How a Psychiatrist Can Help You Sleep Better and Cure Insomnia

At Mental Health and Wellness Associates, our team of top psychiatrists often helps patients who are having trouble sleeping (or struggling with insomnia). Insomnia can have a significant impact on a person's quality of life, affecting their mood, energy level, and ability to function during the day. 

Fortunately, there are several effective treatments available for insomnia, including medications, a specific form of therapy and sleep hygiene recommendations. In this article, we will explain how a psychiatrist evaluates and treats insomnia with medications and behavioral modification recommendations. 

Evaluation of Insomnia

The first step to getting a better night’s sleep is getting a thorough evaluation to determine the underlying cause of insomnia. Often, depression, anxiety, PTSD and other mental health diagnoses can cause and/or make sleep issues worse. An experienced psychiatrist can help determine if your sleep problems are primary or are caused or contributed to by another untreated mental health condition. 
Another important aspect of the evaluation is to determine if you are having trouble falling or staying asleep or both. This distinction will help to determine which treatment options are most likely to be successful for your specific needs. 

Medications for insomnia

There are several medications that have been historically commonly used to treat insomnia. These medications fell into two main categories: benzodiazepines and non-benzodiazepine hypnotics. Benzodiazepines, such as temazepam and lorazepam, have been used for decades to treat insomnia. They work by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which leads to a calming effect and helps to promote sleep. Non-benzodiazepine hypnotics, such as zolpidem and eszopiclone, work in a similar way but were thought to be less likely to cause dependence or withdrawal symptoms.

While medications can be effective in treating insomnia, they are not without their risks. Benzodiazepines, in particular, can be habit-forming and can cause daytime drowsiness, dizziness, and cognitive impairment. Non-benzodiazepine hypnotics can also cause drowsiness and impair cognitive function, although they are generally considered to be less habit-forming than benzodiazepines. 

In recent years, other non-controlled and non-addictive medications have been used as primary treatment options for insomnia. These may include Trazodone, Gabapentin, Hydroxyzine, a new class of medications called orexin-inhibitors and others. 

Because there are many options and no one size fits all best medication for everyone, medications for insomnia should be evaluated and prescribed by a psychiatrist who is experienced will all the available options

Sleep hygiene recommendations

In addition to medications, there are several non-pharmacological treatments for insomnia, including sleep hygiene recommendations and CBT-I. Sleep hygiene refers to the practices and habits that promote healthy sleep patterns. Some examples of sleep hygiene recommendations include:

• Establishing a regular sleep schedule
• Creating a relaxing bedtime routine
• Avoiding caffeine and alcohol before bedtime
• Keeping the bedroom quiet, cool, and dark
• Avoiding screen time before bedtime

Research has shown that sleep hygiene recommendations can be effective in improving sleep quality and reducing symptoms of insomnia. For example, a systematic review of randomized controlled trials found that sleep hygiene education improved sleep quality and reduced the time it took to fall asleep (Ye et al., 2015).

CBT-I is a specific form of cognitive behavioral therapy that is designed and is evidence-based to help with insomnia. It is often combined with other approaches and can be highly successful. 

In conclusion, there are several effective treatments available for insomnia, including medications and sleep hygiene recommendations. While medications can be effective, they are not without their risks and should only be used under the supervision of a healthcare provider. Sleep hygiene recommendations are a safe and effective way to promote healthy sleep patterns and reduce symptoms of insomnia. If you are struggling with insomnia, we encourage you to consider meeting with a psychiatrist to get a proper evaluation and treatment recommendations. 

If you live in the state of California and are looking for help, we would be happy to speak with you. If you are interested in becoming a new patient, please schedule a time to speak with our practice manager (using the "book online" button above) or call our office today.

References:

Ye, Y., Hou, X., Pan, Q., Yu, X., & Chen, Y. (2015). Effects of sleep hygiene education on subjective sleep quality and sleep hygiene awareness among college students: A randomized controlled trial. Journal of nursing education and practice, 5(9), 10-18.

National Sleep Foundation. (2022). Sleep Hygiene. Retrieved from https://www.sleepfoundation.org/articles/sleep-hygiene