Retrain the association
Cognitive behavioural therapy for insomnia, or CBT-I, combines behavioural and thinking strategies. Stimulus control reconnects bed with sleep instead of wakeful struggle. Cognitive work addresses frightening predictions about a poor night. This is structured treatment, not a claim that insomnia is imaginary. Sleep-hygiene tips alone are not equivalent.
Adjust the window carefully
Sleep restriction tailors time in bed to sleep patterns, then adjusts it with monitoring. It is not a sleep-deprivation challenge. Driving, marked sleepiness, bipolar disorder or poorly controlled seizures can require extra caution or a different approach. A trained clinician should guide this.
Assess before adding a sedative
Persistent sleep difficulty despite opportunity, with daytime consequences, warrants assessment. Pain, mood, medicines and other sleep disorders may need attention. Ontario Health recommends CBT-I as first-line treatment. Ask about access, support and how progress will be reviewed.
Review the medicine as well as the night
If medication is used, its next-day effects, benefits, harms and continuing need should be reviewed. Treatment choices depend on the person’s circumstances and preferences. Do not abruptly stop a long-used benzodiazepine; ask your healthcare professional for a supervised plan.