What Do Doctors Prescribe For Insomnia: Treatment Options

Insomnia can have significant side effects if not treated properly, which is why doing so with doctor supervision is best.

Physicians can confirm that you actually have insomnia, and can run a sleep study to gather more data if needed.

Once it’s clear which type of insomnia someone has, a physician will typically recommend one of the following treatments, or a combination.

Cognitive Behavioral Therapy (CBT)

CBT is a safe and highly effective way of treating most types of insomnia. It’s the most preferred by patients in general (1).

Even just a few sessions with a trained therapist can make a large difference in treating insomnia (2).

If you’re not familiar with CBT, here’s a quick description from the Mayo Clinic:

Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.

Essentially, you’re learning to identify thoughts that may be leading to stress, which is arguably the biggest risk factor for insomnia, and reframing them.

When a doctor prescribes CBT, it usually comes with basic sleep hygiene education, and often sleep restriction therapy as well. While these typically aren’t cures for insomnia on their own, they can play a vital role in treatment.

SummaryCBT is an effective and safe treatment for insomnia. The only real downside is that CBT is not quick. It can take weeks or months to start seeing the results that people hope for.

Sleep Medications

Because CBT takes time, it is often prescribed in combination with sleep medication.

There are a variety of medications that help induce sleep and can serve as a short-term solution while the root cause(s) of insomnia is treated.

The types of medication below are the most common ones that are prescribed, although there are others. Additionally, while there are some natural sleeping aids like melatonin, they don’t have enough evidence to suggest that they can treat insomnia by themselves.

Antihistamines

Most antihistamines are over the counter drugs, depending on where you live.

A few common examples of products with the antihistamine diphenhydramine are Benadryl and Tylenol PM. People develop tolerances to these quickly, so they're not a solution for insomnia.

Newer antihistamines don’t cause much drowsiness, but the older generations do cause drowsiness as a side effect.

Some examples of these include Sominex and ZzzQuil.

Antidepressants

There is a deep link between depression and insomnia.

Even in those without depression, certain antidepressants usually improve sleep quality (3).

For example:

• Amitriptyline
• Doxepin
• Trazodone
• Celexa

With that being said, antidepressants can actually cause insomnia in some people, and other serious side effects, which is why they need to be prescribed.

Like all medications, they are viewed as a short term solution.

Benzodiazepines

The final class of sleep medications that are usually prescribed are benzodiazepines, which have a similar effectiveness to antidepressants (4).

However, chronic use of these types of medication does not ultimately lead to high sleep quality (5). They can help people get to sleep, but most people experience lighter, lower quality sleep, with more frequent awakenings.

And as expected, there are often serious side effects to consider, including fatigues, cognitive impairments, and coordination issues (6).

Summary: Commonly Prescribed Treatments for Insomnia

Once a doctor has confirmed an insomnia diagnosis, they will create a treatment plan tailored towards solving the most likely root cause(s) of the sleep issues.

This will typically focus heavily on CBT, but may also include sleep medications for short term symptom relief. In case you're wondering how much CBT for insomnia costs, it's generally pretty affordable, and there are online options as well these days.

Finally, they may also recommend additional relaxation therapies like acupuncture and yoga. While the evidence behind these therapies is mixed, some studies show promise and there are no significant risks when done by a professional (7).

References

1. Insomnia Treatment Preferences During Pregnancy
2. Cognitive Behavioral Therapy for Insomnia and Acute Insomnia
3. Trazodone addition for insomnia in venlafaxine-treated, depressed inpatients: a semi-naturalistic study
4. The Efficacy and Safety of Drug Treatments for Chronic Insomnia in Adults: A Meta-analysis of RCTs
5. Insomnia and psychotropic drug consumption
6. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits
7. Acupuncture for insomnia