Like you, insomnia is complicated.
Insomnia can be short-term (acute), lasting days to weeks. You're stressed for that test. You got dumped. You lost your job. You just learned of a death in the family. Your sleep suffers.
Insomnia can be long-term (chronic), lasting 3 months, years, or decades. Your acute insomnia doesn't get better. You're fatigued, irritable, anxious, and depressed. Your relationships feel less meaningful, less connected. Your work performance suffers. More stress. You worry about sleep. You try harder to sleep. This makes it worse. You're more fatigued. More irritable. The vicious cycle of chronic insomnia begins.
The importance of sleep-focused assessment.
A critical step in overcoming your insomnia is determining why it's happening.
Coexisting health difficulties are the rule, not the exception. Like you, it's complicated.
Is your insomnia better explained by another sleep disorder? Another medical disorder? What about those changes in mood you've noticed impacting your sleep? Anxiety, depression, bipolar, ADHD, PTSD, or substance use? Poor sleep makes your chronic pain worse, which makes it more difficult to fall asleep and stay asleep. What's going on? Where to begin?
A 90-minute clinical assessment with a sleep specialist is one solution to consider.
What is the most effective treatment for insomnia?
Skills. Not pills.
Although sleep medications can effectively manage insomnia for days or weeks due to life stressors, they're not recommended to treat insomnia lasting 3 months or longer.
Based on over 50 years of experimental evidence, the American College of Physicians and the American Academy of Sleep Medicine recommend Cognitive Behavioral Therapy for Insomnia (CBT-I) as the most effective treatment option for chronic insomnia disorder in adults.
CBT-I is a multi-component, individualized treatment involving daily monitoring of your sleep-wake pattern, targeting specific patterns of behavior that are maintaining your insomnia disorder, and refining treatment until you’re able to regularly fall asleep and stay asleep without difficulty.
CBT-I has demonstrated greater long-term improvements in insomnia compared to a variety of sleep medications, including Ambien, Imovane, and Sonata, with no concern for side effects like dizziness, headache, daytime sleepiness, and re-emergence of insomnia when sleep medications are discontinued.
If you’re currently taking sleep medication, you can continue taking these medications during CBT-I treatment.
Depending on your treatment goals, it’s often possible to significantly reduce or eliminate your use of sleep medication during CBT-I treatment. This involves gradually lowering your dosage over multiple weeks in collaboration with your prescribing clinician while implementing CBT-I skills.
How long will it take to successfully treat my insomnia?
Although your total number of appointments will depend on your individualized treatment plan, clinical research trials and our own clinical experience delivering CBT-I suggest that most chronic insomnia disorders are successfully treated after 4 to 8 weekly, 50-minute sessions following your initial clinical assessment.