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Insomnia cures1/28/2024 ![]() Benzodiazepines affect sleep by increasing total sleep time and shortening sleep latency. These agents bind to gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS), causing inhibition of neuronal excitation. ![]() 7,8 Pharmacologic options will be discussed here, as well as concerns surrounding the use of these agents that must be considered when determining the optimal management for an individual with insomnia.īenzodiazepines are one of the most widely used drug classes for the short-term treatment of insomnia. Proper management of chronic insomnia includes the identification of the underlying medical, psychiatric, and psychosocial factors, as well as utilization of nonpharmacologic and pharmacologic treatment. Health care providers must carefully assess those at greatest risk for insomnia, including the elderly, females, shift workers, individuals with comorbid medical and psychiatric conditions, and those with less education. 5,6 Due to the widespread impact of insomnia, adequate identification and management of this condition are critical. Examples include increased use of health care resources, reduced quality of life, effects on physical health, impairment in family and social relationships, and the possibility of emergent psychiatric conditions. 4 This increase is quite alarming, especially considering the myriad negative consequences associated with insomnia. 1 While only 10% of the adult population experiences chronic insomnia, 2,3 in the past 8 years the number of individuals who sleep less than 6 hours a night has risen 13%. An internet search of psychology clinics may also find clinicians who provide CBT-I.While estimates vary depending on the definition of insomnia utilized, an estimated 70 million Americans live with a chronic sleep disorder, which is associated with an economic burden greater than $100 billion in direct and indirect costs every year in the United States. Sleep clinics may have behavioural sleep specialists on site or they can suggest treatment providers. These resources are not equivalent to a full CBT-I program, so if they are not sufficiently helpful, recommend in-person CBT-I. There are also CBT-based self-help books and web-based resources that highly motivated patients may find useful. If this service is not available, online CBT-I is an option. Ideally, patients participate in individually tailored CBT-I provided by a trained clinician such as a psychologist or, in complex cases, a behavioural sleep specialist. Since CBT-I eliminates maladaptive behaviours and cognitions that are at the root of the condition, it yields improvements that endure beyond the termination of treatment. A shorter, two-session behavioural version can be delivered in primary care settings. These are independent of the original cause and perpetuate the condition even after the trigger is no longer present.ĬBT-I is a short-term treatment (usually three to six sessions) that is beneficial for more than 70 percent of patients. It encompasses psychoeducation about sleep and behavioural interventions (e.g., stimulus control therapy) and addresses dysfunctional beliefs that sustain insomnia.Īccording to the cognitive-behavioural model, people with acute insomnia adopt behavioural strategies and cultivate sleep-related anxiety, fueled by unhelpful cognitions about sleep. Cognitive-behavioural therapy for insomnia (CBT-I) is the first-line standard treatment, and should be the initial treatment offered to patients.
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