Sleeping pills give quick, short-term relief but don’t treat the root causes of sleeplessness. So, how to treat insomnia and get deep sleep without medication?
Beware, there are many impractical tips going around. Like, one popular tip to get more sleep is to go to bed earlier.
However, an early bedtime can make it harder to fall asleep as your brain is under psychological pressure to sleep. Similar to performance anxiety, it keeps the brain alert, causing thoughts to race around.
If you notice, insomnia is both a symptom and an illness.
Research points out that it can be treated effectively without medicines. In fact, the first method is the most effective treatment for adult insomnia.
How To Treat Insomnia Without Medication?
We are more stressed and sleepless today. A 2021 study found a 20% rise in sleeping pill use vs pre-Covid-19 crisis.
Here are six research-backed methods to treat insomnia without medications:
1. Cognitive Behavioral Therapy For Insomnia (CBT-I): Best Method
In February 2021, an AASM task force of experts in sleep medicine and sleep psychology named Cognitive Behavioral Therapy For Insomnia (CBT-I) as the treatment of choice and the best available treatment for chronic insomniacs.
CBT-I is a multi-part therapy and includes:
- Cognitive techniques,
- Education on stimulus control,
- Sleep restriction,
- Sleep hygiene literacy, and
- Other counter-arousal methods.
To assess the success of any insomnia treatment, we measure the remission rate, responder rate, sleep quality, sleep latency, and wake after sleep onset.
Compared to medications, CBT-I therapy performs well on all of them.
Moreover, CBT-I is a time-limited treatment, as opposed to medications that must be used for years.
The National Institute for Health and Care Excellence (NICE) formally recommends only CBT-I and pharmacological treatment for insomnia.
2. Stimulus Control For Insomnia
Stimulus control trains your brain (much like Pavlov’s or Seligman’s dogs) to solely relate your bed with sleep (and intimacy). As a result, whenever you are in your bed, you fall asleep fast.
Stimulus control includes behaviors that are designed to:
- dissociate the bed or bedroom from wakeful activities,
- associate the bed or bedroom with sleep, and
- establish a consistent wake time.
To dissociate your bed/bedroom from wakeful activities, avoid doing the following in your bed:
- watch TV,
- play games,
- be on social media,
- do online activities, or
- read work-related material,
- make strategies like to-do lists.
To associate your bed or bedroom with sleep, use the bed for only sleep or intimacy. If possible, don’t enter the bedroom unless you need sleep (or intimacy).
More ways to practice stimulus control to treat your insomnia:
- Try to avoid daytime naps.
- Wake up at the same time every morning.
- Go to bed only when you are sleepy-tired.
- Get out of bed if unable to sleep for 20 minutes or so.
If unable to fall asleep while in bed, experts suggest doing the following:
- Get out of bed and move to another room rather than painfully remaining in bed when sleep is not happening.
- Do something light and gentle, like reading a paper book or listening to a podcast. Return to bed when you start to feel sleepy-tired.
- Strictly avoid anything that requires you to stare at a blue-light screen, such as reading online posts or watching videos on your mobile.
- Avoid lying down on a sofa, as it can make you fall asleep there and hurt yourself while sleeping.
3. Sleep Restriction Therapy For Insomnia
Sleep is a biological necessity. Sleep restriction increases the biological pressure to sleep.
This method keeps the wake-up time constant while limiting the total time in bed.
It makes your brain realize that you must fall and stay asleep to get adequate sleep since the wake-up time is fixed. As a result, you learn to fall asleep faster and get more restful sleep.
Here is how it is practiced:
- Restrict your time in bed to your average sleep duration. Initially, it may mean getting even less sleep than normal.
- Start experimenting with delaying your bedtime while maintaining the wake-up time the same every morning.
- After a few weeks, you may increase or decrease it to achieve sufficient duration and overall sleep satisfaction.
Sleep restriction therapy is contraindicated for people who work in high-risk jobs, like heavy machinery operators or drivers, and those who have mania, hypomania, or poorly controlled seizures.
4. Relaxation Therapy For Insomnia
Anxiety and insomnia have a close connection.
Insomniacs often struggle to sleep as they worry about their lack of sleep. When they cannot stop these anxious and arousing thoughts, their insomnia worsens.
So, how to treat insomnia due to anxiety? By using Relaxation Therapy.
