For Insomnia, Toss the Sleeping Pills, Try Therapy

It may require more work, but researchers say the evidence supports pursuing therapy over pills
By Elizabeth Armstrong Moore,  Newser Staff
Posted May 4, 2016 9:24 AM CDT

(Newser) – The American College of Physicians is issuing new guidelines on how to treat insomnia based on evidence suggesting that the side effects of sleeping pills are "underestimated," while the success of cognitive behavioral therapy (CBT-I) is compelling. "The evidence is quite strong that cognitive behavioral therapy is effective," Dr. Wayne Riley, president of the ACP, tells NBC News. "It works. It's long-lasting, and it has the potential to decrease cost to the health care system." In a press release, he adds that even though there is "insufficient evidence" to allow for a direct comparison between CBT-I and drug treatment, CBT-I is at the very least safer. "Sleep medications can be associated with serious adverse effects," he says.

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The review further found that there isn't enough evidence that drugs like Valium and Xanax actually help people sleep, never mind alternative therapies some people try, such as herbal teas. "Prescribing a sleeping pill is not the desirable first step," another expert tells Fox News, but he adds that therapy isn't on the "radar screens" for primary care physicians. An initial challenge will be training health care workers in providing CBT-I, and also convincing insurance providers to cover it. But the therapy itself takes work, too. Fox notes that it goes well beyond sleep hygiene; one particularly challenging step involves sleep restriction, where insomniacs don't allow themselves to get into bed until a certain number of hours before their alarm is set so that they go to bed exhausted and begin to associate their bed with sleep instead of tossing and turning. (There may be something to that evening glass of milk.)

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