What is the best treatment for insomnia?
The best treatment for insomnia is one that will help you learn to sleep well for years to come.
There are many "quick fix" products on the market that claim to cure insomnia. The benefits from these quick fix solutions are generally short lived at best or non-existent at worst.
Sleep medications, herbal or natural remedies, soundtracks of music or sounds of nature, etc., may have some benefit as they have a relaxing effect on the body, however, they don't address the underlying causes of insomnia. Dependency on sleep aids can also undermine confidence in your body's natural ability to sleep, and thus increase your sleep anxiety.
The following treatments, have been scientifically tested and proven to help you sleep better. Sleep medications are described here as they can offer some immediate relief from sleeplessness, However, it is the two psychology based treatments described below (CBTi and MBTi) that are the most effective long term treatments for insomnia.
While the best long term treatments for insomnia are the non-drug approaches of cognitive behavioural therapy, and mindfulness based therapy (see below), there is a role of sleep medication. If you feel very distressed, and need immediate relief from insomnia, your GP may prescribe medication to help you sleep.
Some common examples of sleep medications are:
- Benzodiazepines (e.g. temazepam/Temaze)
- Benzodiazepine receptor agonists (e.g. zolpidem/Stilnox)
- Melatonin (e.g. Circadin)
- Medications for pain (e.g. pregabalin/Lyrica)
- Antidepressants (e.g. amitriptyline (Endep)
- Certain herbal medications (e.g. valerian)
While sleeping pills can be helpful in the short term, the side effects (e.g., daytime drowsiness, constipation or diarrhoea, dry mouth, dizziness, stomach pains and gas. etc) may outweigh the benefits of the drug you take. Also, some medications can become addictive and cause problems with memory and attention.
The other main problem with sleeping pills is that they are unlikely to address the underlying causes of your insomnia, so they won’t offer you a long-term solution.
Cognitive Behavioural Therapy for insomnia (CBTi)
The most widely studied and recommended long-term treatment for insomnia is a psychology-based treatment called cognitive behavioural therapy for insomnia (CBTi). This treatment can help you to change unhelpful sleep habits and behaviours, shift unhelpful thinking patterns that interfere with sleep, and help you learn to relax the mind and body, to reduce tension, stress and frustration often associated with insomnia. In general, the treatment consists of around 6 one-hour sessions, delivered weekly by a qualified psychologist trained in CBTi. Self-help CBTi programs are also available by following guidelines in books, apps and through online courses.
A recent analysis of all the research on CBTi showed that on average people went to sleep 19 minutes faster and stayed asleep 26 minutes longer after a CBTi intervention. When compared to sleep medication, CBTi has longer lasting benefits, and does not have the negative side effects produced by medication.
For more information about CBTi take a look at these posts:
Mindfulness-based therapy for insomnia (MBTi)
While CBTi is currently the most commonly recommended treatment for insomnia, about 40% of people don’t respond to this approach and can still have sleep problems after treatment. Health professionals and scientists are, therefore, looking for ways to improve treatments to get better results for people with insomnia.
The newest and most promising treatment for insomnia is Mindfulness-based therapy for insomnia (MBTi), which combines CBTi with mindfulness training.
Mindfulness training involves learning a range of mindfulness meditation practices (e.g., body scan, mindfulness of breath, mindful walking, mindfulness of emotions, a three-minute breathing space) and learning how the principles of mindfulness apply to daily life and sleep.
Mindfulness, in essence, is the awareness of your thoughts, feelings, and body sensations as they occur in each moment, while maintaining an attitude of acceptance and non-judgment towards what you notice. One of the many ways that mindfulness can improve your sleep is that it can help you break the cycle of insomnia. It teaches you how to let go of trying to sleep, thereby reducing anxiety and tension, helping you to relax the body and calm the mind.
The broader benefits of mindfulness meditation are well known. Mindfulness meditation has been shown to improve memory, concentration, reduce stress and anxiety, assist with regulating and managing emotions, and improves the way your immune system functions.
Mindfulness not only helps your sleep but improves many other aspects of your health and wellbeing.
For more information on the benefits of mindfulness for sleep take a look at these posts:
Which is the better treatment: CBTi or MBTi?
For a start, either CBTi or MBTi (mindfulness plus CBTi) is a better long-term treatment for insomnia than sleeping pills. CBTi has been around for over 30 years, there is excellent research to show that it is the most effective long-term treatment for insomnia. MBTi is a newer treatment that was first studied in 2008.
Studies published over the past 10 years have shown that MBTi (mindfulness plus CBTi) is at least as effective as CBTi with some research showing that mindfulness training added to CBTi improves outcomes. To date, no study has directly compared the two treatments. This research will most likely be conducted in the next few years.
Here are some of the reasons why MBTi (mindfulness plus CBTi) is likely to be a better treatment to CBTI:
- MBTi is at least as effective as CBTi at improving sleep
- MBTi has the additional benefits of mindfulness meditation on general health and well-being
- MBTi has been shown in at least one study to enhance CBTi, resulting in better outcomes for improving sleep
Mindfulness plus CBTi (MBTi) is likely to be the best long-term treatment for insomnia.
While research is clearly needed to test MBTi directly against CBTi, it is important to keep in mind that no treatment offers a “one size fits all” solution.
Some people may be better suited or may simply prefer one type of treatment over another. People with an interest in meditation or mindfulness-based practises like yoga, tai chi or QiGong, for example, will most likely be attracted to the MBTi approach.
Where can I learn mindfulness and CBTi to overcome insomnia?
A Mindful Way to Healthy Sleep is the only online program that offers an MBTi treatment approach to overcome insomnia, combining intensive mindfulness training with a full CBTi treatment package.
The six-week course teaches you everything you need to know about sleep and takes you step by step through the proven strategies to help improve the quality of your sleep and spend less time awake in bed.
The course is taught through a series of video lessons and practical exercises presented by Dr Giselle Withers, a clinical psychologist with a background in sleep psychology. From the comfort of your own home, you’ll have access to the gold standard treatment approach for insomnia.