Treatment Options For Insomnia: How To Get The Sleep You Need
Insomnia, or frequently having trouble getting enough restful sleep, is one of the most common sleep disorders (also called sleep-wake disorders) and can have a significant impact on your life. Sleep trouble can be frustrating in the moment when you’re lying in bed awake trying to fall asleep. Lack of sleep can also take its toll the next day, potentially causing side effects such as irritability and tiredness which can result in trouble with mood, decision making, work, relationships, and overall happiness and well-being—plus an increased risk of accidents.
In addition, consistently getting insufficient or low-quality sleep over the long term can lead to a variety of health consequences, such as an increased risk of depression, diabetes, hypertension, high blood pressure, obesity, stroke, heart attack, and depression. That’s why finding a solution is a top priority for most people with long-term insomnia. If you’re experiencing insomnia, read on to learn more about insomnia treatment strategies that may help you get back to quality, restful sleep.
What is insomnia?
The term insomnia is defined as a "prolonged and usually abnormal inability to get enough sleep especially due to trouble falling asleep or staying asleep."
Most of us will have trouble falling asleep from time to time, like when we’re worried about a work presentation the next day or when we can’t relax because of the neighbor’s barking dog. However, when you have difficulty falling asleep multiple times per week for a month or more, you likely have insomnia. It can also take the form of having trouble staying asleep and/or not being able to go back to sleep easily after waking up during the night. It’s estimated that as many as 70 million adults in the US live with this condition.
Laying in bed for a long time before you can fall asleep
Being unable to stay asleep
Waking up in the middle of the night or too early in the morning and having difficulty going back to sleep
Excessive daytime sleepiness
Unintentionally being awake many hours each night
Potential causes of insomnia
Pinpointing the exact cause of insomnia can be challenging because there are so many factors that can affect whether or not you get a good night’s sleep. The simplest explanation is poor sleep hygiene. For example, if your sleeping space is bright, noisy, or an uncomfortable temperature or if you have drastically different sleep and wake times from one day to the next, you’re more likely to experience sleep issues.
Next, insomnia can also be caused by underlying physical or mental health conditions. Some of the many physical health conditions that could contribute to sleep issues include anything that causes chronic pain (arthritis, chronic back problems, fibromyalgia), restless leg syndrome, Parkinson’s disease, certain gastrointestinal conditions, breathing conditions like sleep apnea, and dermatological conditions that cause itching. PMS, pregnancy, and menopause could also contribute to poor sleep. Furthermore, certain mental health conditions include sleep difficulties as possible symptoms such as depression and anxiety.
It’s also worth noting that some risk factors may make a person more likely to develop insomnia or other sleep problems. For example, it’s more likely to impact those who:
Work late hours or the night shift
Often travel through different time zones
Have a sedentary lifestyle
Are middle-aged or older adults
Live with depression
Live with chronic pain
Have a lot of stress in their life
Are on certain medications for other conditions
Strategies for better sleep
If you’ve been experiencing insomnia without a clear cause, there are actions you can take. First, see below for strategies that may help you improve your sleep. Next, it may also be helpful to make an appointment with your healthcare provider or find a doctor to discuss your sleep patterns. They can determine whether there may be an untreated underlying cause that can be addressed. Remember, a lack of quality sleep over a long period of time can have serious negative health affects.
If you’re having trouble sleeping, you might try some of the methods below to potentially improve the quality of your rest.
Practice good sleep hygiene
Sleep hygiene refers to your bedtime routine, habits, and sleeping conditions. Practicing good sleep hygiene means adjusting these things to match science-backed recommendations as best you can. The following are all examples of sleep hygiene tips to try, according to The Sleep Foundation:
Sleep and wake at roughly the same times each day
Sleep in a cool, dark room
Choose a comfortable mattress and bed linens
Set a consistent, relaxing bedtime routine
Avoid screens (TV, phone) at least an hour before bed
Get up and do a relaxing activity after 20 minutes of lying in bed without sleeping until you feel tired again
Avoid long or late naps during the day
It’s also worth noting that there’s no one answer to the question, “When should I go to sleep?” when it comes to general sleep hygiene. Instead, sleeping and waking at approximately the same time each day and night, as mentioned above, is usually the key guideline to follow.
