May 3, 2021

Insomnia Causing Problems?

Tossing and turning night after night? Don’t automatically reach for the pill bottle. New guidelines say the first choice to treat chronic insomnia should be cognitive behavioral therapy — a way to condition your body to slumber again.

It takes more time and effort than popping a pill, but the American College of Physicians said Monday the method known as CBT can be effective and doesn’t carry the side effects of medication, a recommendation intended to spur primary care doctors to prescribe the step. If it doesn’t work, then doctors could consider adding a drug.

“Prescribing a sleeping pill is not the desirable first step,” said the group’s Dr. Thomas Tape, chief of general internal medicine at the University of Nebraska Medical Center. Yet for many primary care physicians, the behavioral approach “wasn’t really on our radar screens,” he said.

There are challenges, including finding health workers who are trained to deliver CBT for insomnia. Nor is it always covered by insurance, notes an editorial published along with the recommendation in Annals of Internal Medicine. Here are some things to know:


Adults ages 18 to 60 are supposed to sleep at least seven hours a night for good health. Cheating sleep can increase the risk of health problems from high blood pressure to obesity to fatigue-caused car crashes.

Scroll to Top