Insomnia: see five treatments proven by science – 05/23/2023 – Equilibrium

Insomnia is the most common sleep disorder in the population, according to the Brazilian Sleep Association. Symptoms have a prevalence of up to 35% worldwide, affecting more women and people with lower incomes. In addition, the presence of mental disorders such as anxiety and depression is considered a risk factor for the disorder.

The condition is characterized by difficulty initiating or maintaining sleep, and the diagnosis involves assessing sleep-associated behaviors and complaints.

Although there are many possibilities for treating insomnia, not all of them are scientifically proven or recommended by medical associations. In general, the recommendation is to prioritize behavioral treatments before initiating the use of medications.

See the most indicated treatment possibilities.

Cognitive behavioral therapy

Cognitive-behavioral therapy, known as CBT, is the treatment most recommended by international guidelines, such as the European Society for Sleep Research and the American Academy of Sleep Medicine, for insomnia. It must be conducted by an accredited psychologist.

A study published in the journal Jama in 2004 evaluated the impacts of this type of psychotherapy on patients with insomnia, and concluded that this was the most effective treatment for the disorder, even when compared to the use of medication.

Psychological treatment is usually done through the use of sleep diaries and can be combined with a sleep hygiene routine and other indications of stimulus control. It is also recommended as a complement to drug treatments.

sleep hygiene

Sleep hygiene consists of creating a routine that aims to improve sleep quality and regulate the circadian cycle. In general, eating habits, physical exercise and reduction of stimuli close to bedtime are recommended.

Those who adopt a sleep hygiene routine should, for example, reduce the use of cell phones and caffeine consumption at night, in addition to exposing themselves to natural light in the morning.

Although not indicated as a single component for the treatment of insomnia, sleep hygiene can be associated with other treatments. In addition, changing habits is recommended before drug therapies.

It is indicated as the first intervention in people who do not have other disorders and whose daily habits may be impairing sleep quality.

melatonin

Produced naturally by the human body, melatonin is a hormone whose main function is to promote sleep. Supplementary use of the substance was released in mid-2021 in Brazil, but scientific evidence of its effectiveness is still scarce.

According to international guidelines, melatonin is not indicated to treat insomnia disorders, as the use of the substance has little effectiveness in most cases.

However, recent studies indicate that the substance is safe and has few side effects. According to a 2021 Brazilian survey, the hormone can function as a safe alternative for treating sleep disorders due to the low risk of dependence.

Benzodiazepine anxiolytics

Benzodiazepines are prescription drugs commonly used to treat insomnia. Some of the medications in this group are diazepam, clonazepam and lorazepam.

The use of drugs can bring benefits, but it is recommended for short-term treatment, combined with behavioral interventions. Substance therapy should only be done with specialized medical supervision.

A 2023 literature review indicates that indiscriminate or prolonged use can bring unwanted side effects and, ideally, use should be limited for up to four weeks.

Zolpidem

The drug belongs to a group of drugs known as Z drugs, with an effect and indication similar to that of benzodiazepines, despite having a different function.

It is also a controlled medication, needs medical supervision and should be used in short-term treatments. The drug is also known for its side effects, such as confusion and sleepwalking, and can be addictive.

According to a 2021 study, Zolpidem may be effective in treating insomnia, but risk factors need to be assessed and the risk-benefit ratio studied. In addition, it is recommended that drug treatments be combined with psychological follow-up.