Help for Chronic Insomnia: How to Get Better Sleep
We've all had sleepless nights; when they happen over and over again, it’s time to get help for chronic insomnia.
Nobody likes to toss and turn. After a while, it affects your nights and days.
It becomes hard to feel happy and enjoy life.
There’s a lot of advice and devices out there. They all promise a good night’s sleep. These are often gimmicks, or they don’t work when your insomnia is chronic.
Don’t lose hope, there’s help out there. You can get better sleep. Keep reading to find out how to sleep better when you have chronic insomnia.
Why it's important to get help for chronic insomnia
Many people, when they haven’t been sleeping well and aren’t getting enough rest, get to the point where they feel anxious about bedtime every night.
This anxiety doesn’t help, it actually makes things worse. But even knowing this doesn’t make the bedtime stress go away.
Before clients come to us, they often feel like they have tried everything. Unfortunately, none of it worked the way they needed it to. They’d still be up night after night and feel exhausted every day.
Friends and family aren’t helpful. They either blame the lack of sleep on something the person is doing or just don’t believe how bad it is. They assume the insomniac is being dramatic.
The helplessness is real.
Who has Insomnia: The difference between chronic insomnia and occasional sleep problems
All of us experience a sleepless night here and there, also called short-term insomnia. But how bad does someone’s sleep have to be to count as chronic insomnia, one of the many sleep disorders?
For poor sleep to be considered chronic insomnia, you need to have trouble falling asleep or staying asleep for at least 3 nights a week for over 3 months.
Only 12% of people fall into this category, while 40% of people struggle with poor sleep occasionally.
Also, older adults who are obese and struggle with a mental health condition are more likely to experience chronic insomnia.
Chronic insomnia feels like a never-ending cycle
The hardest part of insomnia is that one bad night isn’t one bad night. It builds on itself and can get worse and worse if the cycle isn’t broken.
If you have one hard night, you’re exhausted the next day when the alarm goes off. You’re more likely to take a nap or sleep in. You’re anxious about getting sleep the next night. The lack of sleep makes your body more stressed. All of these things will make it harder to get sleep the following night.
The more experience you have with not getting enough sleep, the worse these things get.
It begins to feel like a never-ending cycle where the person gets less and less sleep. When the person has such a hard time sleeping, they start avoiding going to bed, which makes all of this worse.
Tips to try before reaching out for help
There are some options to try as you wait for your appointment with a sleep specialist. For some people, these tips make the difference, and you are back to sleeping well every night.
For others, these tips aren’t quite enough, especially if you have been struggling with chronic insomnia symptoms for a while. But they are the first things your doctor will want to try before any other treatment options.
Good sleep hygiene basics: Start by going to bed and waking up at the same time every night. This is important as it allows your body and brain to know when it’s time to go to bed.
You also want to limit the amount of caffeine and alcohol you consume. This is important as both alcohol and caffeine can impact your ability to get good sleep.
You also want to make sure that you have an optimal sleep environment set up. This means that the room you are sleeping in is cold, dark, and quiet.
You also want to get off of your electronic devices for between half an hour and 2 hours before bed.
Behavioral strategies: The first of these strategies is not allowing yourself to stay in bed trying to get to sleep for longer than 15 minutes. If you find you can’t sleep after 15 minutes, it’s time to get up and go into another room. While you are there, try to do something quiet and calm in a dimly lit room until you start to feel tired again.
You also only want to use your bed for sleeping or sex. Do not work or pay bills or do anything else while you are in your bed. This allows your body to only associate the bed with those two things, and it will make it easier to sleep there.
You want to establish a regular sleep routine that you do every night before you go to bed. For some people, this is an hour-long routine including meditation and self-care for others, it might only be 15 minutes. The important thing is that you do the same thing every night, even when you are not home.
If you find that you are having racing thoughts that are interfering with your ability to sleep, you want to keep a journal (not your phone) near your bed so that you can write down the thoughts that are coming up. You can then remind yourself that you have it written down, and you can look at it tomorrow. Meditation and deep breathing can help with this as well.
Lifestyle changes: Some of these lifestyle changes are mentioned above. In order to get good quality sleep, you need to make sure that you have a good sleep routine and that you avoid caffeine and alcohol before bed.
You also want to make sure that you are getting some exercise every day. Cardiovascular exercise helps improve sleep quality and the length of sleep. You do want to be careful about what time you exercise, for some people exercise after 7 pm can contribute to insomnia. Your best bet is to get exercise outside first thing in the morning, but any exercise before 7 pm is going to help you sleep better.
All of these tips are helpful, but they will work best if they are paired with a comprehensive sleep approach created by a sleep expert who is working specifically with you.
Help for Chronic Insomnia: CBT-I
You might find yourself thinking, I do all of these things and I still can’t sleep! What do I do now?
The next thing to try is to find a sleep expert who uses cognitive behavioral therapy for insomnia, also called CBT-I.
