The Non-pharmacological treatment of chronic insomnia review
DOI:
https://doi.org/10.12775/JEHS.2025.80.59417Keywords
chronic insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I), non-pharmacological treatment of chronic insomnia, Mindfulness-Based Cognitive Therapy (MBCT), Acupuncture for insomniaAbstract
Chronic insomnia is a sleep disorder defined by the presence of difficulty initiating or maintaining sleep, or early morning awakening and being unable to return to sleep, occurring at least three times per week for a duration of three months or more. This condition is associated with significant daytime functional impairment or distress, including fatigue, mood disturbances, and cognitive deficits. The aim of this article is to present the non-pharmacological methods of treatment of chronic insomnia. This type of therapy includes elements such as: Cognitive Behavioral Therapy for Insomnia (CBT-I), which incorporates strategies such as: sleep restriction, stimulus control, cognitive restructuring, sleep hygiene and relaxation techniques; Mindfulness-Based Cognitive Therapy (MBCT) and acupuncture. CBT-I have emerged as the gold standard for long-term management.
References
1. Takaesu Y, Sakurai H, Aoki Y, Takeshima M, Ie K, Matsui K, Utsumi T, Shimura A, Okajima I, Kotorii N, Yamashita H, Suzuki M, Kuriyama K, Shimizu E, Mishima K, Watanabe K and Inada K (2023) Treatment strategy for insomnia disorder: Japanese expert consensus. Front. Psychiatry 14:1168100. doi: 10.3389/fpsyt.2023.1168100
2. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
3. Kim WJ, Kim HS. Emerging and upcoming therapies in insomnia. Transl Clin Pharmacol. 2024 Mar;32(1):1-17. doi: 10.12793/tcp.2024.32.e5. Epub 2024 Mar 25. PMID: 38586124; PMCID: PMC10990727.
4. Samara MT, Huhn M, Chiocchia V, Schneider-Thoma J, Wiegand M, Salanti G, Leucht S. Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis. Acta Psychiatr Scand. 2020 Jul;142(1):6-17. doi: 10.1111/acps.13201. Epub 2020 Jun 30. PMID: 32521042.
5. Chan NY, Chan JWY, Li SX, Wing YK. Non-pharmacological Approaches for Management of Insomnia. Neurotherapeutics. 2021 Jan;18(1):32-43. doi: 10.1007/s13311-021-01029-2. Epub 2021 Apr 5. PMID: 33821446; PMCID: PMC8116473.
6. Chun W, Chao D, Qi H, Dongliang Z, Zhenmei L, Jia L. Pharmacological and non-pharmacological treatments for insomnia: A protocol for a systematic review and network meta-analysis. Medicine (Baltimore). 2021 Aug 6;100(31):e26678. doi: 10.1097/MD.0000000000026678. PMID: 34397800; PMCID: PMC8341370.
7. Jaqua EE, Hanna M, Labib W, Moore C, Matossian V. Common Sleep Disorders Affecting Older Adults. Perm J. 2023 Mar 15;27(1):122-132. doi: 10.7812/TPP/22.114. Epub 2022 Dec 12. PMID: 36503403; PMCID: PMC10013715.
8. Rosenberg R, Citrome L, Drake CL. Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies. Neuropsychiatr Dis Treat. 2021 Aug 6;17:2549-2566. doi: 10.2147/NDT.S297504. PMID: 34393484; PMCID: PMC8354724.
9. Hertenstein E, Trinca E, Wunderlin M, Schneider CL, Züst MA, Fehér KD, Su T, Straten AV, Berger T, Baglioni C, Johann A, Spiegelhalder K, Riemann D, Feige B, Nissen C. Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2022 Apr;62:101597. doi: 10.1016/j.smrv.2022.101597. Epub 2022 Feb 9. PMID: 35240417.
10. Walker J, Muench A, Perlis ML, Vargas I. Cognitive Behavioral Therapy for Insomnia (CBT-I): A Primer. Klin Spec Psihol. 2022;11(2):123-137. doi: 10.17759/cpse.2022110208. PMID: 36908717; PMCID: PMC10002474.
