Treating Insomnia in Early Recovery
How to Treat Insomnia in Early Addiction Recovery
by Integrating Cognitive-Behavioral & Pharmacological Techniques
Insomnia is a common issue that impacts many people at various points in their lives. It involves difficulty falling asleep, staying asleep, or waking too early and being unable to fall back asleep. In the U.S., approximately 30% of adults report struggling with sleep, and worldwide estimates suggest that between 10% and 50% of the population experiences ongoing sleep issues.
For individuals in recovery from substance use disorders, insomnia is not only frustrating—it can be a significant obstacle to progress. Many people entering treatment identify sleep problems as one of their top concerns. Research consistently shows a strong link between substance use, mental health conditions, and chronic insomnia. In this article, we’ll examine effective treatment options for insomnia, including cognitive-behavioral therapy and medication, all within the framework of addiction recovery.
Insomnia in Early Recovery
Now, let’s take a closer look at the serious impact insomnia can have on those in recovery from substance abuse. It’s one of the most frequently reported challenges in residential treatment settings. While there isn’t a one-size-fits-all medication that can fully resolve insomnia, there are several proven strategies to help manage it effectively.
Available treatment options include prescription medications, natural supplements, and therapeutic approaches like Cognitive Behavioral Therapy (CBT). To start, let’s explore some of the medical treatments often used to relieve insomnia symptoms.
What Medications can Treat Insomnia?
Insomnia can be managed with certain medications, but it’s important to be aware that these solutions may come with side effects such as daytime fatigue or weight gain. One commonly prescribed medication is Trazodone. When taken correctly—typically about an hour before bedtime—it can support better sleep. However, if someone remains awake for too long after taking it, the medication can have the opposite effect, actually making it harder to fall asleep.
Doxepin is another option. This psychotropic medication is often used in low doses to treat insomnia and typically avoids the “hangover” sensation that can accompany other medications. Hydroxyzine, an antihistamine with sedative properties, is another short-term solution frequently used for sleep support.
Remeron (mirtazapine) is an antidepressant that may also assist with sleep, but it can cause drowsiness the next day and has been associated with weight gain when used long-term.
Seroquel is one of the most frequently requested sleep medications in treatment settings. It helps promote drowsiness by blocking histamine receptors and is also used to manage symptoms of depression and other psychiatric conditions.
A Natural Medication for Insomnia
Melatonin is one of the most commonly used and easily accessible remedies for insomnia. As a natural sleep aid, it is especially appealing to individuals in recovery seeking non-addictive options. Melatonin is a hormone naturally released by the pineal gland in the brain during nighttime, helping regulate the body’s sleep-wake cycle. Its production naturally declines during daylight hours.
For people healing from substance use disorders, melatonin offers a gentle and effective way to improve sleep without the risk of forming new dependencies. Because it’s natural and non-habit forming, melatonin is often recommended as part of a holistic approach to recovery and better sleep hygiene.
How can Cognitive-Behavior Therapy help with Insomnia?
Cognitive Behavioral Therapy for Insomnia (CBTI) is a proven, structured method that helps people overcome sleep difficulties without relying on medication. CBTI promotes long-term improvements in sleep by teaching healthy sleep routines and mindset shifts that reduce dependence on sleep aids.
The therapy typically starts with simple behavioral changes. Individuals are advised to avoid evening stimulants like caffeine, nicotine, and sugar, which can disrupt the natural sleep cycle. Since nicotine cravings can wake someone up during the night, CBTI often includes smoking cessation strategies as well.
CBTI also encourages relaxing bedtime rituals—such as taking a warm bath or listening to soft music—to prepare the mind and body for sleep. Stimulating activities like watching TV or playing loud music are discouraged in the hours leading up to bedtime.
Managing nighttime anxiety is another essential part of CBTI. Many people experience racing thoughts at night, which can lead to a cycle of stress and sleeplessness. CBTI offers techniques to recognize and replace anxious thoughts with more balanced ones. Individuals are encouraged to stay calm, stay in bed, and gently reframe their thinking. Here are a few CBTI-inspired examples:
- I’m new to recovery, so it’s normal to struggle with sleep now—this won’t last forever.
- Even if I’m not sleeping, I can still use this time to relax and be still.
- I may not get eight hours, but resting quietly can still help me function tomorrow.
- Instead of stressing, I’ll use this time to practice the relaxation techniques I’ve learned.
In conclusion
Insomnia affects millions of people in the U.S. and across the globe, and it can be especially difficult for individuals in the early stages of recovery. Addressing sleep issues is an important part of the overall healing process for those in treatment.
In a supportive treatment environment, insomnia can be effectively managed through a combination of medication and Cognitive Behavioral Therapy for Insomnia (CBTI). This evidence-based approach is widely recognized for improving sleep quality and enhancing overall wellness.
For individuals seeking natural solutions, melatonin is a popular and accessible over-the-counter option that supports healthy sleep patterns without the risk of dependency. When paired with CBTI techniques, melatonin can help create a sustainable, long-term strategy for overcoming insomnia during recovery.
