Treatment of insomnia

Abstract

Chronic insomnia is a common complaint in psychiatric practice. The management of patients with insomnia should promote sleep as well as restore normal daytime function. Most treatment modalities, including behavioral and pharmacologic approaches, have been validated in patients with primary insomnia, but may also be helpful in patients with secondary insomnia or insomnia comorbid with medical and psychiatric conditions. Behavioral therapies appear to have longerlasting efficacy after cessation of treatment, and should therefore always be considered. Hypnotics are approved for the short-term treatment of insomnia; they are generally used in the treatment of acute or transient types of insomnia, but are increasingly being used for chronic insomnia as well. In the presence of psychiatric disorders or other sleep disorders, other options such as antidepressants, antipsychotics, or anticonvulsants may help promote sleep.