Insomnia requires treatment adapted to each situation. The first step is to find the cause. Often, insomnia that has been present for several months requires reorganizing lifestyle habits to promote sleep.

To sleep better, start by changing your habits

Treatment through behaviors called ” stimuli control Is particularly effective. It aims to accustom the body to a routine conducive to sleep. It does, however, create a sleep deprivation, which sometimes makes it difficult to apply. Once you regain deep, regular sleep, and the wake and sleep cycles are resynchronized, you can gradually return to a less restrictive routine.

Here are some behavioral rules to be scrupulously observed:

• Go to bed only when you have feel like sleeping. There is nothing worse than trying to fall asleep at all costs.
• Ne pas stay in bed when awake for more than 20 to 30 minutes. When this happens, get up, get out of your bedroom, do some relaxing activity, and go back to bed when you feel sleepy. Repeat these gestures as often as necessary.
• Se lever in the morning at a fixed time, regardless of the day of the week, including Saturday and Sunday, and even if you slept badly. It is true that it cuts down on sleep time, but it helps to sleep all at once. At the beginning, you should not delay getting up to catch up with the hours when you could not sleep: in the long term, this may worsen the problem. When you finally have regular and uninterrupted sleep, you can slightly extend your nights (in 15-minute increments).
• Ne not go to bed less than 5 hours.
• Do no other activity in bed (ideally in the bedroom) other than sleeping or having sex.
• With regard to the nap during the day, opinions diverge. Some experts ban it because it would meet part of the sleep needs. At bedtime, it would therefore be more difficult to fall asleep. Others claim that a short 10-minute nap can be beneficial. To experiment.

Several scientific studies show that this method has been proven. An improvement in sleep is observed from the end of the first month. Its downside is that it takes discipline and motivation. You can try it yourself, but it can also be done as part of cognitive-behavioral psychotherapy.

Medicines for sleeping

If insomnia persists despite everything, sleeping tablets (also called hypnotics) may be prescribed. These drugs can be helpful short term to recover a little (no more than 3 weeks), but they do not treat insomnia and do not eliminate its cause. They work by slowing the activity of the brain. Note that after 1 month of use, they often lose a lot of their effectiveness.

Benzodiazepines

These are the most commonly prescribed sleeping pills. If used regularly, they lose their effectiveness. These all have a sedative and anxiolytic effect, at various intensities. Benzodiazepines specifically indicated to treat insomnia are flurazepam (Dalmane®), temazepam (Restoril®), nitrazepam (Mogadon®), oxazepam (Sérax) and lorazepam (Ativan®). Diazepam (Valium®), marketed in the early 1960s, is hardly used any more, in particular because it causes significant residual drowsiness the next morning.

Non-benzodiazepine sleeping pills

Including zopiclone (Imovane®) and zaleplon (Starnoc®)), they have been on the market for several years. Their duration of action is shorter than that of benzodiazepines, which eliminates the effect of falling asleep that can occur the next morning, during the first hours.

The melatonin agonists

CLike ramelteon (Rozerem), help induce sleep by increasing the level of natural melatonin. They are used especially in case of difficulty falling asleep.

The Antidepressants

At low dose, they can also be used to help sleep better.

Benzodiazepine and non-benzodiazepine sleeping pills have several side effects. For example, they can slow down reflexes and interfere with coordination during the day, which increases the risk of kick and fracture, especially among elderly. In the long term, they risk causing physical and psychological dependence. Finally, the sleep induced by sleeping pills is less restorative, because these drugs shorten the period of paradoxical sleep (the period during which dreams occur).

Notes. It is important to consult your doctor when you want to stop taking sleeping pills or tranquilizers to avoid suffering from withdrawal syndrome. According to a study, the cognitive-behavioral therapy (see above) facilitates the complete withdrawal of chronic insomniacs who have taken benzodiazepines; it also improves the quality of sleep³⁶. The results were visible after 3 months of treatment.

Other treatments

In case of deep anxiety, depression or any other psychological disorder, the doctor may prescribe antidepressants that will relieve insomnia. He can also refer the patient to a psychologist or psychiatrist.

A physical health problem explains insomnia, of course you have to get adequate treatment.

In case of’insomnia caused by pain, pain relievers can be used. However, some of them can cause insomnia. If so, don’t hesitate to ask your doctor to change the prescription.

Behavior therapy

According to the most recent studies, cognitive-behavioral psychotherapy is often more effective than medication to control insomnia26,27. This therapy helps deconstruct erroneous associations or beliefs fueling insomnia distress (eg, “I need to sleep at least 8 hours a night, otherwise I won’t be in good shape the next day”).

Therapy, personalized, can include:

• advice on sleep habits;
• work on unrealistic beliefs and thoughts related to insomnia or on the psychological causes of insomnia;
• learning a relaxation technique.

The number of sessions varies from one individual to another, but as a general rule, improvement is seen after 2 to 3 months of weekly treatments (8 to 12 sessions)27. Its rateefficiency would be 80%, on average. People who are already taking sleeping pills may also benefit.