Fewer Symptoms, Better Sleep: Hope For Your Insomnia

Insomnia is a sleep disorder characterized by difficulty falling asleep or staying asleep. Nearly each year, with twice as many women diagnosed as men. A lack of sleep can have numerous negative effects, including exhaustion, irritability, difficulty focusing, increased accidents, and stress about sleep. In addition, chronic insomnia—lasting for three or more months—can increase the risk of many health conditions, including stroke, diabetes, hypertension, and heart attack.

Experiencing bouts of insomnia can lead to frustration and stress, but there are viable ways to treat insomnia and lessen or eliminate symptoms through therapy and lifestyle changes. Below, we’ll explore some evidence-based strategies for improving insomnia as well as a first-line treatment called cognitive behavioral therapy for insomnia (CBT-I).

Strategies to overcome insomnia

Therapy, specifically cognitive behavioral therapy for insomnia (CBT-I), is the leading treatment for insomnia symptoms, but you can also implement key lifestyle changes to sleep better. The following are some evidence-based strategies that may help relieve your insomnia.

Meditate

You may find that it helps to meditate before you go to sleep to clear your mind and remove thoughts keeping you awake. One study found that older adults experienced less fatigue and insomnia symptoms after completing six mindfulness sessions.

Exercise regularly

You may find that it helps to exercise in the morning or afternoon to help your body be prepared to rest at night. Regular exercise can help you fall asleep and stay asleep. However, it may be best to avoid too much activity in the evening, as it can stimulate your body and keep you awake.

Decrease caffeine consumption

If you’re not ready to eliminate caffeine, consider lessening your daily intake and setting a cut-off time each day, ideally early in the afternoon.

Create an environment conducive to sleep

The ideal sleep environment usually consists of comfortable bed, a dark room, and a cool temperature. You may need to make changes to create this environment in your bedroom, such as removing the TV or investing in blackout curtains and a fan.

Shape your sleep associations

If you are experiencing persistent insomnia symptoms, it may help to use your bed strictly for sleep and sex. For other activities, such as watching TV or reading a book, you can use another space, such as the living room. If you are in bed and can’t fall asleep, consider getting up, completing an activity, and returning to bed when your body and mind are ready.

Follow a consistent schedule

Changing your typical sleep schedule to stay up late on Friday and sleep in on Saturday can be a delightful break in routine. However, it can confuse your body’s internal clock. You might find it helpful to be as consistent as you can about going to bed and waking up each day. Unfortunately, that involves eliminating naps as well.

Stop drinking alcohol three hours before bed

This tip may be surprising as alcohol causes drowsiness. However, alcohol can have a negative impact on REM sleep and cause individuals to wake up often. In addition, using alcohol to aid in sleep can create an unhealthy dependence.

Design a bedtime routine

While parents with young children swear by their bedtime routines, a bedtime routine may also benefit adults. A nighttime ritual that includes activities such as reading, bathing, and listening to relaxing music may signal to your body that it’s time to wind down.

Eliminate screens before bed

Blue lights—those emitted from phones and computer screens—suppress melatonin production. As with caffeine and alcohol, setting a cut-off time to stop using your devices may lead to better sleep. If you must use devices right before bed, consider investing in a pair of blue light glasses to block those wavelengths.

Medication vs. therapy

Medication has often been used to treat insomnia. However, medicine may not be an ideal solution for a long-term condition, and there are risks involved in using sleep aids, such as dependence and withdrawal.

CBT-I tends to focus on mental, emotional, and behavioral blocks that hinder sleep, including behaviors and beliefs that contribute to an individual experiencing insomnia. 

Research on CBT for insomnia (CBT-I)

There have been several studies on the impact of online interventions on chronic insomnia symptoms. According to Stanford Medicine, most people benefit from CBT-I after four to six sessions, with some responding well after just two sessions. 

One study provided CBT-I to 56 individuals who had been experiencing trouble sleeping for at least three months. Additionally, 52% also reported having depression, and 30% reported experiencing anxiety.

During this study, CBT-I was delivered using a virtual program called Space for Sleep. The program consisted of five core modules, each requiring 40 minutes to an hour to complete. Modules included introductory quizzes, videos, interactive activities, informational content, homework suggestions, and summaries.

Researchers found that participants experienced several positive outcomes from completing the program:

• 27% of participants achieved clinically significant change in their insomnia.
• Of those with severe insomnia symptoms, 44% achieved a clinically significant change.
• 8% saw significant improvements to their depression.
• 9% saw significant improvements to their anxiety.

Future research

This research focused completely on CBT-I provided by pre-recorded modules. While the nature of the Space for Sleep program makes it widely available, it offers very limited interaction with care providers. There is a great deal of room to learn about the impact of CBT-I provided by a more personal form of therapy that provides more communication with a care provider through direct online therapy sessions.

Additional considerations

This study supports the use of cognitive behavioral therapy for insomnia (CBT-I). This is in line with the guidance provided by the American College of Physicians, which recommends CBT-I as the first treatment for those experiencing chronic insomnia. It has even been shown to be effective for those experiencing sub-threshold insomnia. Also, CBT-I may be especially useful for people in high-risk groups, including those who are pregnant and those with post-traumatic stress disorder (PTSD).

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Talk to a therapist about insomnia

If you’re experiencing insomnia, you may benefit from speaking with a licensed therapist. If you don’t have time to visit a therapist’s office, you might consider online therapy. With a platform like BetterHelp, you can connect with a therapist via phone, live chat, and videoconferencing from the comfort of your own home. You can also contact your therapist at any time through in-app messaging, and they’ll respond as soon as they can. This may prove to be especially helpful if you can’t sleep and want to send your therapist any thoughts or questions during the night.