Treatment for insomnia may start with lifestyle changes, especially to habits and behaviors directly affecting sleep (see “Lifestyle” below for more information). As well, medications are sometimes prescribed to treat insomnia, and over-the-counter (OTC) sleep aids may also be used (find more information under “Medication”).
If other medical conditions may be affecting your ability to sleep or the quality of your sleep, addressing these may help relieve insomnia. A physical exam with your doctor will identify or rule out potential medical causes of insomnia.
Cognitive behavioral therapy (CBT) may be used to treat insomnia. This approach addresses thoughts and actions that prevent or interrupt sleep while encouraging good sleep habits. For example, by teaching patients ways of dealing with worries that keep them awake, they may find it easier to fall and stay asleep. CBT may involve one-on-one consultations with a therapist or group sessions. The following approaches may also be used as part of CBT:
These lifestyle measures may help you sleep better:
Medications for insomnia are available by prescription and over the counter. Talk with your doctor about the type of medication that may be right for you. Even if you are considering over-the-counter (OTC) sleep aids, it’s important to consult your doctor; you’ll want to discuss side effects associated with these medications as well as address medical issues that may be affecting your sleep.
Basic guidelines for using any medication to relieve sleeplessness include: using the medication only as directed by your doctor and taking only the prescribed dose; not driving or performing other activities that require you to be alert; telling your doctor about other medications you are using; calling your doctor immediately if you have problems related to the medication; avoiding alcohol and drugs; and talking to your doctor about how to stop using the medication.
Doctors sometimes prescribe medication for insomnia. In many cases, prescription sleep medicines are used for short periods, though they may be used longer for treatment of severe chronic insomnia.
Prescription sleep medications are often helpful in the treatment of insomnia, but it’s important to know about the risks associated with these drugs. They can become habit forming; may mask a medical problem causing insomnia and thus delay treatment; can interact poorly with other medications; and can cause grogginess or even worsen insomnia. The following less common but serious side effects are also associated with sleep medicines: severe allergic reactions, facial swelling, high blood pressure, dizziness, weakness, nausea, confusion, short-term memory loss, and sleep-related behaviors such as binge eating or driving while asleep. Talk with your doctor about any side effects you experience while taking prescription sleep medication.
Over-the-counter sleep aids may help relieve occasional sleeplessness. They are, however, not recommended for regular or long-term use. As well, OTC sleep aids are associated with certain risks: many contain antihistamines, which are not safe for some people, and they can cause side effects including dry mouth, dizziness, and grogginess.
Additional OTC sleep aids include dietary supplements such as melatonin and valerian. Be aware, however, that dietary supplements are not monitored for safety or effectiveness by the U.S. Food and Drug Administration. As a safety precaution, it’s therefore important to discuss use of dietary supplements as sleep aids with your doctor, just as you would prescription or OTC medicines.
Insomnia. National Heart Lung and Blood Institute Web site. Available at:http://www.nhlbi.nih.gov/health/dci/Diseases/inso/inso_whatis.html. Accessed August 2010.
Insomnia. Womenshealth.gov. Available at:http://www.womenshealth.gov/faq/insomnia.cfm#g.
Accessed August 2010.