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Insomnia (cont.)

Insomnia Treatment

In general, transient insomnia resolves when the underlying trigger is removed or corrected. Most people seek medical attention when their insomnia becomes chronic.

The main focus of treatment for insomnia should be directed towards finding the cause. Once a cause is identified, it is important to manage and control the underlying problem, as this alone may eliminate the insomnia all together. Treating the symptoms of insomnia without addressing the main cause is rarely successful. In the majority of cases, chronic insomnia can be cured if its medical or psychiatric causes are evaluated and treated properly.

The following therapies may be used in conjunction with therapies directed towards the underlying medical or psychiatric cause. They are also the recommended therapies for some of the primary insomnia disorders.

Generally, treatment of insomnia entails both non-pharmacologic (non-medical) and pharmacologic (medical) aspects. It is best to tailor treatment for an individual patient based on the potential cause. Studies have shown that combining medical and non-medical treatments typically is more successful in treating insomnia than either one alone.

Insomnia Non-Medical treatment and Behavioral Therapy

Non-pharmacologic or non-medical therapies are sleep hygiene, relaxation therapy, stimulus control, and sleep restriction. These also are referred to as cognitive behavioral therapies.

Sleep Hygiene

Sleep hygiene is one of the components of behavioral therapy for insomnia. Several simple steps can be taken to improve a patient's sleep quality and quantity. These steps include:

  • Sleep as much as you need to feel rested; do not oversleep.
  • Exercise regularly at least 20 minutes daily, ideally 4-5 hours before your bedtime.
  • Avoid forcing yourself to sleep.
  • Keep a regular sleep and awakening schedule, i.e. go to bed and get up at the same time every day.
  • Do not drink caffeinated beverages later than the afternoon (tea, coffee, soft drinks etc.) Avoid "night caps," (alcoholic drinks prior to going to bed).
  • Do not smoke, especially in the evening.
  • Do not go to bed hungry.
  • Adjust the environment in the room (lights, temperature, noise, etc.)
  • Do not go to bed with your worries; try to resolve them before going to bed.

Relaxation Therapy

Relaxation therapy involves measures such as meditation and muscle relaxation or dimming the lights and playing soothing music prior to going to bed.

Stimulus Control

Stimulus control therapy also consists of a few simple steps that may help patients with chronic insomnia.

  • Go to bed when you feel sleepy.
  • Do not watch TV, read, eat, or worry in bed. Your bed should be used only for sleep and sexual activity.
  • If you do not fall asleep 30 minutes after going to bed, get up and go to another room and resume your relaxation techniques.
  • Set your alarm clock to get up at a certain time each morning, even on weekends. Do not oversleep.
  • Avoid taking long naps in the daytime.

Sleep Restriction

Restricting your time in bed only to sleep may improve your quality of sleep. This therapy is called sleep restriction. It is achieved by averaging the time in bed that the patient spends only sleeping. Rigid bedtime and rise time are set, and the patient is forced to get up at the rising time even if they feel sleepy. This may help the patient sleep better the next night because of the sleep deprivation from the previous night. Sleep restriction has been helpful in some cases.

Other simple measures that can be helpful to treat insomnia include:

  • Avoid large meals and excessive fluids before bedtime
  • Control your environment.
    • Light, noise, and undesirable room temperature can disrupt sleep. Shift workers and night workers especially must address these factors. Dimming the lights in the bedroom, relaxation, limiting the noise, and avoiding stressful tasks before going to bed may be beneficial. (Refer to sleep hygiene and relaxation therapy above.)
    • Avoid doing work in the bedroom that should be done somewhere else. For example, do not work or operate your business out of your bedroom and avoid watching TV, reading books, and eating in your bed.

A person's circadian rhythm (biological clock) is particularly sensitive to light. Parents who need to sleep during the day may have to make child care arrangements to allow them to sleep.

Medically Reviewed by a Doctor on 5/25/2016

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Insomnia »

Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment.

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