Insomnia (cont.)
How Is Insomnia Treated?
Making lifestyle changes that make it easier to fall
asleep and/or stay asleep can often relieve insomnia. For longer lasting
insomnia, a type of counseling called cognitive-behavioral therapy can help
relieve the anxiety linked to your sleep problem. Anxiety tends to prolong the
insomnia. Several medicines also can help relieve insomnia and re-establish a
regular sleep schedule.
Lifestyle Changes
To relieve insomnia, you should avoid substances that make
it worse and have good bedtime habits that make it easier to fall asleep and
stay asleep. Make sure your bedroom is a comfortable temperature, dark, and
quiet enough for sleep.
Avoid substances such as:
- Caffeine, tobacco, and other stimulants taken too close to bedtime (effects
of caffeine can take as long as 8 hours to wear off).
- Certain over-the-counter
and prescription medicines that can disrupt sleep (for example, some cold and
allergy medicines).
- Alcohol. An alcoholic drink before bedtime may make it
easier for you to fall asleep. But alcohol triggers sleep that tends to be
lighter than normal and makes it more likely that you will wake up during the
night.
Good bedtime habits include:
- Following a routine that helps you wind down and relax before bed, such as
reading a book, listening to soothing music, or taking a hot bath.
- Not
exercising, eating heavy meals, or drinking a lot shortly before bedtime.
- Making
your bedroom sleep-friendly. Avoid bright lighting and minimize possible sleep
distractions, such as a TV, computer, or pet.
- Going to sleep around the same
time each night and waking up around the same time each morning, even on
weekends. If possible, avoid night shifts or alternating schedules at work and
other causes of irregular sleep schedules.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy for insomnia targets the thoughts and actions that
can disrupt sleep. Besides encouraging good sleep habits, this type of therapy
may use several methods to relieve sleep anxieties, including:
- Relaxation training and biofeedback at bedtime to reduce anxiety. These
strategies help you better control your breathing, heart rate, muscles, and
mood.
- Replacing worries about not being able to fall asleep 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 period.
- Talking
with a therapist individually 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.
- Limiting the time you
spend in bed while awake. This method involves setting a sleep schedule and, at
first, limiting total time in bed to the typical short length of time you're
usually asleep. At first, this schedule may make you even more tired because
some of the allotted time in bed will be taken up by difficulty sleeping. The
resulting fatigue (tiredness) is intended to help you get to sleep more quickly.
Gradually, the length of time spent in bed is increased until you get a full
night of sleep.
For success with this type of therapy, you may need to see a
therapist who is skilled in this approach weekly over 2 to 3 months.
Cognitive-behavioral therapy is as effective as prescription medicine for many
types of chronic insomnia. It also may provide better long-term relief than
medicine alone.
Medicines
Several medicines cause sleepiness. Doctors sometimes prescribe
sleep-inducing medicine for 1 to 2 weeks to help establish a regular sleep
schedule. Insomnia medicine helps you fall asleep, but can leave some people
feeling unrefreshed or groggy in the morning. You may also be groggy and should
exercise caution if you must get up before getting a full night's sleep of 7 to
8 hours while taking these medicines. The Food and Drug Administration (FDA)
hasn't approved all insomnia medicines for continuous, long-term use. Your
doctor can help you understand the benefits and potential problems if medicines
will be needed for long periods.
Some people use natural remedies to treat their insomnia. These remedies
include melatonin and L-tryptophan supplements and valerian teas or extracts.
The FDA doesn't regulate these over-the-counter treatments. This means that
their dose and purity can vary from product to product. Their safety and
effectiveness is not well understood.
Medicines also are available to treat symptoms of excessive sleepiness if
your insomnia is the result of shift work or alternating work schedules. You
should discuss your situation with your doctor to determine whether these
medicines, together with improving sleep habits, can help you overcome insomnia.
Next: Key points »
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