Treatment of Primary Insomnia

Abstract

Ten percent to 40% of adults have intermittent insomnia, and 15% have long-term sleep difficulties. This article provides a review of the classification, differential diagnosis, and treatment options available for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Articles were selected based on their relevance to the topic. Evaluation of insomnia includes a careful sleep history, review of medical history, review of medication use (including over-the-counter and herbal medications), family history, and screening for depression, anxiety, and substance abuse. Population-based studies estimate that 10% to 40% of American adults have intermittent insomnia; 10% to 15% have long-term sleep difficulties. 2Insomnia has been associated with decreases in work performance and increases in motor vehicle accidents and hospitalization rates.3 Cost estimates for lost productivity and insomnia-related accidents exceed $100 billion per year. 4 The purpose of this review is to provide a current review of the classification, the differential diagnosis, and treatment options for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Abstracts were reviewed by 2 of the authors (ENR, SLP). Articles were then selected based on relevance to the topical review.

Tratamento não farmacológico para a insônia crônica

“…[5][6][7] Perante esta situação, diversos estudos têm sugerido a utilização de terapias não medicamentosas. 5,[8][9][10] O objetivo deste artigo é descrever os tipos mais comuns e atualizar os seus métodos de utilização para o tratamento da insônia crônica.…”

GPs’ management strategies for patients with insomnia: a survey and qualitative interview study

“…1,2 In published studies 10-40% of the general population report sleep problems in the previous year, with 10-15% describing long-term difficulties. [3][4][5][6][7][8] Insomnia can cause daytime fatigue, distress, impairment of daytime functioning, and reduced quality of life, and is associated with increased risk of mental health problems, drug and alcohol abuse, and increased healthcare utilisation. 1 Insomnia is often multifactorial and management depends on the duration and nature of the sleep disturbance.…”

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders

“…It is strongly recommended long term drug therapy should also be avoided, as dependence and tolerance can develop. [2,3] Previous studies have highlighted the potential use of melatonin in treating primary and secondary [4] sleep disorders in adults [5,6,7] and others have indicated melatonin can decrease sleep onset latency and increase the total time asleep, thus improving sleep quality overall. [8] Ferracioli-Oda et al [9] verified using melatonin in adults with primary sleep disorders improves sleep parameters (i.e., a higher dose has a greater effect on sleep latency and total sleep time).…”