Exercise regularly
According to Charlene Gamaldo, M.D., Medical Director of the Johns Hopkins Center for Sleep, there is “solid evidence” that exercise can help you fall asleep more quickly and improve your sleep quality. Around 30 minutes of aerobic exercise per day can be enough to promote better sleep at night. Since regular exercise can also have a host of other benefits—from increasing mobility to decreasing the risk of disease and improving mental health—it’s typically well worth incorporating this type of activity into your routine.
Try cognitive behavioral therapy for insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment of insomnia that addresses both the short-term and long-term aspects of the condition by modifying sleep-wake patterns and behaviors. Unlike medication, which may only offer short-term relief, CBT-I can provide sustainable strategies for achieving better sleep hygiene and coping with insomnia. To begin this evidence-based treatment, it's crucial to find a doctor or health care provider specializing in sleep disorders who can tailor the approach to your individual needs.
Incorporate nutritious foods into your diet
Most of us are already familiar with the fact that the foods we eat can have direct effects on our health and well-being, and the same is true when it comes to sleep. A 2020 study on how diet relates to nightly rest came up with two key suggestions in this regard. First, a nutritious diet that’s rich in healthy carbohydrates—fruits, vegetables, legumes, and whole grains—seems to help promote more positive sleep outcomes. Second, foods that are naturally rich in melatonin, an important sleep chemical, may help individuals fall asleep faster—especially when consumed close to bedtime. Examples of such foods include almonds, cherries, and kiwi.
It’s typically recommended that you consult with your doctor or nutritionist before making significant changes to your eating patterns. That said, eating a nutritious, balanced diet in general is likely to improve your sleep at least somewhat, in addition to potentially bringing a host of other health benefits.
Limit alcohol and caffeine
Some people believe that alcohol can actually act as a sleep aid because they find it easier to fall asleep after they’ve had a drink or two. However, research does not support this as a helpful habit. While some people may have less trouble falling asleep with alcohol in their system, studies suggest that the substance may actually be associated with poorer sleep quality and shorter sleep duration.
Furthermore, unsurprisingly, caffeine can also have detrimental effects on sleep, such as keeping you wide awake when it’s time for bed. That’s why it’s recommended that you stop caffeine consumption around eight hours before your target bedtime so it can be out of your system by then.
Seek the support of a healthcare professional
As mentioned previously, certain mental and physical health conditions may contribute to insomnia and other sleeping problems. If you haven’t already been to a medical doctor for evaluation, that may be a helpful next step for those experiencing chronic insomnia. They can conduct an exam to see if there may be an underlying physical health issue that’s causing your troubles.
After that, you may also want to seek out the support of a mental health care provider. Again, depression and anxiety are two common but serious mental health conditions that can contribute to trouble sleeping. High levels of stress can as well, since it can set the mind racing and put the body in fight-or-flight mode, which makes relaxing enough to sleep more difficult. If any of these mental health challenges are affecting you, they may be able to suggest coping strategies or treatment options that may help. Simply having a nonjudgmental listening ear could also contribute to you having a more relaxed mind at the end of the day, as therapy can represent a unique opportunity to process life’s challenges, get things off your chest, and be truly listened to and heard.
If commuting to a therapist’s office is not possible for you or doesn’t fit with your schedule, you might find online therapy to be a more convenient option for connecting with a mental health care provider. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist with whom you can speak via phone, video call, and/or in-app messaging from the comfort of home. Since research suggests that digital and face-to-face therapy can be “equally effective” in many cases, you can feel confident choosing whichever format feels best for you.
Takeaway
How long do insomnia treatments last?
The length of time an insomnia treatment lasts varies considerably from treatment to treatment. Ideally, a comprehensive approach to treating insomnia is designed to be permanent as long as the treatment is maintained, although there are exceptions. For example, a person taking medication to treat insomnia may develop tolerance to the medication over time, subsequently lowering its effectiveness.
