For tens of thousands of Americans, the first option when they can’t sleep at night is to reach for a sleeping pill. Research shows that this may not be such a good idea.
According to a review of clinical studies reported in the Annals of Internal Medicine, Cognitive Behavior Therapy (or CBT) is far superior in helping people sleep than any of the commercially sold sleeping medications that promise to remedy one’s insomnia. While CBT works on one’s behavior, making sleep a more positive experience, drugs simply treat an insomniac’s symptoms without addressing the underlying cause.
Insomnia has been linked to a number of physical and mental health disorders as well as substance abuse. An ongoing lack of sleep increases one’s risk of illness and infection, high blood pressure, heart disease, diabetes and chronic pain.
CBT helps patients develop good sleeping habits and avoid those behaviors that keep them from sleeping well. It typically includes the following:
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Stimulus control therapy. This helps remove factors that condition the mind to resist sleep. This could include maintaining a consistent bedtime routine, including wakeup times and avoiding naps; leaving the bedroom when unable to sleep for 20 minutes; and staying away from coffee, alcohol or heavy exercise prior to bedtime.
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Bedtime restriction. This is intended to break the patient’s habit of lying in bed without being able to fall asleep. This treatment decreases the time spent in bed, causing partial sleep deprivation, which makes one more tired the next night.
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Improving the sleep environment. This may include such changes as keeping the bedroom quiet, dark and cool, hiding a clock from view, and removing the TV.
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Paradoxical intention. Paradoxically, worrying over not being able to sleep can actually keep you awake. This therapy involves getting the patient to avoid any effort to fall asleep. By letting go of this worry, you relax, which makes it easier to sleep.
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