Cognitive behavioral therapy for insomnia
The first step in treating insomnia with CBT-I is to identify the underlying causes of the insomnia. People with insomnia should evaluate or have their sleep patterns evaluated and take into account all possible factors that may be affecting the person's ability to sleep. This would involve keeping a sleep diary or journal for a couple weeks. The journal will help to identify patterns of thoughts or behaviors, stressors, etc. that could be contributing to the person's insomnia.
Sleeping disorders following traumatic brain injury
Pharmacological treatments have to be administered carefully. Some medication is highly addictive and the resulting withdrawal syndromes cause even more sleep disturbances, e.g. Insomnia. Possible medications are Zopiclone and lorazepam, which have been proven effective in people with TBI. Also Benzodiazepine hypnotics, Benzodiazepine-receptor antagonists, antidepressants, psychostimulants can be administered, especially in patients with insomnia. Some studies have shown negative effects of hypnotics, such as an increased risk of dementia. In patients with hypersomnia, Modafinil, Armodafinil, Methylphenidate and amphetamines are often used as a treatment for day time sleepiness. Medication should always be prescribed by an expert to make sure that the correct medicament is taken in an appropriate dose.