Relaxation therapy is low-cost and requires minimal resources, but is quite helpful in treating chronic insomnia caused by anxiety and stress.
Here are some relaxation activities that can help insomniacs:
- Progressive muscle relaxation (PMR),
- Autogenic training and guided meditation,
- Diaphragmatic breathing (to relax via the vagus nerve),
- Mindfulness-based therapies like mindfulness meditation.
Mindfulness is attaining a nonjudgmental state of heightened awareness. It trains you to notice your thoughts, emotions, and experiences on a moment-to-moment basis, without getting affected by them.
Most well-informed patients choose relaxation therapy as a treatment of choice for chronic insomnia.
5. Sleep Hygiene Literacy
Sleep hygiene literacy includes a set of lifestyle recommendations:
- Daily exercise.
- Healthy diet.
- Avoiding substance use.
- Education about age-related sleep changes.
- Controlling environmental factors, like noise, light, and temperature.
- Avoid caffeine after 2 pm.
- Avoid or limit alcohol and nicotine, especially within 3 hours before bedtime.
- Give yourself 60-90 minutes of winding down before you go to bed every night. During the winding down period, avoid things that overstimulate the brain, like checking work emails, gaming, and social media. Do light reading, light exercise, listen to relaxing music, take a bath, and do some self-care routine.
- Keep the bed comfortable, lights dim, regulate the temperature to moderately cool, and cut off all sources of noise. Do not play relaxing music in the background; it turns into noise when trying to fall asleep.
- If you wake up at night, don’t check the time. If you have to use the toilet, do so and immediately return to bed.
- Get up at the same time every morning, even on non-working days. It strengthens your body’s natural clock (circadian rhythm or sleep-wake cycle).
- Go out to soak up the sunlight as soon as you get up. Go out even if it is a cloudy day. If you can’t go out, sit by a window.
The potential benefits of sleep hygiene as a single-component therapy are minimal, and no better than control conditions.
The AASM suggests that clinicians do not use sleep hygiene as the only therapy for the treatment of chronic insomnia in adults.
AASM proposes it can be included in multicomponent interventions like CBT-I. In fact, sleep hygiene is part of CBT-I treatment.
6. Paradoxical Intention
This method may sound strange.
Paradoxical intention involves purposefully going to bed at an earlier time and staying awake as long as possible.
It requires you to lie awake for a long period of time while trying not to fall asleep.
Over time. regular practice of this method may reduce performance anxiety and conscious intent to sleep.
AASM has NO recommendations regarding this.
Can insomnia medications harm?
Insomnia medications (sleeping pills) can cause headaches, hallucinations, nightmares, and Alzheimer’s disease. They are addicting in the long term as one gets used to them over time and needs higher doses. They can also worsen sleep apnea and raise the risk of death.
Sleep medications provide symptomatic relief over the short term. They induce sleepiness to make a person sleep faster and longer while ignoring the root cause of their sleep problem.
Most over-the-counter medicines, like antihistamines, make you sleepy but do not help you fall asleep.
What is the most effective cure for insomnia?
Cognitive Behavior Therapy for Insomnia (CBT-I) is the most effective evidence-based method to treat chronic insomnia in adults. CBT-I has been shown to cure insomnia for the longest time after the end of therapy. It has fewer side effects, is more effective in the long run, and improves insomnia symptoms better than medications.
Can low light help insomnia?
Dimming the light in your room around your sleep time signals your brain to release melatonin (the sleep hormone). Exposure to blue-light screens (and also daylight) causes your brain to stop producing melatonin, causing you to be wide awake.
Is insomnia a self-fulfilling prophecy?
Yes, insomnia can become a self-fulfilling prophecy that can persist for an indefinite time. The insomniac goes to bed wanting to sleep, worries about a lack of sleep, fails to stop the racing thoughts, and makes it still harder to fall asleep.
Long-term insomniacs often feel hopeless and helpless. Self-compassion can help change these self-defeating issues.
If the above methods don’t help treat your insomnia without medication, get help from your doctors or a sleep specialist to restore your nighttime slumber.
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Author Bio: Written and reviewed by Sandip Roy — a medical doctor, psychology writer, and happiness researcher, who writes on mental well-being, happiness, positive psychology, and philosophy (especially Stoicism).
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