Non-pharmacological treatment of insomnia

  1. Stimulus control Getting into bed = sleep. The goal is to promote a positive correlation between the bedroom environment and sleepiness.  Go to bed only when sleepiness arises. If you can’t fall asleep within 15-20 minutes (without looking at the clock), get up and leave the bedroom without doing stimulating activities. Do not go to bed until you feel sleepy again. Do not read, talk on the phone, watch TV, play on the computer, etc. in bed.  2. Sleep restriction Reduce the time spent in bed while awake.  Set a strict bedtime and wake up schedule and limit the average expected sleep time. When sleeping time accounts for ≥85% of total bedtime, increase bedtime by 15-30 minutes. Fix the waking time to regulate the body to adapt to the regular sleep-wake rhythm.  3. Relaxation techniques Various breathing techniques, visual resemblance, meditation.  Progressive muscle relaxation exercise (by making the whole body persistently increase and decrease muscle tone to induce sleep; muscle tension training or stretching muscles can achieve relaxation); brief relaxation several times a day, 2 minutes/time; listening to light music, yoga training, etc.  4.Cognitive therapy Find patients’ poor cognition and behavior related to sleep; gradually correct patients’ irrational beliefs and cognitive patterns.  There are great individual differences in sleep duration; dreaming is a normal physiological need of the body; it is safe to take hypnotic drugs under the guidance of a doctor; underestimate the actual sleep duration obtained; stimulus control or sleep restriction will not reduce sleep duration.  5. Sleep hygiene education Emphasis on environmental factors, physiological factors, behaviors and habits that promote comfortable sleep.  Receiving sunlight in the morning is good for regulating your own biorhythms; avoid long naps, short naps (no more than 30 minutes) are possible; no strenuous exercise within three hours before going to bed; no caffeinated food or drugs, no smoking, no alcohol within 4-6 hours before going to bed; no sleep within two hours after a full meal.