What are the treatment options for insomnia?

Insomnia is a sleep disorder that makes it difficult to fall asleep, stay asleep, or get enough sleep.

Too little sleep can be a serious problem for both physical and mental health. It can result in feelings of irritability, anxiety, depression, and fatigue. It can cause problems with memory and concentration, affecting work, school, and the ability to operate a vehicle safely. Chronic insomnia can increase the risk of health issues such as diabetes, high blood pressure, and cancer.

If you are having trouble sleeping or think you have insomnia, it’s important to talk to a healthcare provider. Insomnia is treatable. Here is a look at some of the treatment options.

Identifying the cause of insomnia

The first step to treating insomnia is identifying its cause. There are many different potential causes:

• Stress, especially periods of severe stress, such as the loss of a job, the death of a loved one, or being diagnosed with an illness
• Changes in your sleeping environment—such as in light, noise, or temperature—or changes in a daily schedule
• The use of—or withdrawal from—caffeine and certain medications
• Jet lag and shift work, since they interfere with the body’s natural clock, called circadian rhythm
• Menopause, partly because it can cause symptoms that interrupt sleep, such as hot flashes and mood swings

Numerous medical conditions are also associated with insomnia, such as restless leg syndrome, sleep apnea, gastroesophageal reflux disease (GERD), chronic pain, and neurological conditions like Parkinson’s and Alzheimer’s disease. Mental health disorders like depression, anxiety, and PTSD can also disrupt normal sleep patterns.

When treating insomnia, it’s important to address any underlying issues or health conditions that may contribute to your lack of sleep. For example, if a medication is believed to be interfering with sleep, your healthcare provider may recommend switching to a different medication. They will also likely recommend adjustments to sleep habits and lifestyles, such as exercising more, going to bed at more consistent times, and cutting back on caffeine.

Cognitive behavioral therapy for insomnia

For chronic insomnia—insomnia that lasts more than three months—the first type of treatment is often cognitive behavioral therapy (CBT). CBT involves talking to a mental health professional to identify any factors that may contribute to insomnia. While individual needs will differ, CBT may include the following:

• Sleep education. This means learning what happens during the sleep cycle and how insomnia may develop.
• Sleep restriction. This involves setting a schedule for sleeping and waking. It also involves keeping a journal to track how you sleep. Sleep restriction may not be recommended for people who have manic episodes or seizures.
• Relaxation training. This method aims to counteract negative moods, emotions, and thoughts that interfere with sleep. It also involves scheduling time to relax.
• Stimulus control. This involves removing factors that condition your mind to avoid sleep, such as taking a TV from your bedroom.
• Sleep hygiene. This focuses on developing healthy habits around sleep, such as sticking to a consistent sleep schedule. It also includes making changes to your lifestyle that may interfere with sleep, such as limiting caffeine and alcohol and quitting smoking if you smoke.

These are only a few CBT techniques, and it is important to remember that everyone’s experiences are different. Some people may feel irritable or fatigued when they try CBT. Either way, a mental health professional will work closely with you to develop strategies that cater to your specific needs.

When is it time to switch to a medication?

In some cases, insomnia may need to be treated with medication. Medication is typically prescribed when lifestyle changes and cognitive behavioral therapy techniques prove ineffective on their own. Deciding to treat insomnia with a medication is a decision you will make with your healthcare provider, and the discussion should cover:

• Possible side effects of the medications
• Any medications you are currently taking and the possibility of drug interactions
• Your insomnia symptoms and the type of insomnia you have
• How long you will need to take the medication
• The cost of the medication

Different medications for insomnia work in different ways. Based on your needs, your healthcare provider may recommend a prescription medication or an over-the-counter medication. People with chronic insomnia are typically advised not to use medication for the long term. Short-term use may incur risks if medication is taken incorrectly. Any medication must be taken under the guidance of a healthcare provider and taken exactly as directed.

Remember that insomnia is a common, treatable disorder. If you have difficulty sleeping or find yourself overly tired throughout your day, talk to your healthcare provider.