Changes in your bedtime surroundings and habits that can promote sleep are usually the most important way to manage insomnia.
Behavioral therapies also may be used to treat some patients with insomnia. These therapies include:
Relaxation therapy — Special techniques to quiet the mind and relax the muscles
Sleep restriction — A program that at first permits only a few hours of sleep per night, then gradually increases the nightly sleeping time
Reconditioning — A program that teaches the patient to associate the bed only with sleeping (and sexual activity) by having the patient go to bed only when sleepy and avoid daytime naps
If insomnia is one of the symptoms of a medical disorder, treating the underlying problem may be all that you need. For example, treating restless legs syndrome with specific medication or sleep apnea with a special mask can markedly improve quality of sleep.
Your doctor may prescribe sleeping pills for short term or occasional use. Today there are a wide variety of medications to choose from. Some act quickly and are most helpful if you have trouble falling asleep. Others have a longer duration of action when the problem is staying asleep. Many of the medications are available as generics, which tend to be much less expensive. Older people should avoid the longer acting drugs because the sedation can last much longer than eight or nine hours.
Melatonin, a dietary supplement, works for some people and not others. It has a good safety profile when used in the doses directed on the label.