Peer Reviewed
Feature Article Respiratory medicine
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Treating insomnia: alternatives to drug therapies

Leon Lack

Chronic insomnia is a common and significant disorder that should be treated with nondrug therapy. It can be treated in the primary care setting with a short course of behavioural therapy, with difficult cases referred to specialist sleep clinics.

Key Points
  • Insomnia is a prevalent and debilitating disorder often presenting in general practice.
  • Use of medications to treat patients with insomnia is common but not recommended.
  • Adequate diagnosis is important and should include a sleep diary and patient questionnaire.
  • Treatment of patients with insomnia with an abbreviated (two to three consultations) nondrug therapy is possible and preferred over medication.
  • Two behavioural therapies have been found to be useful: stimulus control therapy for sleep-onset problems and bed period restriction therapy for problems with excessive wakefulness at night.
  • Patients with difficult or more complex sleep disorders should be referred to specialist sleep clinics rather than given medications.

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