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
Nonpharmacological treatments involve different interventions, starting with sleep hygiene, which includes sleep promoting activities such as maintaining a regular and strict sleep schedule and avoiding heavy meals before bedtime in order to restore the natural sleep-wake cycle. Further treatments options are phototherapy and infrared light therapy, which both, aim to treat circadian rhythm disorders such as delayed sleep phase disorder. Especially in patients with hypersomnia, bright light therapy in the morning has been proven to be effective. A prolongation of slow-wave sleep increases glymphatic clearance of metabolic waste products, which can lead to improvements of sleep disorders. Furthermore, studies showed ameliorated sleep pattern due to acupuncture of patients with TBI. Sleep apnea due to TBI can be treated through positive airway pressure, which helps with the development of a regular breathing pattern during sleep and prevents waking up. Cognitive behavioral therapy for insomnia also have been shown to effectively improve sleep in TBI patients. It aims to improve sleep habits and behaviors by identifying and changing the thoughts and the behaviors that affect the ability of a person to sleep or sleep well. The improvement of the quality of sleep and the decrease of depressive severity is associated with he use of near-infrared light for intracellular healing.