This Is How a Sleep Doctor Treats Insomnia

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Dasgupta says one way to categorize your insomnia is by figuring out if it's acute or chronic. "Acute insomnia usually occurs by having a life-changing event (a marriage, a divorce, a heart attack), and we could refer to that as adjustment insomnia," he explains. "And everyone has it. In theory, at least once the acute stress relieves your insomnia goes away. But there are some people where they are predisposed to insomnia, and once they get a trigger, it perpetuates. Based upon definitions, if you're having insomnia for greater than three months, multiple times a week, well, then we could call it chronic insomnia."

He also says that there's sleep-onset insomnia, which is difficulty falling sleep at the beginning of the night. And then there's sleep maintenance insomnia, which is the inability to stay asleep.

Knowing what type of insomnia you have will help your practitioner tailor a treatment plan for you.

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Dasgupta says many people assume that once you visit a sleep doctor, they're going to order a sleep study, but that's not the case for everyone. Your doctor will most likely want to learn more about your lifestyle and health history to understand why you are experiencing insomnia. "You don't need an in-lab or a home sleep study," he says. "The hardest part about diagnosing insomnia is that you've got to spend time with your patient. You've got to get a good sleep history and really figure out what medications are they on, what are other medical disorders do they have, and if there are other triggers. And is there a big psychiatric component?"

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Depending on the case, Dasgupta might try cognitive behavioral therapy. According to the Mayo Clinic, it's often the first step for treatment, and is "a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep." This might involve teaching the patient relaxation techniques and imagery, which can take some time and practice.

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After finding that cognitive behavioral therapy isn't working for the patient, Dasgupta says he might consider prescribing medications. The type of medication will depend on what types of insomnia the patient has. 

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Dasgupta says stimulus control and sleep restriction (which we'll get to below) are two classic behavioral therapies he employs. "Stimulus control means the bed is only meant for one thing," he explains. "It is for sleeping, and it means that if you go to bed and you can't sleep within 15 to 20 minutes, you need to leave the bed, do things that are non-stimulating in a kind of a dim light, and then only go back to bed when you're ready to sleep. Easier said than done."

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Sleep restriction is what you might guess: a set bedtime and a set wake time. "This includes weekends, holidays, travel… those are strict foundations of what we do and those can work for people with acute insomnia and can work chronically," Dasgupta says.

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You want to make sure you're eating well and exercising regularly. The Mayo Clinic recommends avoiding large meals and beverages before bed and avoiding or limiting caffeine, alcohol, and nicotine, which can make it harder to sleep.

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Dasgupta says he personally thinks meditation is amazing and worth a try because there are very little downsides to it. Studies have shown that meditation can help with sleep, along with anxiety and stress.