Insomnia, or the inability to fall asleep at a normal time and remain asleep through the night, can create havoc in the life of an insomniac. Physical and mental health may deteriorate when a person is unable to sleep for an adequate amount of hours a night. Insomniacs often try all the typical avenues of self-treatment, including drinking relaxing tea before bed, creating a calmer bedroom environment, avoiding stimulation before bedtime, or simply not fighting their alertness and engaging in activity rather than attempting to chase elusive sleep. After a diagnosis has been made and underlying causes are completely ruled out since insomnia may be a symptom of an illness, the patient may then be treated either by using cognitive behavior therapy, or with medication.
Cognitive Behavior Therapy and insomnia
Cognitive Behavior Therapy, or CBT, is the obvious first choice for treating insomniacs to avoid needing long-term medication and possibly suffering its negative side effects. CBT also has a higher rate of success in treating insomnia patients. The goal of the therapy is to reprogram the thought process and environmental stimuli that is preventing them from falling asleep normally.
There are several different forms of cognitive behavior therapy. For example, the therapist will teach the patient to control outside stimuli: waiting for sleepiness to set in before going to bed, and staying out of the bedroom and occupying oneself with activities or hobbies until completely ready to go to sleep. Other stimulus control methods include using the bedroom only for sleeping or intimacy, and not doing other activities in the bedroom such as watching television. This creates a positive association with sleep in the proper environment.
More CBT methods include restricting sleep time to short periods a night so that the patient is only in bed while actually sleeping and not being forced to toss and turn, which can create a negative association. As the patient increases actual sleeping, allotted sleep time is increased. Teaching relaxation techniques, called “relaxation training”, enables the patient to use breathing techniques, imagery, and meditation to achieve sleep readiness. Making certain the patient has a quiet sleep environment, ignores the clock or perceived need for a specific amount of hours, avoids caffeine and other anxiety-inducing issues is called “sleep hygiene education”.
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In cases where Cognitive Behavior Therapy is ineffective, or if there is an immediate need to attain some sleep for health reasons, sleep medication may be prescribed by the doctor. Medication can be helpful and effective, although it is not advisable to depend on sleep medication for long term help. Types of sleep medication are nonbenzodiazepine hypnotic medications, melatonin receptor agonists, and benzodiazepine hypnotic medications, which are the classic sleeping pills.
Insomnia sufferers should seek help from a professional health care provider to determine how best to enable them to achieve normal sleep. Cognitive behavior therapy can have excellent outcomes, but in some specific cases a doctor may call for medical intervention.
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