Which intervention is recommended for insomnia?

Which intervention is recommended for insomnia?

• A. Encourage good sleep hygiene and CBT-based strategies such as stimulus control and sleep restriction.
• B. Prescribe sedative-hypnotics for nightly use as first-line therapy.
• C. Encourage daytime napping to compensate for lost sleep.
• D. Increase evening caffeine intake to promote alertness.

Answer: (A)

Insomnia is best addressed with nonpharmacologic, behavioral and cognitive therapies. These approaches target the thinking and habits that keep sleep from improving, and they have durable, long-term benefits without the risks of medications. CBT-based strategies like stimulus control and sleep restriction work by retraining the bed and bedroom as cues for sleep and by strengthening sleep efficiency. Stimulus control guides you to go to bed only when sleepy, use the bed for sleep (and sex), get out of bed if you can’t sleep after a short period, and keep a consistent wake time. Sleep restriction reduces time in bed to more closely match actual sleep time, which helps consolidate sleep and reduces time awake in bed. When combined with good sleep hygiene—regular schedules, a quiet dark sleep environment, and avoiding late caffeine and alcohol—these strategies tackle the core behavioral and cognitive factors driving insomnia. Sedative-hypnotics are not first-line because of dependence risk, potential side effects, tolerance, and rebound insomnia, especially with nightly use. Daytime napping can disrupt nighttime sleep by reducing homeostatic sleep pressure, and evening caffeine worsens sleep onset and quality.

Insomnia is best addressed with nonpharmacologic, behavioral and cognitive therapies. These approaches target the thinking and habits that keep sleep from improving, and they have durable, long-term benefits without the risks of medications. CBT-based strategies like stimulus control and sleep restriction work by retraining the bed and bedroom as cues for sleep and by strengthening sleep efficiency. Stimulus control guides you to go to bed only when sleepy, use the bed for sleep (and sex), get out of bed if you can’t sleep after a short period, and keep a consistent wake time. Sleep restriction reduces time in bed to more closely match actual sleep time, which helps consolidate sleep and reduces time awake in bed. When combined with good sleep hygiene—regular schedules, a quiet dark sleep environment, and avoiding late caffeine and alcohol—these strategies tackle the core behavioral and cognitive factors driving insomnia.

Sedative-hypnotics are not first-line because of dependence risk, potential side effects, tolerance, and rebound insomnia, especially with nightly use. Daytime napping can disrupt nighttime sleep by reducing homeostatic sleep pressure, and evening caffeine worsens sleep onset and quality.