Insomnia is the sleeping disorder caused by difficulty with sleep onset or quality. People with insomnia struggle with sleep and also experience daytime dizziness and other dysfunctions when they are awake. The effective insomnia treatments available are sleep-inducing medicines, cognitive behavioural therapy for insomnia (CBT-I), and combinations of both measures. Lifestyle changes also help you to treat insomnia effectively. The right treatment approach may depend on whether you have short-term or chronic insomnia and your medical history.
Treatment and Management for Insomnia
Here are the best treatment options for insomnia.
- Cognitive Behavioural Therapy for Insomnia (CBT-I)
CBT-I for insomnia is an effective treatment method. It can treat chronic insomnia. It is a structured therapy method, lasts for 4 to 8 sessions, and targets the habits and thoughts keeping insomnia going. Its components consist of
- Relaxation techniques
Relaxation techniques help you deal with stress by allowing you to decompress. By relaxing your muscles and reducing anxiety, it can treat insomnia effectively.
- Light therapy
Light therapy involves using light to push back your clock if you fall asleep early and wake up soon. By resetting the circadian rhythm (body clock) through timed exposure to bright light, it can treat insomnia. This method also mimics natural sunlight and manages hormone production to align with your sleep cycle and your daily schedule or desired lifestyle.
- Sleep restriction
The sleep restriction technique requires you to deprive yourself of sleep partially. Don’t take naps during the day and spend less time in bed. You can spend more time in bed when your sleep cycles improve, and you see improvements in insomnia too.
- Stimulus control
Another CBT therapy for treating insomnia is stimulus control. It involves removing the things from your mind that restrict you from sleeping. You may be taught to have a specific bedtime and a specific time to wake up. You must use the bed when you are going to sleep and leave the room if you don’t fall asleep within 20 minutes. Return to the bedroom once you start feeling sleepy again.
CBT-I works more effectively than sleeping pills and treats insomnia. Its benefits also last even after the treatment period ends.
Sleep Hygiene and Lifestyle Changes
The sleep hygiene and lifestyle changes are also used under the insomnia treatment approach.
- Maintain a consistent schedule
Go to bed and wake up at the same time daily, even on weekends.
- Get morning sunlight
Move outside or get bright natural light exposure shortly after waking to set the circadian rhythm.
- Exercise regularly
Do exercise daily, but finish stressful activities at least 2 to 4 hours before bedtime.
- Limit caffeine and nicotine.
Cut off tea, coffee, chocolates, and smoking at least 4 to 6 hours before bed.
- Avoid alcohol close to bedtime
Avoid alcohol in the evening, because it disrupts sleep later at night.
- Eat lighter and earlier
Don’t eat large or heavy meals within 2 to 3 hours of going to sleep.
- Cut off screen time
Turn off the tablets, TVs, phones, and computers 30 to 60 minutes before going to bed, and block blue light.
- Create a wind-down routine
Before sleep, spend the last hour doing relaxing activities like stretching, reading, or listening to music.
- Optimise your bedroom
Install blackout curtains to keep your room cool at 60–67°F, dark, and quiet, and improve sleep quality.
- Get out of bed if awake
If you do not fall asleep after 15–20 minutes, then move to the next room and do something relaxing till you feel drowsy.
- Limit daytime naps
Avoid late-afternoon naps or long naps; keep it to 10-20 minutes if required.
Medication Treatments
Prescription sleeping pills help people treat short-term insomnia. They cause next-day drowsiness, dependence, and tolerance. They must only be used under a doctor’s supervision, at a low effective dose, and for the shortest possible period. Here are the medications used for insomnia treatment.
- Benzodiazepines
Benzodiazepines (BZDs) are a class of psychoactive drugs. BZDs are approved drugs used to treat insomnia. BZDs are not recommended for insomnia treatment because there is a risk of abuse and dependence. All five insomnia BZDs are classified as Schedule IV controlled substances. People who take these medications develop a tolerance for their sedative effects.
- Nonbenzodiazepines
Nonbenzodiazepines belong to a class of drugs called the ‘Z’ drugs for short. They provide the same relief as BZDs and reduce the adverse effects and abuse potential. They also require a prescription, and the DEA classifies them as Schedule IV controlled substances.
Melatonin agonist
The pineal gland of your brain produces melatonin, a hormone that induces feelings of relaxation and sleepiness. The medicine, known as ramelteon, works as a melatonin receptor agonist and treats insomnia. The effects of ramelteon are less severe than those of the BZDs and Z drugs, because patients may experience nausea, dizziness, and fatigue.
- Orexin receptor antagonist
Orexins work as neurotransmitters in the body that regulate the feeling of wakefulness and sleepiness. The drug is called suvorexant and works as an orexin receptor antagonist. It is used as a sleep-onset or sleep-maintenance insomnia treatment.
- Off-label treatments
Some medications are used to treat other conditions that may reduce insomnia symptoms. These consist of certain antidepressants and antipsychotic medications and are used in some cases.
- Over-the-counter medications
Some over-the-counter antihistamines are also used for insomnia treatment. They have sedating properties and are used as sleeping aids. These are some of the melatonin supplements that can balance the melatonin levels in your body. Even if they don’t require prescriptions, you should still consult with a doctor before consuming it.
Prescription vs. OTC Insomnia Treatments
Both OTC and prescription medicines are used to treat insomnia. They differ in their effectiveness, risks, ingredients, and recommended usage.
| Comparison | Prescription treatments | OTC treatments |
| Availability | Require a doctor’s prescription | Available without a prescription |
| Common types | Benzodiazepines, Z-drugs, ramelteon | Antihistamines, melatonin supplements |
| Primary use | Specific types of insomnia | Occasional sleep difficulties |
| Medical supervision | Required | Medical advice is recommended. |
| Potential risks | Tolerance, dependence, and side effects vary by drug. | Drowsiness, interactions, and other side effects |
Conclusion
Several treatment options are available to treat insomnia. Behavioural therapies and chronic insomnia treatment methods, such as Cognitive Behavioural Therapy for Insomnia (CBT-I), Stimulus Control Therapy, Relaxation Techniques, and sleep restriction therapy, may help patients. Make sure to focus on changing thoughts, behaviours, and sleep habits to improve sleep.
You can also opt for pharmaceutical treatments, such as OTC sleeping aids, prescription sleeping pills, melatonin supplements, and natural remedies to get short-term relief. Lifestyle changes such as reducing caffeine, setting a sleep routine, and avoiding alcohol intake help you create a comfortable sleep environment.