewish Health in Denver. Mayo Clinic confirms CBTi’s effectiveness as a primary treatment.

With CBTi, you’re essentially retraining your brain and body on how to sleep. It works to erase the aversion some people develop to their bed and bedroom and the act of sleeping by training people to use techniques specifically targeting the psychological factors associated with insomnia, such as negative emotions and worries about not being able to sleep.

CBTi can involve breathing techniques, muscle relaxation practices, and other complementary therapies to help you get to sleep. It can also involve changing your sleep routines or bedroom environment to promote sound sleep. While doing CBTi with a trained specialist in person is the best option, online programs can also be effective, especially for self-motivated individuals or those who lack access to a specialist.

The time it takes to overcome chronic insomnia with CBTi varies. For some, therapy may reverse sleep problems in just a few weeks, while others need several months. Like other health conditions, relapse is possible, so remembering and practicing the behavioral skills learned in CBTi is essential if sleep becomes disrupted again.

Medication Options for Insomnia

Prescription sleeping pills can play a role in insomnia management, but they should be used with caution and only for a short period of time. They can have serious side effects and can be habit-forming if relied on for too long, potentially leading to physical dependency. The National Center for Biotechnology Information details potential risks and benefits of sleep medications.

Medication may help prevent a bout of short-term insomnia from turning into a chronic problem, or help jump-start a healthier sleep pattern for someone with chronic insomnia. The idea is to use the medication for a few nights to get back to a healthy sleep schedule, then stop once a great routine is re-established.

Many people also use over-the-counter sleep aids, such as melatonin. Our bodies naturally produce melatonin, a hormone that triggers a series of reactions that help our brains and bodies fall asleep. It’s available as a supplement and, according to research, does not carry the same risk of addiction as prescription sleep aids.