Insomnia is a debilitating condition for millions of Americans. In some cases, insomnia may go away on its own or only last for short periods. In other cases, insomnia may be chronic or lifelong. It is unlikely that there is one cure-all for insomnia because the underlying causes of insomnia are not well understood scientifically and vary from person to person. Saying that insomnia can be cured may be a bit misleading. Nevertheless, there are many effective ways to either manage or mitigate symptoms to “cure” insomnia.
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Insomnia Treatment Options
What are some treatment options for insomnia? Are all treatments created equally? Do some treatments work for everyone while other insomnia treatments only work for a few people? To answer these questions, individuals must have a basic understanding of insomnia treatment guidelines. Some common treatment options for insomnia include cognitive behavioral therapy (CBT), medications, lifestyle modifications and the establishment of bedtime routines. These methods can all be helpful for individuals who struggle with insomnia, whether it exists on its own or alongside another condition.
Cognitive Behavioral Therapy
CBT for insomnia focuses on a variety of techniques to help individuals manage acute (short-term) or chronic (long-term) insomnia. CBT may be an effective option for individuals who have tried other forms of therapy or medication to no avail. CBT for insomnia generally involves learning how to:
- Improve sleep hygiene
- Develop or improve stimulus control
- Restrict sleep
- Use cognitive therapy techniques
- Practice relaxation techniques.
CBT for insomnia can be administered in different ways. If a person can’t undergo individual therapy, they can access a CBT insomnia app on their computers or phones. Such apps are great resources, especially for the aging community and veterans. CBT for insomnia has been shown to decrease insomnia and promote healthy, high-quality sleep.
For some people, taking medication for insomnia can be beneficial and can promote healthy sleep. There are many different insomnia medications, including sleeping pills and other drugs. Some of these can be bought over the counter, while others must be prescribed by a licensed medical professional. Patients should exercise caution when using any sleeping medication, as long-term use can lead to dependency.
Over-the-Counter Sleep Aids
Many drugstores, like CVS, Walgreens, Rite Aid and others have sleep medications that a person can buy at the store without a prescription. These drugs are generally referred to as over-the-counter (OTC) sleep aids. Some of the best OTC sleep aids include a class of drugs known as antihistamines. Antihistamines like Benadryl are known to make individuals drowsy and fight severe allergies, though they should not be used long-term. Other drugs like ZZZQuil have the same active ingredient as Benadryl, known as diphenhydramine. Diphenhydramine is an antihistamine.
Some examples of brand name sleep medications that can be found at drug stores and supermarkets include:
- Benadryl: Active ingredient is diphenhydramine, containing HCl 25 mg per tablet.
- Melatonin: Active ingredient is melatonin, which is a naturally occurring hormone. Dosages of melatonin tablets for sleep usually range from 3-10 milligrams.
- ZzzQuil: Active ingredient is diphenhydramine, containing HCl 50 mg per 30mL dose.
- Unisom: Active ingredient is doxylamine succinate, an antihistamine, with approximately 25 mg per tablet.
Prescription sleep aids do not necessarily require a diagnosis of insomnia but do require a prescription from a licensed medical professional. Often times, prescription sleeping pills have more severe side effects than OTC sleeping aids. Individuals that are on other medications should be particularly cautious when using prescription sleep aids because these medications can amplify the side effects of both medications. Additionally, mixing alcohol and other drugs with prescription sleeping pills can be extremely dangerous. Unfortunately, individuals can develop a sleeping pill addiction and must exercise caution when using these drugs.
Examples of prescribed prescription sleep medications (doses vary depending on the patient) include:
If using medication or CBT for insomnia doesn’t sound appealing, there are many natural treatments for insomnia that individuals can try in the comfort of their own home. These measures range from physical activities to naturopathic remedies. A person may have to try a few different remedies until they find one that works for them. Generally speaking, alleviating life stressors as much as possible and leading a healthy lifestyle can help mitigate insomnia symptoms.
Some lifestyle changes that can help improve insomnia symptoms include:
- Exercising consistently
- Practicing yoga/pilates
- Hiking in nature
- Undergoing acupuncture or massage
- Modifying diet
- Herbal remedies
- Avoiding caffeine and other stimulants
- Avoiding alcohol and other depressants
- Using progressive muscle relaxation
- Using a weighted blanket
- Establishing a relaxing bedtime routine (sleep hygiene)
- Practicing stress-management techniques
Sleep Hygiene Practices
Just as people shower, and brush and floss as part of a personal hygiene routine, individuals can also cultivate good sleep hygiene habits. A type of insomnia known as sleep-maintenance often affects menopausal and post-menopausal women. For these individuals, having good sleep hygiene is critical for alleviating sleep-maintenance insomnia symptoms. Examples of good sleep hygiene practices include:
- Avoiding napping, especially late in the day
- Going to sleep at the same time every day
- Using the bedroom only for sleep
- Limiting fluid and food intake to a few hours before bedtime
What is a sleep clinic? A sleep clinic is a place where medical professionals observe an individual’s sleep from a medical perspective. Often times, individuals stay overnight at a sleep center so their sleeping patterns can be analyzed. The overall goal is to understand and treat sleep conditions like insomnia. Sleep clinics for insomnia typically entail:
- An overnight stay
- A clinical evaluation
- Consultations with sleep specialists
- Diagnostic sleep studies
- Polysomnography (PSG) (a sleep test)
- At-home sleep testing
- Educational discussions
- Continuous positive airway pressure (CPAP) mask fitting
- Actigraphy (monitors rest versus activity periods)
Treating Underlying Causes of Insomnia
Sometimes insomnia is caused by another mental health or physical condition like anxiety or depression. This type of insomnia is referred to as secondary insomnia. In these cases, treating the underlying cause will often result in improvements in insomnia symptoms. For those with co-occurring anxiety or depression and insomnia, there are many treatment options that address both of these conditions. However, it is important to note that for some individuals, there is no identifiable cause of their insomnia.
Insomnia and Anxiety
How are anxiety and insomnia connected? Better yet, how are stress and insomnia connected to one another? Sometimes it is the case of the chicken or the egg problem. Insomnia may come first, or an anxiety disorder may come first. Having high stress levels can also lead to the development of anxiety and/or insomnia. Many individuals struggling with anxiety will lie awake at night thinking about their troubles. Regardless of which mental health condition develops first, one thing is certain — having anxiety can exacerbate symptoms of insomnia.
Insomnia and Depression
Similar to anxiety, insomnia and depression are often related and co-occurring conditions. Depression can lead to many problems falling and staying asleep. Research suggests that disruptions in deep sleep and REM sleep are common in people with depression relative to individuals without depression. Thus, when depression is treated, many insomnia symptoms can be mitigated via medication or natural treatments.
Statistics on Insomnia Recovery
Currently, there are few statistics available on insomnia recovery. Many studies are small, which makes it difficult to make any strong conclusions about insomnia recovery. Nevertheless, a newer study conducted in 2018 recruited over 1,400 adults with insomnia and asked about their ability to recover. Statistics from this study include:
- 75% of individuals with acute insomnia were able to make a full recovery after about 12 months
- 22% of individuals still struggled with acute recurring insomnia
- 3% of individuals went on to develop chronic insomnia
It is common for most individuals to experience insomnia at least once in their lives. Very few will continually struggle with this condition, making insomnia’s prognosis quite positive overall.
Have you or a loved one struggled with primary or secondary insomnia and a co-occurring addiction? The Recovery Village can help. Contact a representative to discuss treatment options for co-occurring insomnia and addiction.
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Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.