Insomnia Treatment

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In addition to following a heart-healthy lifestyle, try to adopt the following bedtime habits. These habits can make it easier for you to fall asleep and stay asleep.

• Make your bedroom sleep friendly. Sleep in a cool, quiet, dark place. Avoid watching TV or looking at electronic devices, as the light from these sources can disrupt your sleep-wake cycle.
• Go to sleep and wake up around the same time each day, even on the weekends. If you can, avoid a schedule that changes or other things that may disrupt your sleep schedule.
• Avoid caffeine, nicotine, and alcohol close to your bedtime. Although alcohol can make it easier to fall asleep, it can cause you to have a sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.
• Get regular physical activity during the daytime, at least 5 to 6 hours before going to bed. Exercising close to bedtime can make it harder to fall asleep.
• Avoid naps, especially in the afternoon. This may help you sleep longer at night.
• Eat meals on a regular schedule and avoid late-night dinners.
• Limit how much you drink close to bedtime. This may help you sleep longer without having to use the bathroom.
• Learn new ways to manage stress. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath. Your doctor may also recommend massage therapy, meditation, or yoga to help you relax. Acupuncture may also help improve insomnia, especially in older adults.
• Avoid certain over-the-counter and prescription medicines that can disrupt sleep (for example, some cold and allergy medicines). Talk with your healthcare provider about which medicines will not disrupt your sleep.

CBT-I is a 6- to 8-week treatment plan to help you learn how to fall asleep faster and stay asleep longer. This is usually recommended as the first treatment option for long-term insomnia and can be very effective. CBT-I can be done by a doctor, nurse, or therapist; you can do it in person, by telephone, or online. It involves the following parts: 

• Cognitive therapy helps you feel less nervous about not being able to sleep.
• Relaxation or meditation therapy teaches you how to relax and fall asleep faster.
• Sleep education helps you learn good sleep habits.
• Sleep restriction therapy gives you a specific amount of time to spend in bed, even if you are not able to sleep during this time. With time, this helps you sleep better when you go to bed. Your sleep time can be increased when you start to sleep better.
• Stimulus control therapy helps you have a regular sleep-wake cycle so you can link being in bed with being asleep. This involves going to bed only when you are sleepy, getting out of bed if you cannot sleep, and using your bed only for sleep and sexual activity.

Prescription medicines

Some prescription medicines used to treat insomnia are meant for short-term use while others are meant for longer-term use. Talk to your doctor about the benefits and side effects of insomnia medicines. Some prescription medicines used to treat other health conditions can also increase your risk of insomnia.

• Benzodiazepine receptors agonists are medicines such as zolpidem, zaleplon, and eszopiclone. Side effects may include anxiety. Rare side effects may include a severe allergic reaction or doing activities while asleep such as walking, eating, or driving.
• Melatonin receptor agonists are medicines such as ramelteon. Side effects include dizziness and fatigue. Some people experience the rare side effects of doing activities while they are asleep, such as walking, eating, or driving; or they may have a severe allergic reaction. 
• Orexin receptor antagonists such as suvorexant are not recommended for people who have narcolepsy. Rare side effects may include doing activities while asleep such as walking, eating, or driving; or not being able to move or speak for several minutes while going to sleep or waking up.
• Benzodiazepines may be prescribed if other treatments and medicines have not worked. Talk to your healthcare provider about the side effects of these medicines, which can include dizziness, confusion, and muscle weakness. Benzodiazepines can also interact dangerously with other medicines. It can be habit-forming and should be taken for only a few weeks.

Off-label medicines

In some cases healthcare providers may prescribe medicines that are commonly used for other health conditions but are not approved by the U.S. Food and Drug Administration (FDA) to treat insomnia. Some of these medicines may include antidepressants, antipsychotics, and anticonvulsants.

Over-the-counter medicines and supplements

Tell your healthcare provider about any OTC products that you are taking.

• OTC products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them to treat your insomnia. Antihistamines can be unsafe for some people.
• Melatonin supplements are versions of the sleep hormone melatonin made in a lab. Many people take melatonin supplements to improve their sleep. However, research has not proven that melatonin is an effective treatment for insomnia. Side effects of melatonin may include daytime sleepiness, headaches, upset stomach, and worsening depression. It can also affect your body's control of blood pressure, causing high or low blood pressure.
• Dietary supplements can be beneficial to your health, but they can also have health risks. Talk to your provider before using dietary supplements.

The U.S. Food and Drug Administration (FDA) regulates dietary supplements under a different set of regulations than those covering "conventional" foods and medicines. The FDA does not currently review dietary supplement products for safety and effectiveness before they are marketed.