Changing your sleep habits and addressing any underlying causes of insomnia, such as medical conditions or medications, can restore restful sleep for many people. If these measures don't work, your doctor may recommend medications to help with relaxation and sleep.
Behavioral treatments teach you new sleep behaviors and ways to improve your sleeping environment. Good sleep habits promote sound sleep and daytime alertness. Behavior therapies are generally recommended as the first line of treatment for people with insomnia. Typically they're equally or more effective than sleep medications.
Behavior therapies include:
- Education about good sleeping habits. Good sleep habits include having a regular sleep schedule, avoiding stimulating activities before bed, and having a comfortable sleep environment.
- Cognitive behavioral therapy. This type of therapy helps you control or eliminate negative thoughts and worries that keep you awake. It may also involve eliminating false or worrisome beliefs about sleep, such as the idea that a single restless night will make you sick.
- Relaxation techniques. Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. These strategies help you control your breathing, heart rate, muscle tension and mood.
- Stimulus control. This means limiting the time you spend awake in bed and associating your bed and bedroom only with sleep and sex.
- Sleep restriction. This treatment decreases the time you spend in bed, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
- Remaining passively awake. Also called paradoxical intention, this treatment for learned insomnia is aimed at reducing the worry and anxiety about being able to get to sleep by getting in bed and trying to stay awake rather than expecting to fall asleep.
- Light therapy. If you fall asleep too early and then awaken too early, you can use light to push back your internal clock. You can go outside during times of the year when it's light outside in the evenings, or you can get light via a medical-grade light box.
Taking prescription sleeping pills — such as zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata) or ramelteon (Rozerem) — may help you get to sleep. Doctors generally don't recommend relying on prescription sleeping pills for more than a few weeks, but several medications are approved for long-term use.
Over-the-counter sleep aids
Nonprescription sleep medications contain antihistamines that can make you drowsy. Antihistamines may initially make you groggy, but they may also reduce the quality of your sleep, and they can cause side effects, such as daytime sleepiness, dizziness, urinary retention, dry mouth and confusion. These effects may be worse in older adults. Antihistamines also can worsen urinary problems, causing you to get up to urinate more during the night.
Oct. 07, 2013
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