![]() Cognitive behavioral therapy in the treatment of insomnia. An american academy of sleep medicine report. Practice parameters for the psychological and behavioral treatment of insomnia: an update. Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Insomnia with objective short sleep duration: the most biologically severe phenotype of the disorder. Vgontzas AN, Fernandez-Mendoza J, Liao D, Bixler EO. Updates in insomnia diagnosis and treatment. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Papers of particular interest, published recently, have been highlighted as: Finally, we evaluate the data examining the risks and benefits of their long-term use and briefly discuss treatment resistance to hypnotics in chronic insomnia disorder. We also discuss their usage in specialized populations such as in children, the elderly, pregnant patients, and their use in the context of common medical and psychiatric conditions. ![]() We detail their mechanisms of action, efficacy, and discuss common side effects and dosages for select medications. While cognitive behavior therapy for insomnia is the recommended first-line treatment, due to limited availability, expense, and other limitations, sedative-hypnotic medications are still commonly utilized treatment options. SummaryĬhronic insomnia is a common sleep disorder associated with significant morbidity and healthcare costs. A 2021 article highlights the lack of evidence on the topic of treatment-resistant insomnia. A large cohort study published in 2022 found significant safety issues in using low-dose quetiapine for insomnia. Recent FindingsĪ 2022 review with network meta-analysis found eszopiclone and lemborexant to be relatively more effective than other options for long-term treatment, and doxepin and zaleplon showed favorable tolerability. We reviewed existing guidelines from the American Academy of Sleep Medicine (AASM) and recent literature from PubMed to detail the basic physiology of the sleep-wake system and discuss all current FDA approved sedative-hypnotics and common non-FDA approved medications for insomnia.
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