Characterized by persistent difficulty in the onset or maintenance of sleep, consolidation, or quality, insomnia remains a common issue worldwide. People with this sleep disorder struggle to get adequate sleep despite having all the opportunities. They also experience frequent daytime sleepiness, making it difficult to function and make the most of their days effectively. Based on different surveys and studies, insomnia affects 10% to 30% of the world’s population today.
Due to the rising prevalence of the disorder, experts have been investigating more about potential insomnia therapies to support their lives. While different medications are readily available, most people prefer going for therapies to treat the sleep disorder, especially in the long run, as the latter is associated with fewer side effects.
Gold Standard for Treating Severe Insomnia: The Role of CBT
For most people, experts recommend a mixture of sleep aid and cognitive behavioral therapy for insomnia or CBT-i. While there is no single best treatment method to keep the problem under control, CBT-i has shown great promise in improving the short- and long-term symptoms.
As the first-line treatment for insomnia, CBT-i does not involve any health risks like sleep medications.  The therapy is delivered by a licensed psychologist with adequate training in making the best use of this therapy. The therapy focuses on improving sleep quality and duration by identifying anxieties in people related to their sleep. It helps these people replace their underlying anxieties with healthier attitudes and beliefs.
The following are the main components to expect from a cycle of CBT-i:
Sleep Hygiene and Education
CBT-i involves educating patients about healthy lifestyle habits and sleep patterns to help them realize why they are experiencing insomnia. More specifically, this therapy focuses on boosting behaviors that promote restful, high-quality sleep while eliminating the ones that trigger sleep problems. For instance, a therapist may advise a patient to go to sleep and get up at the same time every day while discouraging them from drinking alcohol or coffee too close to bedtime.
It is common for many people with insomnia to feel anxious at the mere thought of falling asleep. This anxiety can prolong and exacerbate their symptoms greatly. For such people, therapists recommend stimulus control which includes various steps to reduce these sleep-related anxieties while harboring a positive link with sleep. These steps may include using the bed only for sleep and sex, lying down only when you feel tired, and getting up every day simultaneously. Stimulus control also discourages daytime napping and asks sleepers to get out of bed after 10 minutes if they fail to fall asleep and only return once they feel truly tired.
Sleep Restriction & Compression
Both methods aim to enhance the quantity and quality of sleep by decreasing the time a person spends in bed. A practitioner usually asks them to maintain a diary to check how much time they spend in bed awake each night and compare it with the hours of sleep they get. Following this, these experts implement sleep restriction, which sharply curtails the time spent in bed. On the other hand, sleep compression is a slower process but aims for a similar outcome, i.e., to minimize the time a person spends awake in bed.
Multiple types of relaxation techniques are available to benefit people fighting insomnia. These techniques may include muscle relaxation, breathing exercises, and meditative sessions. Biofeedback therapy is a newer integrative therapy introduced to help people with insomnia. More information about this therapy is available in the next section.
Unfortunately, the United States has a very limited number of qualified behavioral sleep medicine therapists. So if you wish to choose one, ensure to verify their credentials through specific professional organizations, such as the following:
- American Psychological Association
- Association of Behavioral and Cognitive Therapies
- American Board of Sleep Medicine
- Society of Behavioral Sleep Medicine
Long-Term Treatment of Insomnia: Integrative Therapy and Supplements
Some people may rely on integrative techniques and supplements to manage their insomnia symptoms, with or without other therapies. These integrative therapies include various examples, and their efficacy may vary from one technique to another. Talking to a doctor before trying any complementary technique to help with insomnia is always a good idea, especially if you are already on other therapy or taking medication. Following are some integrative-medicine remedies to manage insomnia:
- Herbal Remedies: Some people suggest that chamomile, an essential oil or tea, has sedative effects promoting sleep. The same effects have been noticed for valerian supplements that help people with sleep disturbances. However, remember that there is not much research on this topic, and so far, their benefits are more like a suggestion than a confirmed fact. Moreover, unlike sleep medications, these products are not regulated by the FDA; hence, little is known about their safe and adequate dosage, efficacy, and side effects. For people interested in trying these herbal remedies, it is best to speak with a doctor first to avoid any unwanted adverse effects.
- Biofeedback Therapy: This therapy allows professionals to track various biological reactions in a body, such as breathing, heart rate, and muscle tension. Sleep specialists then utilize this information to identify patterns affecting their sleep while helping them develop suitable adjustment strategies.
- Yoga: Researchers think that yoga can improve sleep quality, lower stress levels, and even improve physical health.
- Mindfulness Meditation: This technique involves using certain procedures, such as guided imagery or breathing methods, to help people become more aware of their sensations, thoughts, and feelings. Research shows that stress-reduction programs based on mindfulness can significantly improve overall sleep patterns in people with insomnia.
- Hypnosis: Also known as hypnotherapy, this treatment option helps a person relax their mind and body. When performed adequately by a trained therapist, it can also benefit sleep.
- Massage: This therapy is known to relax the body, which, in turn, helps improve sleep quality while minimizing daytime dysfunction and sleep disturbances. A study performed on a small scale even predicted that massage therapy may work better than sleep medications in certain people with underlying insomnia. 
- Acupuncture: Acupuncture is an ancient Chinese technique people use to relax their bodies. Experts have been investigating this technique for managing insomnia for a long time with some positive benefits. The technique involves inserting fine needles, sometimes along with health or small electric signals, at specific points on the skin to influence overall bodily functions. So far, several clinical trials have proven its efficacy in managing insomnia; however, additional research is needed. 
Choosing Complementary Therapies for Insomnia: Points to Consider
Remember that the FDA does not approve many complementary therapies for insomnia currently known and practiced by many people. Hence, they may not be harmless to everyone at all times. By definition, these therapies are included in the accepted standard of care practice in the United States. Hence, before you go for these insomnia therapies, keep consider the following points in mind:
- Before trying an alternative approach, always chat with a doctor and inform them of the specifics.
- Avoid taking any preparations that include more than one herb.
- If you are trying a herbal product that causes you to experience side effects, such as vomiting, nausea, anxiety, diarrhea, rapid heartbeat, skin rashes, etc., stop taking it immediately and contact a doctor.
- Beware of certain therapies, such as acupuncture, as they may not benefit everyone.
- Be careful while selecting a professional to deliver therapy, as the successful outcomes depend greatly on the therapist you are dealing with.
Can insomnia therapies cure my problem?
While curing insomnia is not easy, it is not impossible either. Sometimes, combining sleep hygiene measures with proven therapies, like CBT-i, works wonders for people, helping them go to sleep more easily and wake up feeling well-rested. The key to gaining this outcome is recognizing the problem early and seeking help as soon as possible.
How long does CBT-i take for treating severe insomnia?
For most people, CBT starts showing some benefits in 2 to 3 weeks of frequent sessions. However, this therapy has no set time frame to show positive results. Some people may start noticing them very soon into treatment, while others may have to work on their issues for a few weeks before benefitting from it.
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