Getting to the Source of Your Patients' Insomnia

Matthew A. Goldenberg, DO


May 18, 2016

In This Article


By going beyond the diagnostic criteria, targeting the specific deficits caused by your patient's insomnia, and either ruling out or treating comorbid psychiatric and medical conditions, you can improve outcomes in patients with insomnia. In all cases, a thorough evaluation of your patient's insomnia will yield opportunities to educate regarding sleep hygiene, which in itself can often significantly improve sleep.

My experience indicates that compared with reflexive prescribing of pharmacotherapies, following these diagnostic and behavioral modification suggestions will yield superior and longer-lasting results in many patients. I suspect one reason sleep-aid medications often have limited effectiveness is that they do not address the underlying causes of insomnia, such as undiagnosed psychiatric or medical conditions, or poor sleep hygiene.

Obtaining a restful night's sleep can improve all aspects of a patient's life and prove very satisfying for both them and you. Unfortunately, many patients who present to psychiatrists (or primary care physicians) with chronic insomnia have not previously had a full insomnia workup or been educated regarding proper sleep hygiene. These are the areas I encourage you to begin with in your assessment and intervention. I hope this review has given you more confidence in doing so.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.