Your doctor may recommend other strategies related to your lifestyle and sleep environment to help you develop habits that promote sound sleep and daytime alertness.

Talk to your doctor about recommendations. You can go outside during times of the year when it's light outside in the evenings, or you can use a light box. If you fall asleep too early and then awaken too early, you can use light to push back your internal clock. Also called paradoxical intention, this therapy for learned insomnia is aimed at reducing the worry and anxiety about being able to get to sleep by getting in bed and trying to stay awake rather than expecting to fall asleep. Once your sleep has improved, your time in bed is gradually increased. This therapy decreases the time you spend in bed and avoids daytime naps, causing partial sleep deprivation, which makes you more tired the next night. Practicing these techniques can help you control your breathing, heart rate, muscle tension and mood so that you can relax. Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can't go to sleep within 20 minutes, only returning when you're sleepy. This method helps remove factors that condition your mind to resist sleep. The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. It may also involve eliminating the cycle that can develop where you worry so much about getting to sleep that you can't fall asleep. It can help you control or eliminate negative thoughts and worries that keep you awake. The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. Typically, CBT-I is equally or more effective than sleep medications. Cognitive behavioral therapy for insomniaĬognitive behavioral therapy for insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. If these measures don't work, your doctor may recommend cognitive behavioral therapy, medications or both, to help improve relaxation and sleep. Tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.Ĭhanging your sleep habits and addressing any issues that may be associated with insomnia, such as stress, medical conditions or medications, can restore restful sleep for many people. If the cause of your insomnia isn't clear, or you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night at a sleep center. You may also be asked to keep a sleep diary for a couple of weeks. In addition to asking you sleep-related questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness. Occasionally, a blood test may be done to check for thyroid problems or other conditions that may be associated with poor sleep. If the cause of insomnia is unknown, your doctor may do a physical exam to look for signs of medical problems that may be related to insomnia. Depending on your situation, the diagnosis of insomnia and the search for its cause may include:

Remedies for severe insomnia