Therapy may help beat insomnia

DEAR DOCTOR K: I struggle with insomnia. How can I overcome this problem without drugs or supplements?

DEAR READER: Insomnia is a common problem in which sleepless nights turn into fatigue-filled days. A form of cognitive behavioral therapy known as CBT for insomnia targets the root cause of insomnia. This short-term talk therapy teaches people to change unproductive thinking and behaviors that get in the way of a good night’s sleep.

Researchers recently looked at 20 trials of CBT-I. On average, people treated with CBT-I fell asleep almost 20 minutes faster and spent 30 fewer minutes awake during the night compared with people who didn’t undergo CBT-I.

These improvements are as good as, or better than, those seen in people who take prescription sleep medications.

A common recommendation from CBT-I is to get out of bed if you don’t fall asleep within 20 minutes. The idea is to associate your bed with relaxation, not frustration and worry.

People with insomnia also tend to worry about the consequences of poor sleep. A CBT-I therapist can help you replace negative thoughts with more positive ones.

Here are some “sleep hygiene” habits to help you get some shuteye:

Stay away from stimulants.

Don’t nap if you can avoid it.

Exercise regularly, but not within a few hours of bedtime.

Go to bed and wake up at the same time every day, no matter how much sleep you’ve gotten.

Make your bedroom a sleep sanctuary. Reserve it for sleep, intimacy and restful activities. Keep it cool, dark and quiet.

Don’t watch the clock.

Establish a relaxing routine before bedtime.

Basically, some patients are looking for a pill that makes them sleep like a baby every night, without side effects. If there were such a pill, I’d prescribe it.

The sleep hygiene habits I recommend do work. Many of my patients have told me: “Well, I have to tell you I was dubious, and it didn’t happen immediately. But I’m definitely sleeping better, so thanks.”