For anyone who has ever struggled with chronic insomnia, using a relatively fast-acting prescription sleep medication like Ambien may seem like an appealing option. While sedative drugs can help you fall asleep quickly, they also come with a risk for side effects, and a prominent doctors’ organization is now recommending that patients with insomnia try therapy before sleeping pills.
A research team with the American College of Physicians looked at a decade’s worth of studies on cognitive behavioral therapy and insomnia, and the group is now recommending that patients with insomnia use a treatment approach called cognitive behavioral therapy (CBT) before turning to medication.
Ambien Popular Sleep Medication
CBT as First-Line Insomnia Treatment
Sleeping pills have proven to be effective in the short-term treatment of insomnia, but some medications can be habit-forming or may have dangerous side effects. In 2013, the FDA told manufacturers of zolpidem products (including Ambien, Edluar, and Zolpimist) to lower their recommended doses, since some people using those products to sleep at night still had a high enough level of the drug in their bloodstream the next morning to impair driving and other activities.
Cognitive behavioral therapy does not have this same risk of side effects and has proven to be effective at treating insomnia by giving patients the tools needed to manage their sleep habits. While doctors typically only recommend using sleeping pills for a few days or weeks at a time, the skills a patient develops through cognitive behavioral therapy can help that person get a better night’s sleep for years to come.
How CBT for Insomnia Works
Cognitive behavioral therapy is an approach that involves identifying harmful thought patterns and introducing behavioral changes to combat those unhealthy beliefs. A healthcare provider who is trained in CBT for insomnia might ask their patient to keep a sleep diary to identify their sleep habits, hours of sleep, and disruptions that woke them during the night. The healthcare provider can then talk to the patient and review the diary to come up with recommended behavioral changes.
Behavioral changes that sleep doctors and therapists frequently recommend for insomnia include:
- Avoiding the use of electronics in the bedroom (e.g. checking your phone or watching TV in bed)
- Avoiding naps during the day
- Setting a time in the evening when worries will be set aside until the next day
- Getting out of bed and doing something else until you feel drowsy if you’re unable to fall asleep
- Getting regular exercise
If you have insomnia, talk to your doctor to see if they are trained in cognitive behavioral therapy. If not, they may be able to recommend a therapist who can help you start sleeping better.