Doctors can offer several treatments for insomnia. Depending on the type of your condition and how severe it is, your doctor may suggest new sleeping habits or lifestyle changes first before moving on to therapy with a mental health professional and then medications.
When you have primary insomnia, it means you have trouble sleeping because of insomnia itself, and not a health condition or something happening in your life. Secondary insomnia is the result of another problem, such as a medical condition or substance abuse, that disrupts your sleep.
You may also have short-term insomnia, brought on by a change in schedule or other source of stress. Or your insomnia may be chronic, which means it is ongoing.
Sometimes, lifestyle changes are enough to get your sleep back on track. Other times, you may need further treatment. Either way, most likely, the first thing your doctor will tell you to do is take up good sleep habits.
They may suggest that you:
- Keep a strict sleep schedule. Go to bed and get up as close to the same time every day as possible.
- Be active. Regular exercise promotes better sleep. Try to get your workout in at least a few hours before bedtime. Sometimes, when you exercise too close to bedtime, it can keep you awake.
- Curb naps. Don’t let daytime sleep rob you of nighttime sleep. If you need your nap, keep it under 30 minutes and finish it before 3 p.m.
- Skip caffeine. The effects can last for hours, so if you have to have it, make sure it’s early in the day.
- Eat light before bed. A full belly can keep you up.
- Create a comfortable sleep space. Make it dark, quiet, cool, and free of electronics.
- Have a bedtime ritual. Find a routine that helps you wind down, such as a warm bath, soft music, or reading before bed.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
If healthy sleep habits don’t get you the sleep you need, your doctor may suggest cognitive behavioral therapy for insomnia (CBT-I). This is a type of talk therapy that can help change the way you think about sleep so that you can get more of it. Doctors typically go to CBT-I to treat insomnia before trying medications.
CBT-I teaches you different techniques to improve sleep, which include:
- Stimulus control. Your therapist will make sure you have good sleep habits.
- Relaxation techniques. Deep breathing, muscle relaxation, and biofeedback are all ways to get your body in the right state for sleep.
- Sleep restriction. In this method, you stay out of bed and don’t let yourself sleep until a preset time, so your body is sleep-deprived and you feel more tired the next night.
- Passive wakefulness. Instead of trying to sleep when you get in bed, you try to stay awake in hopes of “tricking” your body out of the usual anxiety that goes along with trying to fall asleep.
- Light therapy. If you fall asleep too early and wake up too early, a light box or natural light can help push your body’s internal clock back.
You can have CBT-I by yourself or in a group. Typically, you’ll go for four to eight sessions.
Your doctor can help you select an over-the-counter medication or prescribe a sleeping pill. Prescription sleep medications can help you fall asleep, stay asleep, or both. The goal is to take them just long enough to get your sleep back on track. You shouldn’t use most sleep medications beyond a few weeks. So typically, they’re not a good option if you have long-term insomnia.
Types of prescription sleep medications include:
- Benzodiazepines, such as estazolam, flurazepam, quazepam (Doral), temazepam (Restoril), and triazolam (Halcion)
- Nonbenzodiazepines, such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
- Antidepressants, such as doxepin and trazodone (Oleptro)
- Melatonin receptors, such as ramelteon (Rozerem)
These medications can come with side effects such as grogginess during the day and a risk of falling. You can also become addicted to some prescription sleep aids. Talk to your doctor about these risks and any side effects to watch out for if you use these medications.
Over-the-Counter Sleep Aids
You can get some sleep medications without a prescription. Most over-the-counter medicines have antihistamines, which make you drowsy. But you shouldn’t use them long-term. Common side effects of these options include daytime sleepiness, dizziness, confusion, a decline in thinking skills, and trouble peeing, especially in older adults. Talk to your doctor or pharmacist to make sure an antihistamine is safe to take along with any other medications you may use.