Other treatments require ongoing, sometimes lifelong, effort to maintain. For example, behavioral therapy for insomnia helps someone develop behavioral routines that support sleep onset and high sleep quality. However, if those routines aren’t maintained, they cannot be effective. Generally, behavioral treatments are only as effective for long as the person benefiting from them commits to the behavioral routine.
When should you seek treatment for insomnia?
A formal diagnosis of insomnia requires that sleep difficulties occur at least three times per week for a period of three months. If you’ve reached that threshold, strongly consider reaching out to a professional for help with your sleep disturbance. However, you don’t need to wait until sleep problems become severe before seeking treatment. If you regularly struggle to fall asleep, wake up during sleeping hours, or rarely feel rested, consider reaching out to a professional. You may also want to consider keeping a sleep diary to help the professional understand the scope of your concerns.
How is insomnia typically treated?
Treatment for insomnia typically involves making changes that promote good sleep habits, improve sleep quality, and balance the sleep-wake cycle. For example, cognitive behavioral techniques for insomnia focus heavily on improving sleep hygiene. Sleep hygiene refers to actions taken nightly that help maintain an environment that promotes sleep. Examples include avoiding caffeine, lowering the temperature of the sleeping area, ensuring the space is dark, avoiding certain over-the-counter medications, and avoiding the use of electronics within half an hour of bedtime.
Therapy typically begins with basic sleep education and discussion of strategies to enhance relaxation. The therapist may also investigate underlying causes, such as excessive stress and anxiety, and recommend strategies to address them. As treatment continues, the therapist might introduce more advanced techniques, like sleep restriction therapy.
In some cases, a medical professional may determine that their patient could benefit from sleep medications. Sleeping pills vary widely in their mechanism of action, side effects, and effectiveness. The medical provider often works alongside a therapist who provides behavioral strategies to manage insomnia to coordinate the use of medication and psychotherapeutic techniques. Natural over-the-counter remedies, like melatonin supplements, are also sometimes recommended, but the evidence supporting their use is mixed.
How do you treat insomnia without medication?
Because the effectiveness of insomnia medication can vary considerably, many consider non-pharmacological treatments the first-line approach to managing a sleep disorder. Those who seek professional help for their insomnia and do not want to take medication would likely benefit from meeting with a therapist or other mental health professional. They can use evidence-based strategies like cognitive behavioral therapy for insomnia (CBTI) to help their patients develop behavioral strategies that support good sleep habits or utilize advanced techniques like stimulus control therapy. Therapists can also assess possible underlying causes, like anxiety, and recommend strategies to manage them.
Can a person recover from insomnia?
Insomnia is a common concern. Evidence suggests that 10% to 15% of the general population are affected by sleep disturbances. Most of those cases eventually resolve, but some people will experience persistent sleep disturbances that require ongoing, potentially lifelong, treatment. In many cases, that means adhering to behavioral strategies and taking prescribed medications. Although some people will experience ongoing sleep problems, most people are able to recover from their insomnia with adequate treatment. However, it is possible that life changes or other factors could induce a new course of insomnia, potentially requiring further treatment.
How can I help myself sleep with insomnia?
One of the best ways to address sleep troubles without professional help is to practice good sleep hygiene. Sleep hygiene refers to behaviors and routines that promote drowsiness and restful sleep. Some common sleep hygiene tips are listed below:
- Maintain a consistent sleep schedule. Try to go to bed and wake up around the same time each night and day, even on weekends or holidays.
- Create a good sleep environment. Ensure that your sleeping area is cool, quiet, and dark.
- Don’t drink alcohol before bed. While alcohol can make a person feel drowsy, it can significantly disrupt sleep quality, ultimately reducing the amount of restful sleep.
- Avoid naps during the day.
- Learn relaxation techniques. Strategies like breathing exercises and progressive muscle relaxation can help you feel calm and ready to rest at bedtime.
- Avoid over-the-counter medications that disrupt sleep. Some cold and allergy medications can interfere with sleep.
- Get regular physical activity. Exercise during the day can help reduce excess energy at bedtime.
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