There are two main types of treatments for insomnia.
The first one is psychological.
Psychological treatments aim at modifying the behaviors that cause insomnia. This form of treatment has been around since the 1930s.
The second is pharmacological.
Pharmacological treatments emerged more recently. They are aimed at using prescribed drugs to reduce insomnia.
Indeed, several randomized clinical trials have found that both treatments are effective.
Both psychological and pharmacological treatments help with short term and long term insomnia.
But in this article, we’ll go over mostly the psychological treatments for insomnia since they don’t involve medication.
Here are the treatments we will discuss:
- Stimulus control
- Muscle relaxation
- Sleep hygiene
- Sleep Restriction
- Paradoxical intention
- Cognitive-behavioral therapy
Let’s dive in!
1. Stimulus control
The underlying notion for this treatment is simple. Insomniacs link certain non-sleep related activities in the bedroom to sleep. Let me explain.
If there’s a TV in your bedroom, you watch it often.
And staying awake watching TV is a problem for falling asleep, and consequently insomnia symptoms.
This, in turn, leads to the insomniac associating the bedroom with their sleep problem.
This association triggers their alertness and arousal when they need to sleep. Therefore it decreases their chances of falling asleep when they are in bed.
But the cycle of wrong association becomes chronic.
This is because not falling asleep when in bed creates agitation and even more arousal. It’s a negative cycle.
So stimulus control therapy aims to modify the activities that deepen wrong associations and stokes wakefulness.
Instead of watching TV at night, do something else.
Research in the Journal of Clinical Psychology suggests asking one good question. Here it is: ‘‘Has 15–20 minutes passed?’’
If it does, insomniacs can then they should get up. The benefit is it helps identify signs of sleepiness.
2. Muscle relaxation
Progressive muscle relaxation is where you tense your muscles for about 4 to 7 seconds. And then you relax them for another 20 to 45 seconds.
You do this for about 10 to 30 minutes right before you sleep.
All this while, you’re rotating the tense and relaxing using different muscle groups each time.
For example, use muscles in your:
Why is this technique so powerful?
It helps insomniacs to find those feelings of relaxation and tension in their body. This, in turn, enables them to consciously relax when they feel tense.
This technique typically takes 10–30 minutes.
And the homework involves instructing the patient to practice at home during the day and before bedtime.
Studies show that progressive muscle relation is the most effective insomnia treatment.
3. Sleep hygiene
Sleep hygiene refers to the environment and behaviors surrounding our bedtime.
If you combine all the activities you do right before sleep, you’ll have a good picture of what your sleep hygiene is.
Unfortunately, most of us have stuck with poor sleep hygiene for years.
We go to bed late, eat late at night, and pay little attention to our bedroom environment.
Things to pay attention to include:
When we have the right temperature, not only do we sleep well, we also sleep longer.
This because our body’s temperature because of our body’s sleep cycle and rhythm follows that of our body temperature.
Controlling what we see right before bed is crucial if we want to improve sleep hygiene. The biggest factor for most of us is bedroom light.
For starters, avoid all loud noises if you want to sleep better.
Most people cannot sleep in loud environments. If that’s you, consider using white noise to block out distractions and sleep faster.
The closest touch we get regarding sleep is in two main categories: the materials we wear and the materials we touch (or bedding).
5. Sleep restriction
In this treatment, the idea is to reconfigure the sleep-wake cycle so it’s better aligned with your actual sleep need.
Think of it as a gym for your sleep. You want to build the right circadian rhythm muscles that promote regular sleep.
You are retraining the body’s internal clock to discard poor sleep behavior and schedules.
Over time, with sleep restriction, insomniacs are conditioned to feel sleepy when they go to bed. This, in turn, helps them to fall asleep faster.
5. Paradoxical intention
The paradox of this therapy is it instructs insomniacs to actually go to bed and stay awake.
How is staying awake going to enable you to sleep?
The goal is to shrink the anxieties about sleep – whether it’s how long you sleep or how fast you sleep.
This is not a method used often and more studies might be needed to prove it’s effectiveness.
But, if insomniacs have tried other techniques without success, this might be a good last resort.
6. Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is when you use more than one of the techniques we just discussed to tackle insomnia.
Cognitive therapy aims to disrupt thoughts that prevent us from sleeping.
Because of sustained poor sleep, insomniacs tend to have unhealthy beliefs, ideas, and thoughts about sleep.
These beliefs can include the worrisome thought that they’ll never be able to sleep well again.
Or that even when they sleep, they wouldn’t be the needed hours of sleep.
The growing evidence for CBT as an effective treatment for persistent insomnia is compelling.
Researchers enrolled over 4,000 participants and did 85 clinical trials. They found that CBT helped 70% of the patients improve their sleep.
And those gains continued for 6 months and more after the treatment
Part of CBT is education. If you’re experiencing signs of insomnia, know that you’re not alone.
And that about 70 percent of adults only get between 6 and 9 hours of sleep.
Plus, the average adult wakes up a lot of the time during the night but don’t remember.
Treating insomnia is not always about taking medication.
Some of these techniques can help you reduce the insomnia symptoms and improve your sleep.
It’s helpful to consult with your doctor who may be able to provide a detailed plan on using any of these techniques to combat insomnia.