Medical Library

INSOMNIA? Natural Treatment is Better

by Steven Brown, M.D., Ph.D.
©2008

We have all seen the unrealistic promises on the internet about easy cures for cancer, high blood pressure, and every other health problem. But if you can’t sleep, there is good news: natural treatment for insomnia, without drugs or surgery, really is better.

The Problems with Pills

If you have insomnia, you do not need me to tell you that insomnia affects your mood, your relationships, your overall health, and your job performance. You are probably wondering, though, why you should not just pop a pill. Isn’t that the easy way to go?

In the short run, pills may not be bad for a healthy young person. However, the FDA has not approved most sleeping pills for long-term use. Unfortunately, many of them cause rebound insomnia. In other words, when you stop the pills, you cannot sleep, not because you still have insomnia, but because your body is hooked on the pills. Still worse, all drugs have potential toxicities, including the ones marketed as “natural.” Valerian, for example, can damage the liver.

More importantly, studies show that cognitive therapy provides better long-term results than using medication. Since cognitive therapy gives better results with less risk, why take pills?

Cognitive Therapy

Of course, if you have insomnia, you need to see your doctor. You may have a medical condition that is causing the problem, and you may need specific treatments, including medications. But if you are the typical person with insomnia without other medical issues, cognitive therapy may be your best option. Cognitive therapy uses simple psychological techniques to re-educate your mind and body about how to sleep well.

If you have ever taken care of a baby for more than a few days, you have already used cognitive therapy. Do you remember rocking her and singing 15 verses of your once favorite lullaby? Finally, she seemed to be asleep. Slowly, carefully, you got up. You glided over to the crib. You leaned over and gently placed the little angel on the mattress. You held your breath as you turned away, and then….WAAAAA! She was wide-awake again, and the process began anew. This pattern of going to sleep was not healthy for you or the baby.

You probably did not give your baby a sleeping pill. More likely, when the baby was old enough, you limited daytime naps so that she would be sleepier at night. Eventually, you got the child accustomed to falling asleep alone in her crib or her bed after only two verses of a lullaby. She may have cried some the first few nights, but eventually, she developed a pattern that was healthier for both of you.

All of us, from cradle to grave, have a bedtime routine. For some of us, the pattern is healthy. We climb into bed, turn out the lights, and are snoring before our spouse has finished setting the alarm clock. Others of us end up with a pattern of lying in bed for two hours, tossing, turning, looking at the clock, and finally drifting off to sleep, only to awaken three hours later.

Psychologists refer to the development of new habits as cognitive therapy. Just as parental cognitive therapy teaches children new sleep habits, you can teach yourself healthier sleep patterns and break the grip of insomnia.

What to expect

Typically, a trained sleep therapist, usually a psychologist, teaches cognitive therapy in half a dozen 20 to 60 minute sessions. What principles do they teach their tired pupils?

Principles

The first task is to relieve anxiety by overcoming misconceptions about sleep.

  • It is normal to get less sleep as we get older. Many of us do not need the standard 8 hours a night.

  • Missing one night of sleep is not the end of the world.

  • It is possible to retrain yourself.

Practice

Here are some of the approaches that help build a healthy sleep pattern.

  • Daytime naps are the enemy of nighttime sleep.

  • Use your bedroom only for sleep and sex. If you lie in bed to work, watch television, and eat ice cream, you are not training yourself to fall asleep when you get into bed.

  • If you do not fall asleep within 15 minutes of going to bed, get up and do something else until you are sleepy. Do not reinforce the pattern of tossing and turning.

  • Do not drink caffeine after noon.

  • Exercise, but not too close to bedtime.

  • Get as much daytime sunshine as possible, up until 6 pm, to help set your biological clock.

  • Keep a sleep diary. Once you discover how many hours you are sleeping per day, stay in bed only that length of time. When you are sleeping that much in a healthy pattern, you can increase the length of time in bed by 10 to 15 minutes each week.

The Payoff

It was not easy for that baby to adapt to a new bedtime routine. It is just as hard for us as adults to break unhealthy sleep patterns. Just as a sleeping pill for a baby would be an unhealthy way to hide the problem, sleeping pills for adults often postpone the healthiest solutions. Getting advice from your doctor about healthy sleep habits can help you defeat the insomnia that keeps you from a more restful life.