What Are the Most Effective Therapies for Insomnia in Lynbrook, NY?
Therapies for insomnia that work start with cognitive behavioral therapy for insomnia, known as CBT-I. The American Academy of Sleep Medicine (AASM) recommends it for chronic insomnia disorder in adults, and the National Heart, Lung, and Blood Institute (NHLBI) says it is usually recommended as the first treatment option for long-term insomnia. This guide explains how CBT-I works, how it compares with medicines and supplements, and how to choose care if you live in Lynbrook, NY. It also shows where our insomnia care at Vector Sleep Diagnostic Center in Rego Park, Queens fits in.
This article was reviewed by Dmitriy Kolesnik, MD, a neurologist board certified in Sleep Medicine and Medical Director of Vector Sleep Diagnostic Center in Rego Park, Queens.
Vector has served patients since 2005 and runs 900 to 1000 overnight sleep studies a year. Our medical director, Dr. Dmitriy Kolesnik, is board certified in neurology and sleep medicine.
How Common Is Insomnia?
The AASM reports that as many as 35 percent of adults complain of insomnia. It separates short-term insomnia, which lasts up to three months and occurs in 15 to 20 percent of people at any given time, from chronic insomnia, which happens at least three times per week for at least three months and affects about 10 percent of people. A published review of CBT-I puts the share of adults who meet the criteria for an insomnia disorder at about 7 to 18 percent. Lynbrook sits in Nassau County, and the same numbers apply to commuters and families there as anywhere else in the country.
If you are not sure which type fits you, start by tracking your nights. Our sleep diary template for insomnia shows what to write down before an evaluation.
CBT-I: The First Therapy to Consider
The NHLBI describes CBT-I as a six to eight week treatment plan that helps you fall asleep faster and stay asleep longer. A doctor, nurse or therapist can deliver it. Sleep Foundation adds that treatment often takes from six to eight sessions, although the length differs with each person’s needs. A journal review of CBT-I states that it produces results equivalent to sleep medication, with fewer episodes of relapse and a tendency for sleep to keep improving after treatment ends.
Sleep Foundation reports that when the techniques are used together as multicomponent CBT-I, as many as 70 to 80 percent of patients with primary insomnia improve. The same journal review cites a 2015 meta-analysis of 20 randomized controlled studies in chronic insomnia. It found average reductions of 19 minutes in the time it takes to fall asleep and 26 minutes in time awake after sleep onset, with 8 more minutes of total sleep time and sleep efficiency up by 10 percent.
The Parts of CBT-I
The table lists the parts of CBT-I as the NHLBI describes them.
| CBT-I part | What it does |
|---|---|
| Cognitive therapy | Helps you feel less nervous about not being able to sleep |
| Relaxation or meditation | Teaches you how to relax and fall asleep faster |
| Sleep education | Builds good sleep habits |
| Sleep restriction | Gives you a set amount of time in bed, even if you cannot sleep during all of it, then increases it as sleep improves |
| Stimulus control | Links bed with sleep: go to bed only when sleepy, get out of bed if you cannot sleep, and use the bed only for sleep and sexual activity |
Sleep restriction needs a sleep diary to start. Sleep Foundation explains that a provider calculates your average time asleep from the diary and sets time in bed to that amount plus 30 minutes, then widens the window as sleep improves. Sleep Foundation also notes that the risks of CBT-I are likely mild, but facing unhelpful thoughts and behaviors can be uncomfortable and may cause temporary stress.
Medicines, Melatonin and Light Therapy
The NHLBI says some prescription medicines for insomnia are meant for short-term use while others are meant for longer-term use, and it advises talking with your doctor about the benefits and side effects. Some prescription medicines used for other conditions can also raise the risk of insomnia, so review everything you take with your provider.
Over-the-counter products need the same care. The NHLBI warns that antihistamine sleep aids can be unsafe for some people. It also states that research has not proven melatonin to be an effective treatment for insomnia, and lists possible side effects such as daytime sleepiness, headaches, upset stomach and worsening depression. Your provider may also recommend light therapy, where you sit in front of a light box at a planned time each day to set and maintain your sleep-wake cycle.
If you take sleep medication now and want to start CBT-I, ask your provider before changing anything. Do not stop a prescription on your own.
Healthy Habits That Support Therapy
The NHLBI lists habits that make it easier to fall asleep and stay asleep. They support CBT-I and do not replace it.
