By Peter M. Vishton, PhD, William & Mary

Edited by Kate Findley and proofread by Angela Shoemaker, The Great Courses Daily

Insomnia is a condition that affects millions of people. A study by the Centers for Disease Control and Prevention found that nine million Americans are regular users of prescription sleep medication. Professor Vishton explains why this solution isn’t effective in the long run and what you should do instead.

Problems with Sleeping Pills

Research shows that getting eight full hours of sleep is essential for mental clarity, emotional regulation, and overall cognitive health. However, many people experience insomnia, which means they have significant trouble falling or staying asleep. 

Sleep medication is a go-to strategy for most people when insomnia strikes. There are two big problems with relying on this.

The big one is that standard sleep medications—AMBIEN^®, for example—disrupt REM sleep. Most medications that function as depressants do the same thing, as does going to sleep after several alcoholic drinks. REM, which is the state of deep sleep when you dream, is critical to feeling refreshed and recharged the next morning.

Second, with regular use, humans develop a tolerance to sleep-inducing medications. Even if the medication works well when you first start taking it, your body will adapt to it. 

Those homeostasis systems in your brain will recognize that a depressant is about to arrive and take steps to counteract it. Eventually, unless you increase the dosage, the sleep aid will stop being effective. Increasing the dosage is dangerous and can result in overdose and death if done carelessly.

Does Melatonin Work?

Unlike most sleeping pills, melatonin supplements are not depressants. Melatonin is a hormone produced by the brain as part of the process of inducing sleep. 

By taking melatonin orally, this process can be brought on more quickly. This can be effective in the short term—over a few days, perhaps, as you’re struggling to overcome jet lag or resetting the time that you fall asleep at night. 

However, in the long term, melatonin isn’t an optimal solution for insomnia. Several studies have suggested that over time, people develop a tolerance to melatonin supplements, as with any other consistently taken medication. Also, mild side effects such as headaches, stomach cramps, or irritability can become an issue.

Naturally Combat Insomnia

How can you combat insomnia if you don’t take sleeping pills, then? Professor Vishton recommends strengthening your unconscious association between your bedroom and sleep. 

Many people who report problems with insomnia also do lots of things while sitting in bed. They watch movies, work on their computer, make calls, and even eat meals.

To the extent that you do this, the unconscious systems that regulate your sleep come to associate all of these non-sleep activities with your bed. You climb into bed, hoping to sleep. You have consciously decided that it’s sleep time based on processes that are occurring in your frontal lobes, presumably. 

However, your sleep regulation is controlled by unconscious systems. Your unconscious control systems know that you’re in bed and perceive that you are ready to watch a movie, work on a computer, or eat.

To fix this, Professor Vishton suggests that you stop doing all of these non-sleep activities in bed. When you go to bed, turn out the lights, and shut your eyes. 

If you’re fighting a bout of insomnia, you’ll probably just have to lay there for a while. This will be especially true if you’ve been taking a sleeping pill but stop on that particular night. 

Your body will be producing extra activity to counteract the expected depressant medication, which will make it that much harder to fall asleep. If you find yourself lying there awake, just keep relaxing and wait for sleep to come to you. Be patient. 

Learning to Relax

That’s easy to say, but this is hard if you’ve been battling insomnia for a while. You might find yourself feeling angry about being plagued with this problem and anxious that it won’t go away.

Both of these are associated with increases in activation of the limbic system and the sympathetic part of the autonomic nervous system. Both will make it harder to fall asleep. 

“I recommend meditating,” Professor Vishton said. “Mentally focus on your breathing, and try to clear your mind; try to stop thinking about falling asleep. Try to stop thinking altogether. If a thought intrudes as you do this, just gently push it aside, and continue.”

When you’re in the process of changing your associations with your bedroom, you may sleep very little the first night. Over time—typically a week or so—your unconscious mind will learn to sleep normally again. If you put a tired body into a fully dark, quiet, cool, comfortable space, and make it lie still for a while, with few exceptions, it’s likely to fall asleep.

“I should say, when you do sleep—and I’m confident that you will sleep eventually—you will, by definition, lose consciousness,” Professor Vishton said. 

There are times when people fall asleep and then gently wake up without ever realizing it. You might be drifting in and out of sleep without ever knowing it. 

“Even if it feels like it’s not working, I urge you to stick with this strategy for at least a week or so,” Professor Vishton said. “Some patience is required here, but there’s really good evidence that this sleep association strategy works.”

This article was edited by Kate Findley, Writer for The Great Courses Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for The Great Courses Daily.