Breaking up with Insomnia

Recently I have been aware that many of my clients complain of difficulties sleeping, regardless of their other concerns being addressed in therapy. I went over my client list, and a full 40% of the adults I am working with have issues with sleep. Of these, 30% report sleeping too much as one symptom of their depression. However, the other 70% of my folks with sleep issues reported insomnia - difficulty going to sleep or remaining asleep. According to the National Institute of Health, 30% of adults in the United States struggle with insomnia, either as a primary diagnosis or a symptom of another disorder.

We live in a country where we tend to look to pills to fix all of our pain and undesirable conditions; insomnia is no different. Melatonin is the hormone produced in our bodies to regulate sleep and wakefulness; some people take melatonin supplements to treat insomnia with good results. In my mind that is definitely appropriate because we are simply supplementing the hormone in our body that already regulates the sleep cycle. There are many other medications that are prescribed for sleep. While I support the use of medication to treat a lot of different disorders (depression, anxiety, bipolar, etc.) I am fairly reticent to turn to medication to treat sleep problems. None of the medications address the origin of the sleep problem; they treat it as a symptom but the underlying cause is left intact. I am far less supportive of medication for insomnia than for other medical and mental conditions.

There are a number of other ways to treat insomnia without turning to medication. Cognitive behavioral therapy can be used to address it without relying on medication. Often unwanted thoughts or worries are making it difficult to sleep - that's the cognitive part of the therapy. The behavioral part is based on developing good sleep habits and avoiding behaviors that make sleeping more difficult. Some of these are things you can actually do without the help of a therapist, and include:

• Maintaining a consistent bedtime
• Avoiding naps
• Don't stay in bed for longer than 20 minutes if you are having difficulty falling asleep
• Avoiding caffeine or alcohol too close to bedtime
• Give yourself time and opportunities to wind down before bedtime
• Do not use handheld electronics an hour before you want to fall asleep
• Make sure your bedroom is comfortable for sleep: the right temperature, not too loud, dark enough, no other distractions
• Relaxation training: progressive muscle relaxation, breathing exercises, mindfulness, meditation techniques, guided imagery, self-hypnosis
• Paradoxical intent: remaining passively awake (actively trying NOT to fall asleep)
• Biofeedback

Poor sleep can have significant effects on the quality of our lives, but there are things we can do to improve it. Medication certainly is an option, but there are many other techniques that are just as effective, and which may actually address the underlying cause of the sleep disturbance. If you or someone you love is struggling with insomnia, consider trying some of these techniques; you deserve a good night's sleep.