What is the focus of treatment for insomnia?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Management of insomnia may involve further challenges. If sleep difficulties are not the presenting complaint, there is often too little time to address them at an office visit.

Physicians receive very little training in medical school on sleep disorders and their impact on patients’ overall health and quality of life. In fact, most providers rate their knowledge of sleep medicine as only fair. Finally, many providers are not aware of the safety issues; knowledgeable of the efficacy of cognitive-behavioral and pharmacologic therapies; or able to determine when a patient should be referred to a sleep medicine specialist.

The management of insomnia varies depending on the underlying etiology. If the patient has a medical, neurologic, psychiatric, or sleep disorder, treatment is directed at the disorder. Even when comorbid causes of insomnia (ie, medical, psychiatric) are treated, however, variable degrees of insomnia can persist that require additional interventions. In such cases, patients can benefit from cognitive-behavioral therapy (CBT) [16, 17] and a short course of a sedative-hypnotic or melatonin receptor agonist (see Treatment).

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