Key takeaways
- The American College of Physicians recommends cognitive-behavioral therapy for insomnia (CBT-I) as the initial treatment.
- Relaxation techniques are typically part of CBT-I but are less effective alone.
- Regular schedules and a wind-down routine help most people.
First-line treatment
The American College of Physicians recommends that all adults with chronic insomnia disorder receive cognitive-behavioral therapy for insomnia as the initial treatment, and that doctors discuss medication only if CBT-I alone is not enough.[1] (source 1)
Where relaxation fits
CBT-I combines sleep scheduling, changing unhelpful thoughts about sleep and relaxation training. Practising the relaxation response in the evening can help the body and mind unwind, and the technique is safe to use if you wake in the night.
Habits that help
- Keep a regular wake-up time, including weekends
- Use the bed only for sleep, and get up if you cannot sleep after about 20 minutes
- Limit caffeine in the afternoon and alcohol near bedtime
- Keep the room dark, quiet and cool
- Put screens away before bed
Common questions
Is it a problem if I fall asleep during relaxation practice?
No. It is not harmful. If it happens often, practise in a seated position earlier in the day.
Where can I find CBT-I?
Ask your clinician. It is available from trained therapists, in groups and through validated digital programs.
Sources
- Qaseem A, Kansagara D, Forciea MA, et al. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133. doi:10.7326/p16-9016