Insomnia

TABLE OF CONTENTS

Insomnia

Treatments

Non-drug

Prescription Drugs

Ambien (Zolpidem) Ambien CR (Zolpidem) Belsomra (Suvorexant) Edluar (Zolpidem) Intermezzo (Zolpidem) Lunesta (Eszopiclone) Zolpimist (Zolpidem)

Over-the-counter Drugs

What Leading Medical Organizations Recommend When Treating Insomnia

WHAT TO TRY FIRST

The American Academy of Sleep Medicine recommends that all people with insomnia try to improve sleep hygiene by keeping a regular schedule, having a healthy diet and regular daytime exercise, having a quiet sleep environment, and avoiding napping, caffeine, other stimulants, nicotine, alcohol, excessive fluids, or stimulating activities before bedtime.

If insomnia persists, the Academy suggests psychological and behavioral therapies or medications used alone or in combination (although some organizations, like the British National Health Service, are reluctant to suggest medications because of limited benefit and important side effects).

  • Cognitive behavioral therapy: effort to change the patient’s sleep related beliefs and behaviors through therapy (in person or using an app) and behavioral treatments including relaxation therapy and sleep restriction (consolidating sleep to bedtime). A recent systematic review concluded that cognitive behavioral therapy is highly effective and can have a long lasting impact on insomnia.
  • Medications: The choice of drug depends on the symptom pattern – some drugs work better for helping people fall asleep or for helping with middle-of-the night awakenings and side effects (some drugs cause more drowsiness and dependence).

WHAT ELSE TO TRY

If one approach does not work combining approaches may help (for example, adding a medication to cognitive behavioral therapy). 

SOURCES

Journal of Clinical Sleep MedicineClinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults. Published 2008.
National Center for Biotechnology Information. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015;163(3):191-204. doi:10.7326/M14-2841.
National Health Service (UK). Insomnia - Treatment. Published September 2013.