Friday, February 18, 2011

Effective treatment for chronic insomnia

photo by graur razvan ionut

is a problem which affects milions of people every night (one third of adult population). If you ever had difficulty falling asleep, maintiaing your sleep or early awakaning, you know that insomnia is not only a nighttime problem. Lack of sleep seriously affects ability to function during the day, reduces quality of life, affect physical and mental health.
Here you can read more about types of insomnia and its causes .

Even one sleepless night can be a horrible experience (as an parent, been there, done that), but chronic insomnia is a struggle on several levels. One of the biggest challenges is treatment. Unfortunately, the medication which is currently used (succesfully!) in insomnia creates tolerance and dependence. It means that the longer you take your sleeping pill, the less likely it is to help you sleep, you are more likely to need higher doses, and if you stop taking it you may experience very unpleasant withdrawal symptoms.

Is there any non-drug effective treatment for insomnia then?
Many doctors would use antidepressants or antipsychotics, even if the sufferer doesn't have any of these disorders because these drugs have sedative (soothing, calming) effects. However in many countries these medication are not licenced to treat insomnia. Moreover, as Dr David M. Allen warns in his post, there may be other potential side effects of long term use of antipsychotics for patient without psychotic illness.

If not medication, what then?
You should always start by improving you sleep hygiene.
If your sleep problems are not related to any other physical or mental health problems (chronic primary insomnia) American Academy of Sleep Medicine recommends the following non-pharmaceutical approaches:

1. Stimulus control therapy
(training, which helps the sufferer re-associate the bed and bedroom with sleep and re-establish sleep-wake cycle)

2. Relaxation (learning different techniques to help you relax your muscles and deal with intrusive thoughts at bedtime)

3. Sleep restriction (this approach suggests that you don't stay in bed when you are not asleep)

4. Cognitive behaviour therapy (CBT) with or without relaxation (CBT part is focused on helping you change your beliefs and attitudes to insomnia)

5. Multicomponent therapy (a combination of sleep hygiene, stimulus control and sleep restriction strategies)

6. Paradoxical intention (in this method the sufferer is told to stay passively awake and avoid any effort to fall asleep)

7. Biofeedback

You can read the AASM report here.

Have you ever try any of these approaches? Did they work for you?

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