11. Rossman J. Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. Am J Lifestyle Med. 2019 Aug 12;13(6):544-547. doi: 10.1177/1559827619867677. PMID: 31662718; PMCID: PMC6796223.
12. Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, Bastien C, Berzina N, Bjorvatn B, Dikeos D, Dolenc Groselj L, Ellis JG, Garcia-Borreguero D, Geoffroy PA, Gjerstad M, Gonçalves M, Hertenstein E, Hoedlmoser K, Hion T, Holzinger B, Janku K, Jansson-Fröjmark M, Järnefelt H, Jernelöv S, Jennum PJ, Khachatryan S, Krone L, Kyle SD, Lancee J, Leger D, Lupusor A, Marques DR, Nissen C, Palagini L, Paunio T, Perogamvros L, Pevernagie D, Schabus M, Shochat T, Szentkiralyi A, Van Someren E, van Straten A, Wichniak A, Verbraecken J, Spiegelhalder K. The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. J Sleep Res. 2023 Dec;32(6):e14035. doi: 10.1111/jsr.14035. PMID: 38016484.
13. El Basiouny D, Habib HI. Cognitive Behavioral Therapy for Insomnia (CBT-I): A Comprehensive Review. Indian J Sleep Med 2023;18(4):62–65.
14. Aslan, S., Aslan, ZT., Coşkun, N. (2021). A Review: Effectivity of Mindfulness Based Treatments for Insomnia. J Cogn Behav Psychother Res; 10(3),330343. https://doi.org/10.5455/JCBPR.106780
15. Chan SH, Lui D, Chan H, Sum K, Cheung A, Yip H, Yu CH. Effects of mindfulness-based intervention programs on sleep among people with common mental disorders: A systematic review and meta-analysis. World J Psychiatry. 2022 Apr 19;12(4):636-650. doi: 10.5498/wjp.v12.i4.636. PMID: 35582336; PMCID: PMC9048455.
16. Evanger LN, Flo-Groeneboom E, Sørensen L and Schanche E (2024) Mindfulness-based cognitive therapy improves insomnia symptoms in individuals with recurrent depression: secondary analyses from a randomized controlled trial. Front. Psychiatry. 14:1231040. doi: 10.3389/fpsyt.2023.1231040
17. Camino M, Satorres E, Delhom I, Real E, Abella M, Meléndez JC. Mindfulness-based Cognitive Therapy to Improve Sleep Quality in Older Adults with Insomnia. Psychosoc Interv. 2022 Jul 20;31(3):159-167. doi: 10.5093/pi2022a12. PMID: 37361010; PMCID: PMC10268553.
18. Liu C, Zhao Y, Qin S, Wang X, Jiang Y, Wu W. Randomized controlled trial of acupuncture for anxiety and depression in patients with chronic insomnia. Ann Transl Med. 2021 Sep;9(18):1426. doi: 10.21037/atm-21-3845. PMID: 34733978; PMCID: PMC8506741.
19. Zhao H, Liu C, Ye H, Shi K, Yao Y, Wang M. Advancements in the physiopathological study of acupuncture treatment for insomnia: A review. Medicine (Baltimore). 2024 Jun 28;103(26):e38476. doi: 10.1097/MD.0000000000038476. PMID: 38941420; PMCID: PMC11466160.
20. Yao L, Liu Y, Li M, Zheng H, Sun M, He M, Zhong Z, Ma S, Huang H and Wang H (2024) The central regulatory effects of acupuncture in treating primary insomnia: a review. Front. Neurol. 15:1406485. doi: 10.3389/fneur.2024.1406485
21. Luo SW, Huang NP, Xiang Q, Huang XQ, Tan ZW, Teng X, Li XJ, Tu X, Gao XL. A systematic review and meta-analysis of acupuncture combined with Tuina in the treatment of insomnia. Medicine (Baltimore). 2022 Dec 23;101(51):e30703. doi: 10.1097/MD.0000000000030703. PMID: 36595758; PMCID: PMC9794265.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Aleksandra Rudzka, Maria Anna Madejska, Antonina Drzewiecka, Artur Drzewiecki, Wiktor Korczak, Monika Gaszyńska, Wojciech Falkowski, Anna Krysińska, Weronika Woźniak, Jakub Magielski
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 119
Number of citations: 0
