So, why am I still awake?

Researchers from the University of Texas Southwestern Medical Center at Dallas review nonpharmacologic options. It’s for anyone who wants to start a discussion with their doctor or healthcare provider.

Nonpharmacologic treatments produce reliable and sustained improvements in sleep patterns of patients with insomnia, according to the authors.

Cognitive behavior therapy has multiple components.

  • Cognitive psychotherapy
    • Identifies dysfunctional beliefs about sleep
    • Challenges their validity
    • Replaces them with more adaptive substitutes
  • Sleep hygiene
    • Teaches good sleep habits
  • Stimulus control
    • Helps associate the bedroom with sleep and sex only, and not other wakeful activities
  • Sleep restriction
    • Limits time in bed to maximize sleep efficiency
  • Paradoxical intention
    • Removes the fear of sleep by advising to remain awake
  • Relaxation therapy
    • Teaches techniques to reduce high levels of arousal that interfere with sleep

The bottom line?
“Cognitive behavior therapy involves 4 to 8 weekly sessions of 60 to 90 minutes each.”  The authors recommend that it “should be used more frequently as initial therapy for chronic insomnia.”

3/14/09 21:47 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.