Chronic insomnia.

Abstract

Insomnia is a prevalent complaint in clinical practice that can present independently or comorbidly with another medical or psychiatric disorder. In either case, it might need treatment of its own. Of the different therapeutic options available, benzodiazepine-receptor agonists (BzRAs) and cognitive-behavioural therapy (CBT) are supported by the best empirical evidence. BzRAs are readily available and effective in the short-term management of insomnia, but evidence of long-term efficacy is scarce and most hypnotic drugs are associated with potential adverse effects. CBT is an effective alternative for chronic insomnia. Although more time consuming than drug management, CBT produces sleep improvements that are sustained over time, and this therapy is accepted by patients. Although CBT is not readily available in most clinical settings, access and delivery can be made easier through use of innovative methods such as telephone consultations, group therapy, and self-help approaches. Combined CBT and drug treatment can optimise outcomes, although evidence to guide clinical practice on the best way to integrate these approaches is scarce.

• Authors: Charles M Morin, Ruth Benca
• Journal: Lancet (London, England) (Lancet) Vol. 379 Issue 9821 Pg. 1129-41 (Mar 24 2012) ISSN: 1474-547X [Electronic] England
• PMID: 22265700 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2012 Elsevier Ltd. All rights reserved.

Chemical References

• GABA-A Receptor Agonists

Topics

• Arousal (physiology)
• Brain (physiopathology)
• Chronic Disease
• Cognitive Behavioral Therapy
• Comorbidity
• Drug Therapy, Combination
• GABA-A Receptor Agonists (therapeutic use)
• Humans
• Prognosis
• Sleep Initiation and Maintenance Disorders (epidemiology, physiopathology, therapy)
• Treatment Outcome