LIFESTYLE MODIFICATION, SLEEP HYGIENE AND PHARMACOTHERAPY OF CHRONIC INSOMNIA

Chronic insomnia is one of the most common sleep disorders, characterized by persistent difficulty in initiating sleep, maintaining sleep, or experiencing restorative sleep despite adequate opportunity for sleep. It affects physical health, mental well-being, cognitive performance, and overall quality of life. Effective management requires a comprehensive approach that combines lifestyle modification, sleep hygiene, behavioral therapy, and pharmacotherapy. Lifestyle modifications such as maintaining a regular sleep schedule, engaging in regular physical activity, reducing caffeine, alcohol, and nicotine intake, managing stress, and following a balanced diet contribute significantly to improved sleep quality. Sleep hygiene practices, including optimizing the sleep environment, limiting screen exposure before bedtime, avoiding daytime naps, and establishing relaxing bedtime routines, support healthy sleep behaviors but are most effective when combined with other evidence-based interventions. Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first-line treatment for chronic insomnia due to its sustained long-term benefits. Pharmacological treatment, including benzodiazepines, non-benzodiazepine hypnotics, melatonin receptor agonists, dual orexin receptor antagonists, and low-dose antidepressants, may be considered for selected patients when non-pharmacological measures are insufficient. Drug therapy should be individualized and used cautiously because of the risks of tolerance, dependence, residual daytime sedation, and adverse effects. This review summarizes current evidence on lifestyle modification, sleep hygiene, and pharmacotherapy, highlighting their roles in improving sleep quality and patient outcomes. A multidisciplinary, patient-centered treatment strategy that integrates behavioral and pharmacological approaches offers the most effective long-term management of chronic insomnia.