BOSTON—Insomnia can take many forms, from trouble falling asleep in the first place to unwelcome awakenings during the night. The February 2011 issue of the Harvard Mental Health Letter discusses some options to help people with insomnia get a good night’s sleep.
For chronic insomnia, the treatment of choice is cognitive behavioral therapy (CBT). Both the American Academy of Sleep Medicine and the National Institutes of Health recommend trying CBT before trying medication, because CBT is just as effective as prescription medication at alleviating chronic insomnia in the short term and may be more effective in the long term. When used to treat insomnia, CBT helps people change negative thoughts and beliefs about sleep into positive ones, so that they don’t keep themselves awake worrying.
Prescription medications can be useful for some people with transient or short-term insomnia. Drugs should be used at the lowest dose and for the shortest possible period of time. Drug stores carry a confusing variety of over-the-counter sleep products that usually contain various types of antihistamines as active ingredients. Over-the-counter antihistamines are generally safe, but sleep experts usually advise against using them because they can have side effects and are often ineffective in relieving sleep problems.
Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, notes that the following approaches may also be helpful in treating insomnia, either used on their own or combined with CBT.
Sleep restriction. Spending less time in bed promotes more restful sleep and helps make the bedroom a welcome sight instead of a dreaded destination.
Reconditioning. This technique helps people learn to associate the bedroom with sleep instead of sleeplessness. It suggests strategies such as these:
- Use the bed only for sleeping or sex.
- Go to bed only when sleepy.
- Get up at the same time every day and do not nap.
Relaxation techniques. Meditation, breathing exercises, progressive muscle relaxation, and visualization of peaceful settings can calm the mind and relax the body.
Read the full-length article: “Overcoming insomnia”
Also in this issue:
- Motivational interviewing
- Smoking increases risk of dementia
- Options for treating anorexia
- Social relationships and longevity
- Did Lou Gehrig really have “Lou Gehrig’s disease”?
The Harvard Mental Health Letter is available from Harvard Health Publications (www.health.harvard.edu), the publishing division of Harvard Medical School, for $59 per year. Subscribe at www.health.harvard.edu/mental or by calling 877-649-9457 (toll-free).
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