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The most commonly used sleep aid is alcohol, and it is anything but a sleep aid. Many patients with insomnia will have two or three night caps in the evening before bed to try to help them fall asleep. But many of these things are very understandable aspects that people will turn to when they start trying to self-medicate their insomnia. And sadly, they are only making matters worse for themselves.

Very understandably, many insomnia patients try to self-medicate their condition with varied “sleep aids”. The tragedy us that most of them not only fail to help but actually make insomnia worse.

Most common among these is alcohol, which hurts your sleep in at least three different ways: 1) it sedates your brain, rather than generating naturalistic sleep 2) it increases the frequency of nighttime awakenings and makes it harder to fall back to sleep, and 3) it inhibits REM sleep.

THC also inhibits REM sleep, and users can develop a dependency on and tolerance to it, requiring more to get the same sleep effect. Worse still, THC is associated with a severe withdrawal insomnia, which only leads to relapse use.

Another ineffective tool is melatonin. Melatonin does not help people with insomnia sleep, as we discussed in the episode all about Melatonin.

The other option is classic prescription sleeping pills. However, based on their safety concerns and their minimal effectiveness long-term, the American Academy of Sleep Medicine and the American College of Physicians (ACP) now state that classic sleeping should no longer be the first-line treatment for insomnia. Instead, the first line treatment for insomnia should be the non-drug approach called cognitive behavioral therapy for insomnia (CBTi), and the one that Matt typically advocates for.

At a high level, CBTi involves working with a trained clinician for several weeks to change your habits, behaviors, mental beliefs, and stress around sleep. Many people with insomnia lose all confidence in their sleep and have terrible anxieties around not sleeping—in other words, their sleep controls them, and CBTI is designed to reverse that.

Many clinical studies have shown that CBTi is just as effective as sleeping pills in the short term yet has no negative side effects. Unlike sleeping pills, its benefits can last for many years after stopping work with your therapist.

Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.

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