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Rehabilitation: Insomnia and Sleep Hygiene

Sleep restriction therapy, stimulus control, CBT-I, exercise effects on sleep

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Rehabilitation: Insomnia and Sleep Hygiene?

Chronic insomnia is difficulty initiating or maintaining sleep occurring 3 nights weekly for 3 months with daytime impairment. It is bidirectionally linked with chronic pain, anxiety, depression, and cardiovascular disease. Rehabilitation patients with musculoskeletal conditions, stroke, or post-surgical recovery face higher prevalence and poorer outcomes when sleep is poor.

Cognitive behavioral therapy for insomnia (CBT-I) combines sleep restriction (limiting time in bed to actual sleep time, then gradually expanding), stimulus control (use bed only for sleep and intimacy), cognitive restructuring (challenging dysfunctional sleep beliefs), and relaxation training. Six to eight sessions produce sustained improvement.

Sleep hygiene measures include consistent sleep-wake schedule, dark cool bedroom, avoidance of caffeine after noon and alcohol within 3 hours of bedtime, no screens 1 hour before sleep, regular exercise but not within 2 hours of bed, and bed-only-for-sleep policy. Pharmacologic adjuncts (melatonin, low-dose doxepin) reserved for refractory cases.

Symptoms

Difficulty falling asleep over 30 minutes
Frequent night awakenings
Early morning awakening unable to return to sleep
Daytime fatigue and irritability
Concentration problems and accidents

Risk Factors

Chronic pain conditions
Anxiety and depression
Shift work and irregular schedules
Caffeine and alcohol use
Older age and post-menopause

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For insomnia persisting over 3 months
  • When daytime function is impaired
  • If hypnotic dependence is developing
  • For sleep apnea screening with snoring
  • For CBT-I referral

Treatment Methods

01
CBT-I as first-line therapy
02
Sleep restriction and stimulus control
03
Sleep hygiene measures
04
Relaxation training and mindfulness
05
Short-term hypnotic only if needed
06
Treatment of underlying pain or mood disorder

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.