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Can't Sleep? Try The Couch

If insomnia keeps you up at night, psychological and behavioral therapies may help you sleep.

So say sleep experts including Charles Morin, Ph.D., of Canada's Universite Laval in Quebec.

The researchers reviewed 37 studies of more than 2,200 adults with insomnia.
The studies, published from 1998 to 2004, covered various psychological and behavioral sleep therapies, including these strategies:

  • Go to bed only when you're sleepy.
  • If you can't sleep, get out of bed.
  • Use the bedroom only for sleeping (no reading, TV, etc.)
  • Get up at the same time every morning.
  • Don't nap.
  • Ease stress through meditation, progressive muscle relaxation, and other methods.
  • Challenge your beliefs about sleep (for instance, don't worry about sleep).
  • Curb bedroom light and noise.
  • Lead a healthy lifestyle.

    In most of the studies, sleep diaries kept by patients showed these therapies eased insomnia. The findings were true for people whose insomnia had no known medical cause, as well as those with medical or psychological illnesses.

    The results held during follow-ups lasting up to a year. "Treatment benefits are well-sustained over time," Morin's team writes.

    Nearly a quarter of the studies looked at older patients — over 60 years old, on average. The therapies worked for them as well, according to the review.

    Four studies focused on patients who had been taking sleep drugs. With psychological or behavioral therapy for insomnia, those patients generally cut back their use of the drugs.

    That doesn't mean they all got great sleep every night. But their results were better than insomnia patients who didn't get the therapies.

    Which therapy worked best? That's not clear, since most studies combined several methods. Future studies might be able to pinpoint the most effective therapies, say Morin and colleagues.

    SOURCES: Morin, C. Sleep, Nov. 1, 2006; Vol. 29: pp. 1398-1414. News release, American Academy of Sleep Medicine.

    By Miranda Hitti
    Reviewed by Louise Chang, M.D

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