The Best Medicine for Insomnia May be Psychological: The Sleep Doctor, Dr. Michael Breus, shares lifestyle changes to help enjoy better sleep

Sleep deprivation from any cause, including insomnia, sleep apnea or just not enough time, affects every organ system and every disease state. It affects all forms of both medical and psychological treatment and can bring on severe psychological distress. Symptoms include difficulty falling asleep, difficulty staying asleep, waking up too early, feeling tired and irritable, daytime sleepiness, mood changes, attention, concentration or memory problems, and frustration or worry about sleep.

When insomnia occurs at least three nights a week for one month or longer, it is time for treatment. Often, good sleep habits and self-care can cure a mild case of short-term insomnia. Some sleep aids, including sedatives, minor tranquilizers and anti-anxiety medications, become habit-forming or pose a potential for overdose if not used as directed. While an over-the-counter sleep aid may help with an occasional sleepless night, it is inappropriate for chronic insomnia. If there is no underlying medical condition fueling the insomnia, then there is almost certainly a mental health component.

Cognitive behavioral therapy (CBT) has been adapted for use in this disorder with remarkable results. In many cases, CBT for insomnia can be more effective than medication or supplements, and certainly longer lasting. This structured therapy teaches a person how to alter behaviors that worsen insomnia and learn new ways to think about and promote sleep. In some cases, the use of a supplement can help break the cycle of insomnia, and then CBT can be used to treat it.

Here are some basic lifestyle changes that can be quite helpful. Try not to worry about sleep before going to bed. Provide distraction with reading, prayer or meditation. Avoid clock-watching; turn the clock around and use only the alarm. Make the bedroom comfortable for sleep; keep it dark, quiet and not too cold or warm. Use a sleeping mask to block light or earplugs or a fan to block noise. Relax before bedtime by reading, listening to relaxing music, bathing or doing another relaxing activity. Don’t eat a heavy meal late in the day; a light snack before bedtime may help with sleep, though. If these suggestions do not help, contact a behavioral sleep specialist and get formal therapy.

Insomnia is not the only situation that a behavioral sleep specialist is qualified to treat. Other problems include:

Delayed or Advanced Sleep Phase Syndrome: Here a person’s body clock is either going too fast or too slow compared to the rest of society.

CPAP Compliance: Sleep apnea is treated with a specialized medical device called a continuous positive airway pressure (CPAP) machine, but few people like using it. Issues with claustrophobia exist, but there are several possible forms of treatment.

Childhood and Adolescent Sleep Disorders: Bedtime refusal, nightmares, night terrors, nighttime fears, etc. require a different approach than with adults.

Michael Breus, Ph.D., is a board-certified sleep specialist and a diplomate of The American Board of Sleep Medicine in private practice in Scottsdale. He is the author of the bestselling book, Good Night: The Sleep Doctor’s 4-Week Program to Better Sleep and Better Health. For more information, call 480-999-5900 or visit DrBreus.com.