How do you counsel patients who are hesitant to try behavioral therapies for insomnia instead of starting a sleep medication?

I try to be very understanding of the desire to have an easier solution to sleep difficulties, which are so common. It is challenging that our gold standard and best strategies to help people sleep better require a lot of effort on the patient's part. Starting with that validation can be very helpfu...

I generally ask patients to try behavioral strategies first, such as box breathing, sleep, music, optimizing sleep hygiene, etc. If this isn’t effective, then we go to pharmacologic therapies, but usually a combination of the two.

I personally find that sleep onset insomnia is very frequently linked to unrealistic bedtime expectations. Sleep restriction also generally helps. However, that concept is difficult buy in for patients. I usually advise sleep restriction to 7 hours. In patients where the bedtime schedule varies, I a...

The VA has a free app that has a light psychoeducation component but a fairly robust sleep journal + sleep restriction guidance. Other than typical simple behavioral strategies and fixing up sleep hygiene issues, I will generally offer non-habit-forming sleep aids first; however, if someone is sayin...

If they have a moderate to severe anxiety spectrum disorder that is comorbid, then medication is likely to be needed. I will continue to encourage the patient to consider CBT, but I am also prepared to usually have to consider a medication in such situations.

Our Sleep Center has access to a CBT for...