The Solution to Sleep Without Medication


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A good night’s sleep almost guarantees that we will wake up feeling refreshed and ready for the day ahead. On the contrary, a lack of sleep can leave us feeling sluggish and interfere with the body’s natural rhythms. Sleep allows for the body and brain to recover throughout the night and it plays an essential role in our overall wellbeing. For those struggling with sleep disorders, such as insomnia, the long-term effects from a lack of sleep can impair both their overall health and quality of life.

“Insomnia is defined by having trouble falling asleep or struggling to stay asleep throughout the night.”

A study at Perelman School of Medicine at the University of Pennsylvania found that about 25 percent of adult Americans will develop acute insomnia each year. Acute insomnia is diagnosed when an individual is unable to fall asleep or stay asleep for at least three nights out of the week over a duration of two consecutive weeks. Once insomnia occurs at minimum three nights per week over a consistent period of more than 3 months, it is considered to be chronic insomnia. The American Medical Association (AMA) states that 10 percent of Americans suffer from chronic insomnia. The development of chronic insomnia can lead to both physical and mental health risks such as depression, anxiety, diabetes, and hypertension if left untreated.

“Fortunately, researchers have found an extremely effective treatment for insomnia called Cognitive Behavioral Therapy for Insomnia (CBT-I).”

Cognitive Behavioral Therapy (CBT) is a common form of psychological therapy used to treat a variety of mental health disorders. CBT is a talk therapy approach where the patient works directly with a therapist to work to improve their mental health. CBT-I takes the fundamentals of CBT but is designed specifically for those with insomnia. CBT-I has been well-researched and is proven to be a highly effective treatment approach for insomnia.

CBT-I offers an all-natural approach and has been shown to be equally effective as the use of sleeping medications in short-term use. Furthermore, CBT-I yields greater long-term benefits than the use of sleeping medications making it the first-line treatment option for individuals with insomnia. Data from clinical trials show that 80 percent of individuals treated with the use of CBT-I had reported improvements in their overall sleep. Philip Gehrman, director of the Sleep, Neurobiology and Psychopathology lab at the University of Pennsylvania reported that even the patients who had been struggling with insomnia for decades were able to experience significant improvements in their sleep. Some patients saw these improvements within as little as four sessions of CBT-I.

While CBT-I does focus on mastering sleep hygiene (simply put as “good sleep habits”), it also goes beyond these methods and dives into focusing in on the anxieties and stressors one may experience surrounding sleep. Sleep hygiene may not be the entire focus of CBT-I, but it still plays a vital role in allowing for a good night’s rest. Sleep hygiene focuses on implementing positive habits that will benefit sleep such as avoiding the use of screens at night, keeping to a consistent sleep schedule, avoiding large meals before bed, and making the bedroom a relaxing space intended for sleeping. These habits and routines surrounding sleep are important to first undertake to ensure one’s environment will allow for good sleep.

“Bedtime may feel more like a time of stress…”

Once good measures have been put in place for a good night’s sleep, CBT-I will then focus on targeting the negative beliefs a patient may have regarding their sleep. For many individuals dealing with chronic insomnia, they may be faced with constant worries about how they will be able to fall asleep each night. Bedtime may feel more like a time of stress for them if they are staying wide awake throughout the night. CBT-I works to provide relief to these anxieties by focusing on mindfulness, meditation, and other relaxation techniques such as deep breathing. Additionally, individuals with insomnia oftentimes do not associate their bed or bedroom with a place of rest, and instead it starts to become a place of stress. These associations occur as they find themselves aimlessly fidgeting throughout the night which can then make it seemingly more difficult for a good night’s sleep. CBT-I suggests that patients should only remain in their bed if they are feeling sleepy to help limit these associations.

“By setting attainable and realistic goals for the night, they can limit the stress and pressure they place on themselves to get an ideal night’s sleep.”

CBT-I also works to set attainable expectations with patients when it comes to their sleep. For instance, it is quite unlikely that an individual with chronic insomnia will be able to find themselves getting a full eight hours of solid sleep throughout the night. If they set these unrealistic goals of having an ideal night of sleep each night, it can end up resulting in more worry and less sleep. By setting attainable and realistic goals for the night, they can limit the stress and pressure they place on themselves to get an ideal night’s sleep. Eventually, they can work up to their desired sleep goals, but this will likely take time.

The standard treatment of CBT-I for insomnia patients is delivered over the course of six to eight sessions. Each session throughout the process follows a specific agenda such as an initial evaluation, adherence, relapse prevention, etc. The result for patients undergoing CBT-I is typically falling asleep faster and staying asleep throughout the night. This is a major improvement for anyone dealing with insomnia.

Before trying CBT-I, it is important to seek out a health care provider and ensure that there is not an external issue causing sleep disturbances. Some medical issues may impair sleep and may be the root cause of the issue. Therefore, it is important to rule out any other possibilities as they would require a separate treatment. If your doctor does recommend trying CBT-I, it is a well-researched, natural, and safe treatment for insomnia that can provide significant improvements.

Amanda Johnson is a recent graduate from the University of Southern California where she received her degree in Psychology. In addition to her university studies, she earned her Integrative Nutrition Health Coach certification from the Institute of Integrative Nutrition (IIN).

This article was reviewed and approved by Emeran Mayer, MD