Behavioral programs

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:

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Stimulus control therapy helps to strengthen the connection between the bedroom and sleeping by following such strategies as using the bedroom only for sleeping and sexual activity. In this type of therapy you will learn that activities like eating, working, paying bills, arguing, and watching television should not be pursued in bed. You'll also learn to get into bed only when sleepy. And if you are unable to sleep after 15 to 20 minutes, you should leave the bedroom and to do something restful, such as reading with a dim light.

Temporal control therapy promotes the routine of the sleep-wake schedule. In this type of therapy you'll learn strategies like avoiding daytime naps as well as getting out of bed at the same time each day, including weekends and holidays, no matter how well or how long you slept the night before.

Sleep restriction therapy seeks to increase the quality of sleep by limiting time spent in bed to sleeping only. In this therapy, you and the therapist will devise a strategy for not spending too much time in bed awake. For example, if you spend 6 hours asleep every night, you can limit yourself to 6 to 6.5 hours per night in bed. This creates some mild sleep deprivation, which is expected to increase your chance to sleep the next night. Your time in bed is increased gradually 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. It also is helpful in whittling down overblown fears about your 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.

Relaxation techniques and meditation This section has more on relaxation techniques and meditation, which can help reduce any stress that is causing your insomnia or making it worse.