Diagnosis and treatment of chronic insomnia

Saddichha, Sahoo (2010) Diagnosis and treatment of chronic insomnia. Annals of Indian Academy of Neurology, 13 2: 94-102. doi:10.4103/0972-2327.64628

Author Saddichha, Sahoo
Title Diagnosis and treatment of chronic insomnia
Journal name Annals of Indian Academy of Neurology   Check publisher's open access policy
ISSN 0972-2327
Publication date 2010-06-25
Year available 2010
Sub-type Critical review of research, literature review, critical commentary
DOI 10.4103/0972-2327.64628
Open Access Status DOI
Volume 13
Issue 2
Start page 94
End page 102
Total pages 9
Place of publication Mumbai, India
Publisher Medknow Publications and Media
Language eng
Abstract Insomnia is a disorder characterized by inability to sleep or a total lack of sleep, prevalence of which ranges from 10 to 15% among the general population with increased rates seen among older ages, female gender, White population and presence of medical or psychiatric illness. Yet this condition is still under-recognized, under-diagnosed, and under-treated. This article aims to review the operational definitions and management of chronic insomnia. A computerized search on PubMed carried from 1980 to January 2009 led to the summarization of the results. There are several strategies to manage chronic insomnia. To initiate treatment, it is necessary to define it and differentiate it from other co-morbid psychiatric disorders. Non-pharmacologic strategies such as stimulus control therapy and relaxation and cognitive therapies have the best effect sizes followed by sleep restriction, paradoxical intention and sleep hygiene education which have modest to less than modest effect sizes. Among pharmacotherapeutic agents, non-benzodiazepine hypnotics are the first line of management followed by benzodiazepines, amitryptiline and antihistaminics. However, adequate trials of combined behavior therapy and pharmacotherapy are the best course of management.
Keyword Chronic
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
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