- Make the bedroom sleep friendly: cool, quiet and dark, with no TV or devices, since their light can disrupt your sleep-wake cycle.
- Keep a steady schedule: go to sleep and wake up around the same time each day, even on weekends.
- Mind caffeine, nicotine and alcohol: avoid them close to bedtime. Alcohol can make it easier to fall asleep but tends to make sleep lighter.
- Move earlier in the day: get regular activity at least 5 to 6 hours before bed, and avoid afternoon naps.
- Wind down: read a book, listen to soothing music or take a hot bath, and learn new ways to manage stress.
Finding Insomnia Care for Lynbrook Residents
The journal review of CBT-I points out that there is currently a shortage of trained CBT-I practitioners, which is one reason it is underused. The Society of Behavioral Sleep Medicine keeps a directory of behavioral sleep medicine providers who offer CBT-I, according to the AASM. Vector is in Rego Park, Queens, and we see patients from Nassau County and across the New York City area. Here is what to look for when you compare options:
- A diagnosis first: the AASM says a sleep doctor diagnoses chronic insomnia and makes sure nothing else in your sleep is causing it. A specialized sleep evaluation looks for that cause.
- CBT-I training: ask whether the provider delivers CBT-I and how many sessions the plan includes. Our CBT-I page explains the program.
- Format: CBT-I can be in person, by phone, by video or online, so a commute does not have to block treatment.
- A look at other disorders: restless legs syndrome and sleep apnea can sit behind insomnia. Read about sleep apnea care and what to bring to an RLS consultation.
- Insurance: check what your plan covers before you book.
For a broader look at why insomnia keeps going and how we approach it, see our insomnia treatment solutions guide and our overview of how insomnia treatment restores healthy sleep patterns. If a sleep study is the right next step, see our sleep studies.
Take the Next Step Toward Better Sleep
Treatment starts with a clear picture of your sleep. The team at Vector Sleep Diagnostic Center in Rego Park, Queens, can evaluate your sleep and explain your options. Email vectorsleep@gmail.com or call (718) 830-2800.
Frequently Asked Questions About Insomnia Treatment
What is the difference between sleep hygiene and CBT-I?
Sleep hygiene is a set of general habits such as a cool, quiet, dark bedroom, a steady wake time and avoiding caffeine and alcohol close to bedtime. CBT-I includes sleep education like this and adds targeted parts, such as stimulus control, sleep restriction and cognitive therapy, that change how you respond to bed and sleep. The NHLBI lists both under its insomnia treatment guidance.
Can insomnia be a sign of another sleep disorder?
Yes. The American Academy of Sleep Medicine says insomnia is most often associated with another problem that drives it, and names restless legs syndrome as one example of a sleep disorder that can cause insomnia or make it worse. A sleep evaluation helps find out whether something else is keeping you awake.
How do I know if my insomnia is chronic?
The American Academy of Sleep Medicine describes chronic insomnia as sleep trouble that occurs at least three times per week and lasts at least three months. It also says a sleep doctor diagnoses chronic insomnia.
What should I do if CBT-I does not work for me?
Sleep Foundation says CBT-I does not always work right away and that skills take time to learn and practice. If CBT-I alone is not enough, it advises speaking with a doctor about the risks and benefits of using sleep medication alongside CBT-I. A sleep evaluation can also check for a second condition that is getting in the way.
How does CBT-I compare with sleeping pills?
The NHLBI says CBT-I is usually recommended as the first treatment option for long-term insomnia. A published review of CBT-I reports results equivalent to sleep medication, fewer episodes of relapse, and sleep that can keep improving after treatment ends. Your physician decides what fits your situation, so do not stop or start a prescription on your own.
Can I do CBT-I online or by video?
Yes. The NHLBI says CBT-I can be done in person, by telephone or online, and the AASM says visits can be in person, by video or telemedicine, or with online programs. Sleep Foundation describes digital CBT-I as effective in children, adolescents and adults.
Sources
- American Academy of Sleep Medicine, Sleep Education: Insomnia, prevalence, types, causes and CBT-I recommendation
- National Heart, Lung, and Blood Institute: Insomnia Treatment, CBT-I parts, medicines, melatonin, light therapy and healthy habits
- Sleep Foundation: Cognitive Behavioral Therapy for Insomnia, effectiveness, session length, sleep restriction and risks
- Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia, American Journal of Lifestyle Medicine, 2015 meta-analysis figures, prevalence and practitioner shortage
