The behavioral treatment of insomnia an alternative to drug therapy.

The use of hypnotic drugs to treat insomnia is criticized because of (a) tolerance effects, (b) carry-over effects, (c) alterations in sleep patterns, (d) rebound effects, and (e) attributional effects. Behavioral treatments represent a more viable alternative and are reviewed under four headings: (a) systematic desensitization: (b) applied relaxation; (c) attribution-based therapies; and (d) classical conditioning therapies. The behavioral therapies are predicated upon three views of insomnia: first, that insomnia results from excessively high levels of arousal prior to and during sleep; second, that insomnia occurs when the sleep environment lacks sufficient stimulus control over sleeping; and finally, that insomnia is often enhanced and maintained by exacerbation cycles in which worries about not falling asleep interfere even further with one's sleep.