How Is Insomnia Treated?

Treatment of insomnia depends on the cause. Nondrug therapy includes using relaxation therapy, controlling stimulation (for example, caffeine ingestion or evening exercise), and limiting time in bed to regular sleep hours. Medications directed toward a specific sleep-disrupting cause should also be considered.

Sedative-hypnotic drugs do not cure insomnia, but they may relieve symptoms. Short-term use (2-3 weeks) of sleeping pills may be warranted for chronic insomnia while other treatments or behavioral therapies are being started.

The choice of sedative-hypnotic depends on the type of sleep problem. If an individual has trouble falling asleep, a quick-acting but short-lasting drug such as zolpidem (Ambien) may be prescribed. These types of drugs are useful because they may be taken after several hours of trying to fall asleep, yet the effects do not last long enough to cause difficulty waking in the morning. Drugs that have longer-lasting actions, such as flurazepam (Dalmane), temazepam (Restoril), estazolam (ProSom), and antidepressants, are useful for individuals who wake up after initially falling asleep.