Non-pharmacological treatment of insomnia – psycho-behavioral interventions

  1.Relaxation therapy: Stress, tension and anxiety are common triggers of insomnia, and relaxation therapy can alleviate the adverse effects of these factors.  2. Stimulus control therapy: Patients with insomnia may associate their bed and bedroom with the fear of not falling asleep or other waking events, rather than with the more pleasant expectation of sleep. Stimulus control therapy is a strategy that aims to break this association by increasing the likelihood of falling asleep. Patients should not go to bed until they feel sleepy, and the bed should be used primarily for sleep (not for reading, watching TV, eating, or worrying). They should not lie awake in bed for more than 20 minutes. If they are still awake after 20 minutes, they should leave the bedroom and engage in a relaxing activity, such as reading or listening to soothing music. At this time, patients should not engage in activities that stimulate or reward them for staying awake in the middle of the night, such as eating or watching television. In addition, they should not return to bed until they are tired and ready to sleep. If they return to bed and are still unable to sleep within 20 minutes, repeat the process. An alarm should be set to wake the patient at the same time every morning, including weekends. Daytime naps are not allowed.  3. Sleep restriction therapy: Many insomnia patients attempt to increase their chances of sleeping by increasing their bedtime, but this often does not work and further decreases the quality of sleep. Sleep restriction therapy increases the drive to sleep by shortening the time spent awake in bed to improve sleep efficiency.  4, cognitive behavioral therapy: Insomnia patients often feel fear of insomnia itself and are overly concerned about the adverse consequences of insomnia. They often feel nervous and worried about sleeping well when they are close to sleep. These negative emotions make sleep further deteriorate, and the aggravation of insomnia in turn affects the patient’s mood, forming a vicious circle between the two. The purpose of cognitive therapy is to change the patient’s cognitive bias about insomnia and to change the patient’s irrational beliefs and attitudes about sleep problems.