This cognitive behavioral therapy is targeted at insomnia and is considered the Gold Standard Treatment for Chronic Insomnia by the American Academy of Sleep Medicine.
As we’ll discuss in the next section, CBT-I is more effective than sleep medication for long-term use.
CBT-I is a well-rounded treatment that targets both the physical and emotional aspects of Chronic insomnia.
Here is what to expect if you decide to try CBT-I:
Sleep restriction therapy: This part feels counterintuitive, but it is also a part of CBT-I that is going to help you sleep better soon. You and your sleep specialist therapist will track how much sleep you are actually getting, including the amount of time you sleep, and the amount of wake time you are spending in bed.
Your therapist then guides you in decreasing the amount of time you spend in bed. This surprisingly shortens the amount of time you are spending awake in bed and increases the quality of sleep you are getting. Together, you slowly increase the amount of time you are spending in bed until you are sleeping better and longer.
This not only decreases your sleep latency, or how long it takes you to fall asleep, but also consolidates your sleep and helps you sleep better. You must consult a sleep expert during this process, as if it’s done wrong, it can exacerbate your insomnia.
Stimulus control therapy: This is where you strengthen the positive associations with sleep. Your sleep expert therapist will guide you through how to do this and make it work best for your life.
This seems easy, but it is really powerful in helping you to sleep better.
Cognitive restructuring: This intervention helps with the anxiety and dread that someone with insomnia experiences around sleep. Cognitive therapy techniques are used to help with the thought loops that occur when you can’t sleep at night or when you are avoiding bedtime.
Sleep hygiene education: Your therapist works with you to make sure that you understand sleep hygiene and then helps you to apply it to your life.
Relaxation techniques: Relaxation is a key part of sleep. If you can’t calm down, you can’t sleep. Your therapist will teach you different relaxation techniques, like deep breathing exercises and progressive muscle relaxation. This will give you lots of options to help you calm down enough to sleep.
CBT-I is a very active sleep intervention. You keep a sleep diary of your sleep patterns and have to pay attention to your behaviors and thoughts.
But it is very effective. It is considered the gold standard treatment for chronic insomnia.
You can participate in CBT-I through individual therapy, group therapy, and, if needed, through an app.
Individual CBT-I therapy is recommended if you feel like your case is very unique or you have extra factors that are important to keep in mind.
Group therapy can be helpful in that it allows you to see that other people are struggling as well. This helps you to feel less alone and allows you to get ideas from others, as well as the therapist, if you are struggling.
Digital programs can be an effective and affordable option if you can’t access individual or group therapy.
Other treatment options
For some people, CBT-I for primary insomnia is not the best treatment option.
Sleep medication is the treatment option that most people think about when looking for help for their insomnia symptoms. As mentioned before, when it comes to long-term use, CBT-I is more effective.
Medication can be helpful for getting a good night’s sleep fast. Your doctor may prescribe them for short-term use. It’s important to note that these medications are not meant to be used over a long period of time, and you can become dependent on them to sleep. This can cause an even bigger problem than what you are dealing with.
Some people can pair medication with CBT-I and get effective results that way, but this is up to the individual and their sleep therapist.
Other approaches that some find helpful are meditation and mindfulness-based interventions. Light therapy has been helpful for some. Other people find some help with different supplements like melatonin or magnesium. It’s important to talk to your medical provider.
Some of these interventions might be helpful if CBT-I isn’t right for you.
Ruling out medical conditions
Some medical conditions might interfere with treatments for chronic insomnia, so you must talk to your healthcare provider. They can assess you for other sleep disorders like sleep apnea or restless legs syndrome that might interfere with sleep treatment.
They will look at possible risk factors and look at your health information to determine if you have a medical condition that can interfere with your sleep. They might also recommend a sleep study.
They might also help you with things like chronic pain that might be interfering with sleep. As well as look at the medications you are taking for possible side effects.
Your medical provider will also assess you for mental health conditions that might exacerbate your insomnia and need to be considered before CBT-I, like Post-traumatic stress disorder or bipolar disorder.
It’s important to talk to your doctor about the best insomnia treatment option for you and your life.
Do I need CBT-I?
So you might be wondering how I decide if I need CBT-I? Here are some ways that you can tell if CBT-I might be needed.
If you’ve tried self-help strategies and they are not helping. Or if your insomnia is significantly impacting your functioning, and you have been struggling for months without improvement.
CBT-I might be helpful if you also have anxiety or depression that seems to be impacting your sleep.
The last thing that might be an indication that CBT-I would help is if you’ve tried sleep medication and it isn’t making the difference you hoped for.
What to expect during a CBT-I consultation
During your consultation, you’ll talk to your therapist about your history and current experience of insomnia symptoms. They will assess whether or not they think you need a medical evaluation before you start therapy. If they determine that you are a good fit for CBT-I, then they will schedule your first appointment.
Get help for Chronic Insomnia
If you are struggling with chronic insomnia and you are ready to start sleeping better at night and having better days. It’s time to get help for chronic insomnia by scheduling a consultation today.
