Insomnia is the most frequent sleep disorder. It is a symptom, and is defined as “chronic inability to obtain the amount of sleep needed for optimal functioning and well-being”. Untreated insomnia is associated with significant morbidity and mortality. Thorough assessment of insomnia is essential in choosing the most appropriate strategy for management. If a cause of insomnia is identified, initial treatment should be directed at specific factor. Since insomnia is a chronic condition, long-term and safe treatments are warranted. Non-pharmacologic options have been available for decades, but lack of physician awareness and training, difficulty in obtaining reimbursements and questions about efficacy have limited their use. These therapies offer the greatest potential for long term gains in preventing recurrence of insomnia. Pharmacological options are most useful for acute insomnia. They are commonly used but long term use of hypnotics can become complicated by drug tolerance, dependence or rebound insomnia. Non-pharmacological interventions produce reliable and durable clinical benefits in the treatment of primary insomnia, insomnia associated with medical or psychiatric conditions and insomnia in elders. Additional research is still needed to develop and validate treatment algorithms that would optimize outcomes and reduce morbidity. Author concludes that non-pharmacological therapies should always be a component in management of Insomnia.
展开▼
