Behavioral Therapy

Several behavioral therapies are available to help you with your insomnia. 

They may be used in combination with each other and/or with medications. Many of these therapies are aimed at strengthening associations between the bed and sleep and decreasing the amount of time spent lying in bed worrying about not sleeping, which, of course, only makes sleep more elusive.

Behavioral therapies include:

Stimulus control therapy helps to strengthen the connection of the bedroom with sleeping rather than with insomnia.

• The bedroom is to be used only for sleep and sexual activity. Eating, working, playing and watching television are not allowed in bed.

• Avoid using or checking electronics in bed.

• Go to bed only when sleepy. If unable to sleep after 15 to 20 minutes in bed, leave the bedroom. Return only when drowsy. Until drowsy, engage in restful activities such as reading in dim light. Do not use electronics during this time.

Relaxation techniques target issues that may cause insomnia.

• Exercises that tense and relax each muscle group help the muscles relax.

• Stressors may be decreased by meditation, in which thoughts are redirected towards pleasant topics.

Temporal control therapy promotes the routine of the sleep-wake schedule.

• Get out of bed at the same time each day.

• Avoid daytime naps.

Sleep restriction therapy seeks to increase the quality of sleep by limiting time spent in bed to sleeping only.

• Do not spend too much time in bed awake. For example, the amount of time spent in bed may be kept to 6 to 6.5 hours per night if your total sleep time is 6 hours nightly. The mild sleep deprivation that is allowed to develop is expected to increase your ability to sleep. Your time in bed is increased slowly by going to bed earlier until you are sleeping the amount of time that leaves you feeling rested.

Cognitive behavioral therapy focuses on exploring beliefs and assumptions about sleep and changing mistaken beliefs that contribute to insomnia.

• An example of such a fear: If you don't fall asleep soon, you'll be so tired tomorrow that you'll lose your job. Cognitive behavioral therapy may be particularly helpful for people who have chronic insomnia.

• Helpful in whittling down overblown fears about your insomnia.