Harvard Health Letter

A pill-free way to fight insomnia

fighting insomnia without pillsIf you're searching for a way to fall asleep without medication, consider cognitive behavioral therapy (CBT). A recent review of 20 randomized controlled trials on CBT, published June 9, 2015, in Annals of Internal Medicine, found that the technique helped people with chronic insomnia and no underlying medical problems fall asleep about 20 minutes faster and improved sleep efficiency by about 10%. Traditional CBT aims to identify, challenge, and replace dysfunctional beliefs and attitudes with positive ones. CBT for insomnia uses this approach as well, and adds four additional components: stimulus control to strengthen the association between bed and sleep; sleep restriction to limit time spent in bed; sleep hygiene, such as sleeping in a cool, darkened room; and relaxation techniques. Researchers point out that CBT requires much more effort than taking a pill. But they say CBT is better tolerated than medication, and it teaches skills that can be maintained over time. Harvard sleep expert Dr. Lawrence Epstein agrees. "Studies have shown CBT is equally effective as sleep medication, avoids the side effects associated with medication, and has longer-lasting improvements in sleep," he says. 

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