A good night’s sleep is a precious thing. Almost half of the adults in the U.S. report trouble staying asleep 3 or more nights per week and another 4 out of 10 report trouble falling asleep at night. This tracks with what I see in clinical practice, offering naturopathic treatment for insomnia in Olympia, Washington here at Whole Health Naturopathy. I ask my patients about sleep quality and quantity because it is essential for mental and physical health. You feel better in the short term with a good night of sleep, and you will be much healthier in the long term because of it.
In clinical practice I use many approaches to improving sleep for my patients. A person’s insomnia can range from a nuisance to a crisis. Over the last 12 years I have seen a variety of tools work for people! Everyone is unique, and it is in the art of medicine to honor what a patient’s preference in treatment is with a balance of a clinical recommendation from me. I can prescribe herbal therapies, sleep hygiene, pharmaceutical medication, acupuncture, psychotherapy, lifestyle changes, nutrient therapies, various ways to use melatonin, and plenty more unique-to-the-individual options.
I’ve changed my approach this year, though. In the interest of starting lower in what naturopathic medicine calls “the therapeutic order” and addressing underlying factors rather than long-term use of supplements or medications, I often recommend people try the cognitive behavioral therapy approach first to see how much changes in a short period of time with this simple approach.
I now tend to recommend a cognitive behavioral therapy approach for insomnia as a first step. If we need to use other therapies in addition to this for the short or long term we have many options. However, I have found this to be a relatively simple, effective way of treating and curing insomnia for many people. This lines up with the research, as multiple randomized controlled trials and several meta-analyses show that this approach is equal to medication and has more durable benefits after treatment is discontinued (BMC Fam Pract).
I used to regard using cognitive therapy for insomnia as a last resort. Why? First of all, it used to be the case that you had to see a specially trained practitioner to guide you through this process. Those practitioners were hard to find, cumbersome to see regularly, and often costly to access for most people. Secondly, there is some upfront suffering involved in using this process, rather than using a sleep aid that would simply shift you from sleeping less to sleeping more.
Excitingly, cognitive behavioral therapy for insomnia (CBT-i) is now easily accessible. There is a FREE, high quality app available to anyone with a smartphone, called CBT-i Coach. This app walks you through the key elements of the CBT-i process. It also provides a variety of relaxation techniques and sleep education. This app was developed by a collaboration between the Department of Veterans Affairs and Stanford University and is easy to use and has a pleasant user interface. You can download the app here.
It is an excellent starting point for treatment of insomnia. It is not a replacement for medical care, of course, as insomnia can be caused by many medical conditions such as hyperthyroidism, bipolar disorder, or perimenopause, menopause to name a very few. If you are experiencing insomnia, it is still important to check in with your medical provider. And, this is a great non-pharmacologic, non-habit forming, FREE, way of treating insomnia in many circumstances.
I very much appreciate that this collaboration between the VA and Stanford University resulted in such a valuable public tool, and one for us doctor’s too! Treating CBT-i went from something that was relatively inaccessible and challenging , to something that is now widely available and effective. This is one example that reminds me how, when we share resources—especially for basic needs like sleep—we can improve all of our lives in simple yet powerful ways. We all deserve a night of good sleep and supporting each person on their individual path towards that is one of the joys of my clinical practice. I will always celebrate with a patient when they come in and tell me that they are sleeping better!
If you are in the greater Olympia, Washington area and looking for a more natural way to treat your insomnia, or are curious about being evaluated for diagnosis and treatment of insomnia, I would love to see you at Whole Health Naturopathy. Give us a call today to get started: (360) 943-9519 ext. 6.