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What behavioral and non-drug treatment therapies are available for insomnia?

Behavioral methods are effective in all age groups, including elderly patients. In addition, medications cannot cure this condition and prolonged use frequently results in dependency. When doctors prescribe "behavioral interventions" to treat insomnia, they are recommending changes in behaviors that may be causing or reinforcing poor sleep. Below are several

behavioral interventions that your doctor may recommend for insomnia.

Stimulus control

Stimulus control is now considered the standard treatment for primary chronic insomnia and may be helpful for some patients with secondary insomnia as well. The primary goal of stimulus control is to regain the idea that the bed is for sleeping. Stimulus control involves eliminating activities or circumstances that "trigger" or stimulate you to stay awake. The goal is to help you form a psychological connection between the bedroom and sleeping.

Relaxation techniques

Relaxation techniques include deep-breathing exercises, meditation, and light stretching. Relaxation techniques, such as controlled breathing to relieve tension and meditation to relieve worry, are useful and safe for inducing sleep. Limiting the amount of time a person spends lying awake in bed when he is having trouble falling asleep may help. Instead, the person should get out of bed and engage in relaxing activities (for example, reading or listening to soothing music). Time spent in bed can be gradually increased as sleep improves. Learning about sleep from a therapist or another source can also be helpful.

Stabilizing the sleep-wake cycle

This approach is meant to help you regain the right balance of sleep and wakefulness. It also aims to improve your "sleep efficiency" so that the time you are in bed is spent sleeping (rather than staring at the ceiling).

Sleep-restriction therapy

At first, this approach might sound counter-productive. However, the purpose behind this behavioral therapy is to increase your need for sleep by temporarily shortening the amount of sleep per night. This creates a "sleep debt." You then gradually lengthen the amount of sleep until you are getting an adequate amount.

Cognitive-Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of therapy that emphasizes observing and changing negative thoughts about sleep (such as, "I'll never fall asleep"). It also employs actions intended to change behavior. Studies have been mixed on its effectiveness, although evidence is now heavily weighted toward positive benefits. This form of counseling or "talk therapy" is used when a person with insomnia needs to "work through" any thoughts or attitudes that may be leading to sleep disturbances. It consists of identifying distorted thinking or attitudes that are making you feel anxious or "stressed," and then replacing these thoughts with more realistic or rational ones.

Biofeedback

Biofeedback is also effective but requires being monitored with an electroencephalogram (EEG), a device that measures brain waves. Patients are given feedback to recognize certain states of tension or sleep stages so that they can either avoid or repeat them voluntarily.

Exercise

Exercise may be one of the best ways to achieve healthy sleep. One study found that exercise is as good for promoting sleep as the use of benzodiazepines, a prescription sleep aid. Some research has found that yoga practice may have specific benefits on sleep health. Yoga uses meditation, deep breathing techniques, and movements that emphasize stretching and balance. A government-sponsored clinical trial is underway to determine if yoga helps people with insomnia.

Light Therapy

The circadian rhythm is more a function of darkness and light rather than actual time of day. Bright light can discourage drowsiness, and darkness can cause sleepiness, day or night. The use of a special light box may be helpful. The procedure is noninvasive and simple. The patient sits a few feet away from a box-like device that emits very bright fluorescent light (over 4,000 lux) for about 30 minutes every day.

More information on insomnia

What is insomnia? - Insomnia is difficulty falling asleep or staying asleep or a disturbance in sleep that makes sleep seem inadequate or unrefreshing.
What types of insomnia are there? - Insomnia can be classified as transient, intermittent, and chronic insomnia. Insomnia is also characterized as primary or secondary insomnia.
What causes insomnia? - About half of all insomnia cases are caused by psychological or emotional problems. Sleep apnea or hyperthyroidism can also cause insomnia.
What causes transient insomnia? - Transient insomnia is often caused by a temporary situation. A reaction to change or stress is one of the most common causes of short-term and transient insomnia.
What causes chronic insomnia? - One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma.
What're the risk factors for insomnia? - The strongest risk factors for insomnia are psychiatric problems. Insomnia is more common in women than men.
What're the complications of insomnia? - Complications of insomnia include impaired mental functioning, accidents, mortality rates, stress and depression, heart disease, headaches.
What are the symptoms of insomnia? - Symptoms of insomnia can be different for each individual, and people with insomnia might experience a variety of symptoms.
How is insomnia diagnosed? - The diagnosis of insomnia is made by a physician based on the patient's reported signs and symptoms.
What's the treatment for insomnia? - Treatment of insomnia may involve treatment of the underlying medical disorder. Medications given for insomnia include sedatives, tranquilizers, and antianxiety drugs.
Behavioral and non-drug treatment therapies for insomnia - Behavioral therapies are effective for insomnia. Stimulus control is the standard treatment for primary chronic insomnia.
What prescription drugs are available for insomnia? - Rescription sleep medication may be required to cure insomnia. Various types of prescription medication include benzodiazepines, antidepressants.
What over-the-counter medications are available for insomnia? - Over-the-counter medications for insomnia include Nytol, Sleep-Eez, and Sominex. Antihistamines may be used as mild sleep inducers.
Does melatonin help to cure insomnia? - Melatonin, or 5-methoxy-N-acetyltryptamine, is a hormone produced by pinealocytes in the pineal gland. Melatonin may help certain older people with insomnia.
What natural insomnia remedies are available? - Many alternative treatments are effective in treating both the symptom of insomnia. Many people with insomnia choose herbal remedies for treating insomnia.
How to prevent insomnia? - Prevention of insomnia involves balance of rest, recreation and exercise in combination with stress management, regular physical examinations, and a healthy diet.
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