Insomnia Treatment

Insomnia treatment depends on the cause, but may include improving sleep habits, behavioral therapy, sleeping pills, and treatment of other conditions.

The treatment for insomnia depends on the cause of the insomnia. Your treatment course might include one or more of the following:

• Improved “sleep hygiene” (sleep habits)
• Behavioral therapy
• Sleeping pills
• Treatment of underlying medical conditions

In general, improved sleep hygiene is useful for most people with insomnia. To learn more about good sleep habits, see our Insomnia Prevention page. Key factors include a consistent bedtime and wake time, a bedtime routine, a comfortable sleeping environment, and the avoidance of stimulating factors like substances and screen use close to bedtime.

In some cases, worrying about not being able to sleep may actually make it more difficult to sleep. If you can’t sleep, it’s usually best to get out of bed and do a quiet activity, rather than staying in bed and trying to force yourself to sleep. For some people, making a to-do list before bed can reduce the tendency to stay awake worrying and planning.

Behavioral therapy may include education about sleep hygiene, and can also include other techniques. You may learn relaxation techniques to help you fall asleep. Cognitive behavioral therapy helps you learn to control anxiety and negative thoughts that may keep you awake. Sleep restriction treatment is sometimes used; in this treatment, you purposely deprive yourself of sleep so that you’re very tired, and then the next time you sleep, you fall asleep and stay asleep easily, helping you to retrain your brain to sleep well.

There are prescription sleeping pills that are sometimes useful. However, it’s important not to rely on them for more than a few weeks, because you may become dependent on them and they may also cause undesired side effects. Prescription sleeping pills are better than over-the-counter ones, which often have more side effects and tend to reduce the quality of your sleep, meaning that you still feel tired in the morning even though you spend more hours sleeping.

If you have any underlying medical condition that is causing your insomnia, your doctor will also prescribe treatment for this condition. These conditions may be found on blood tests or on the sleep study.

For instance, you may need medication for hyperthyroidism (high thyroid hormone). For women who are having trouble sleeping due to menopause, hormone replacement therapy may help them sleep; this treatment does carry some risk, so talk with your doctor to determine whether it’s worth it to you.

A treatable condition may be found on the sleep study, such as sleep apnea, in which the patient stops breathing many times every night (and may not be aware of the wakings). Sleep apnea can often be treated with a special machine that gently blows air into the airways to keep them open.

For people with depression or anxiety, treating the underlying condition may improve sleep as well as other symptoms.

References

Centers for Disease Control and Prevention (CDC). “Sleep and Sleep Disorders.” CDC website (2015). http://www.cdc.gov/Sleep/index.html

National Institute of Neurological Disorders and Stroke (NINDS). “Brain Basics: Understanding Sleep.” NINDS website (2014). http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm

Mayo Clinic Staff. “Insomnia: Treatments and drugs.” Mayo Clinic website (2014). http://www.mayoclinic.org/diseases-conditions/insomnia/basics/treatment/con-20024293

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