Conclusions
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.
Medscape Psychiatry © 2016 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Getting to the Source of Your Patients' Insomnia - Medscape - May 18, 2016.
Comments