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Chronic Insomnia / Insomnia Disorder

Relaxation Techniques

Relaxation therapy can be used to limit cognitive arousal and reduce muscular tension to facilitate sleep.1, 2, 3, 4

Common relaxation techniques include:5, 6

  • Progressive muscle relaxation
  • Meditation
  • Mindfulness
  • Guided imagery
  • Breathing techniques
  • Listening to music

Progressive muscle relaxation involves learning to relax one muscle at a time until the entire body is relaxed. The patient should be encouraged to practice relaxation techniques over several consecutive weeks, and should be informed that therapeutic effects commonly occur at a gradual rate over time. It may also helpful to ask the patient to practice relaxation techniques during the daytime and not only at night when trying to fall asleep.

Table. Components of progressive muscle relaxation

Instruct the patient to follow these steps:

  • Lie or sit comfortably
  • Close the eyes
  • Establish a relaxed, abdominal breathing pattern
  • Try to discourage everyday thoughts by focusing on a neutral mental stimuli, such as a peaceful word or image, when this focus is lost re-establish the focus without getting frustrated
  • Contract and then relax the muscles of the following body parts gently for one to two seconds and repeat this process several times
  • Begin this muscle relaxation technique with the muscles in the face, and then the jaw and neck, upper arms, lower arms, fingers, chest, abdomen, buttocks, thighs, calves, and feet
  • Repeat this cycle for approximately 10-20 minutes

If the patient is feeling tense during trying to get to sleep, advise them to go into another room and take a few, gentle, slow and deep breaths until they feel less tense, and repeat this several times throughout the night if necessary. If thinking about matters that need to be done the next day, writing a short task list may help dismiss these thoughts. Further considerations include asking the patient to review the day backwards; when they went to bed, turned out the lights, put slippers under the bed, walked from the bathroom to the bed, brushed teeth and so on. The purpose of this exercise is to avoid anxious thoughts about lack of sleep, and instead focus on more mundane things.

Music may improve subjective sleep quality (but not specifically reduce the length of time it takes to get to sleep, increase the amount of sleep someone gets, or reduce the number of times someone wakes up) by enhancing relaxation (decreasing sympathetic arousal, anxiety and stress responses) and/or acting as a distraction from stressful thoughts.7 Pre-recorded preferred slow, soft, relaxing and soothing music can be listened to for 25–60 minutes daily, either at bedtime or throughout the day, over 3 days to 5 weeks.8


AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset

Quick links


  1. Alparslan GB, et al. Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized. Holist Nurs Pract 2016;30(3):155-65
  2. Blanaru M, et al. The effects of music relaxation and muscle relaxation techniques on sleep quality and emotional measures among individuals with posttraumatic stress disorder. Ment Illn 2012;4(2):e13
  3. Ziv N, et al. The effect of music relaxation versus progressive muscular relaxation on insomnia in older people and their relationship to personality traits. J Music Ther 2008;45(3):360-80
  4. Means MK, et al. Relaxation therapy for insomnia: nighttime and day time effects. Behav Res Ther 2000;38(7):665-78
  5. Centre for Clinical Interventions: Progressive muscle relaxation
  6. Winkelman JW. Overview of the treatment of insomnia in adults. In UpToDate, Benca R (ed). Waltham, MA: UpToDate 2020
  7. Jespersen KV, et al. Music for insomnia in adults. Cochrane Database Syst Rev 2015;8:CD010459
  8. www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/mental-health/music-for-insomnia-in-adults