Treatment of Insomnia
Cognitive behavioral therapy:
The mainstay of treatment for insomnia is cognitive behavioral therapy (CBT) along with judicious use of hypnotic agents. Cognitive behavioral therapy should be considered as first-line intervention for chronic insomnia. Recent study had shown that cognitive behavioral therapy had a long-term effect of improved sleep-related psychological activity and daytime functioning compared to other medications in chronic insomnia.1
Pharmacological treatments:
Pharmacological treatments for insomnia involve judicious and intermittent usage of benzodiazepine or nonbenzodiazepine hypnotics.
Benzodiazepines:
The most commonly used class of hypnotics is benzodiazepines such as
These medications can develop tolerance and dependence, especially after consistent usage over prolonged period.
Nonbenzodiazepines:
Nonbenzodiazepines cause both psychological and physical dependences, and the same memory and cognitive disturbances as benzodiazepines, in addition to morning sedation.
Sedatives:
Other sedatives used in treatment of insomnia include antidepressants and antihistamines.
Nevertheless, long-term use of sedative hypnoticsis contraindicated due to adverse effects that can outweigh benefits, including habituation, dependency, andimpairment of daytime psychomotor and cognitive performance,daytime drowsiness and rebound insomnia.
General therapeutic recommendations for insomnia include the following:
- Practice relaxation techniques before sleep time.
- Avoid large meals, excessive fluid intake and strenuous exercise before bedtime.
- Avoid sleep-disturbing substances such as alcohol, nicotine and caffeine before bedtime.
- Avoid reading and watching television while on the bed.
- Establish a bedtime routine.
Next page: Guidelines for better sleep
Written by: Healthplus24 team
Date last updated: April 14, 2012