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Insomnia Treatment Options

Insomnia is primarily diagnosed by clinical evaluation. Once diagnosed, the goal of treatment is to improve sleep quality and reduce related daytime impairments.

What are the treatments for insomnia?

Treatment for insomnia typically begins with behavioral changes, such as following a regular sleep schedule, exercise and avoiding caffeine. If these changes do not help, your psychiatrist may prescribe therapy. Because insomnia strongly predicts depression and anxiety disorders, you psychiatrist will assess you for depression and anxiety. Because insomnia can worsen your anxiety or depression, we will treat your anxiety and/or depression. Alcohol and insomnia are also closely related and many people with insomnia drink to treat their insomnia. The same is true for cannabis use. In both cases, we will assess and treat these co-occurring conditions.

Sleep hygiene is an easy way to improve your sleep.

  • Blue light from electronic devices impacts circadian rhythms and interfere with sleep.
  • Going to bed a different time every night can cause or worsen insomnia.
  • Too much light or noise can interfere with sleep
  • not getting enough exercise can worsen insomnia

Cognitive behavioral therapy (CBT) is considered to be the most appropriate treatment for patients with primary insomnia and is also effective for insomnia related to a comorbid medical or psychiatric condition. CBT is the most effective non-drug approach to treat insomnia. This type of therapy can help people improve their sleep hygiene and change thinking and behavior patterns that are contributing to their insomnia. He may also recommend mindfulness training.

He will review your medications to decide if any of your medicines are responsible for insomnia.

Medical conditions such as an enlarged prostate can wake men several times at night.

Other medical conditions that must be evaluated include acid reflux, allergies, arthritis, back pain and more. He will be review treatment to determine whether it my need adjustment.

  • Sedative- hypnotics (sleeping pills) like benzodiazepines are the most prescribed drugs for insomnia. They provide short-term relief from symptoms but do not cure and can be addictive.
  • Prescription medications like zolpidem (Ambienâ), eszopiclone (Lunestaâ), and trazodone (Desyrelâ) are available but can often help you get to sleep but not keep you asleep. Some are habit forming and some of these have unwanted side effects so are best for short term use.
  • Over-the-counter options like melatonin can help to regulate your sleep wake cycle.
  • Antihistamines like Benadrylâ and Unisomâ are not recommended because there is little evidence of their effectiveness, and they cannot only affect sleep quality but also become less effective with quickly.

As you can see, there are a variety of medications that can be used to treat insomnia.

What are the consequences of untreated insomnia?

If left untreated, insomnia can lead to a variety of other problems, including fatigue, irritability, moodiness, difficulty concentrating, and an increased risk of accidents. Insomnia can also worsen existing medical conditions, such as anxiety and depression. In some cases, untreated insomnia can even lead to suicidal thoughts or behaviors.

Greenwich Village Psychiatry offers evidence-based, individualized treatment using medication and psychotherapy, and state-of-the-art therapies. When people are directly involved in creating their own treatment plan including wellness goals and support services, they experience improved outcomes. Our psychiatrists are caring and compassionate doctors who will work with you to find solutions that meet your unique needs. Contact us to schedule a consultation to get the correct diagnosis and your treatment options.

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
  • Learn more