For people struggling with insomnia, sleep training is an underutilized treatment that can move patients away from medication to a lifetime of better sleep, according to osteopathic physicians.

While insomnia is a common, often chronic health condition, sleep specialist Hiral Patel, DO, says those patients don’t often get the treatment they need because most insomnia patients receive medication without a referral to a sleep specialist. While sleep aids are a helpful short-term solution for many patients, most people with recurring insomnia benefit from a referral to a sleep specialist who can offer long-term solutions.

“Sleep specialists want to get to the root of the problem, not just treat the symptoms,” says Patel in a release. “As an osteopathic physician, I want to help my patients overcome their current sleep challenges and prevent future episodes. Sleep therapy can greatly improve quality of life for patients because it provides strategies that can be used whenever sleep issues occur. ”

Sleep training through cognitive behavioral therapy (CBT-I) is effective because it retrains the brain, addressing triggers for insomnia and any underlying anxiety about sleep, according to Patel. The process typically involves weekly appointments, for 6 6 to 8 weeks. During those sessions, patients learn simple techniques to disrupt the cycle of insomnia.

Sleep Training Essentials

Set a benchmark
Patients can track how long they spend in bed both awake and asleep for a week to understand the average time they spend waiting to fall asleep. The patient then pushes back bedtime by their average “wait time,” eventually falling asleep sooner and resuming their normal sleep schedule.

Derail anxiety
Often people are kept awake by the litany of responsibilities they are afraid to forget, Patel says. Instead of lying in bed, obsessively recounting each looming task, sleep therapists recommend writing a to-do list for the following day. That way all responsibilities are accounted for and committed to paper, so patients can rest easy.

Reframe the issue
Aside from personal and professional anxieties, the fear of not sleeping is enough to keep some people awake. The mind races with questions, like “What if I can’t sleep tonight… and tomorrow night?” Sleep training offers an objective process to examine those thoughts and decide whether they are realistic and probable.

Shift focus
Another part of that discipline is redirecting the mind energy to a different specific physical process. By observing one’s own heartbeat or breathing, and concentrating on slowing it down, patients can regain a sense of control and quiet racing thoughts.

Adopt new habits
Sleep troubles may begin much earlier in the day with behaviors related to diet, exercise and screen time, which are generally categorized under sleep hygiene. General guidelines for good sleep hygiene include:

  • Exercise at least 10 minutes a day
  • Get outside both during day and night
  • Avoid overly rich or spicy foods at night—this includes citrus fruits and sodas, which can cause indigestion
  • Avoid substances like nicotine, caffeine, and alcohol close to bedtime
  • Keep the bedroom cool and dim
  • Avoid screen time immediately before going to bed

“Ultimately, we find patients sleep better and faster, without medication, when they complete sleep training,” Patel says. “Many are able to avoid future bouts of insomnia and others can resolve a reoccurrence by working through the strategies they learned.”