![]() ![]() ![]() Insomnia can affect your memory and concentration. Your provider may also recommend healthy lifestyle habits such as a regular sleep schedule, cognitive behavioral therapy for insomnia, and medicines to help you manage your insomnia. To diagnose insomnia, your healthcare provider may ask about your sleep habits and ask you to keep a sleep diary. ![]() Chronic (long-term) insomnia occurs 3 or more nights a week, lasts more than 3 months, and cannot be fully explained by another health problem. Short-term insomnia may be caused by stress or changes in your schedule or environment. Insomnia can get in the way of your daily activities and may make you feel sleepy during the day. This happens even if you have the time and the right environment to sleep well. With insomnia, you may have trouble falling asleep, staying asleep, or getting good quality sleep. Hypnotic medications are also efficacious but must be carefully monitored for adverse effects.Insomnia is a common sleep disorder. Behavioral treatments should be used when possible. A thorough clinical history is often sufficient to identify factors that contribute to insomnia. Behavioral treatments should be used whenever possible, and medications should be limited to the lowest necessary dose and shortest necessary duration.Ĭonclusions and Relevance Clinicians should recognize insomnia because of its effects on function and health. Among pharmacologic interventions, the most evidence exists for benzodiazepine receptor agonist drugs, although persistent concerns focus on their safety relative to modest efficacy. Brief behavioral interventions and Internet-based cognitive-behavioral therapy both show promise for use in primary care settings. Quantitative literature reviews (meta-analyses) support the efficacy of behavioral, cognitive, and pharmacologic interventions for insomnia. The diagnosis of insomnia is established by a thorough history of sleep behaviors, medical and psychiatric problems, and medications, supplemented by a prospective record of sleep patterns (sleep diary). The etiology and pathophysiology of insomnia involve genetic, environmental, behavioral, and physiological factors culminating in hyperarousal. Insomnia is a risk factor for impaired function, development of other medical and mental disorders, and increased health care costs. The prevalence of insomnia disorder is approximately 10% to 20%, with approximately 50% having a chronic course. Objective To review the assessment, diagnosis, and treatment of insomnia in adults.Įvidence Review Systematic review to identify and summarize previously published quantitative reviews (meta-analyses) of behavioral and pharmacologic treatments for insomnia.įindings Insomnia is a common clinical condition characterized by difficulty initiating or maintaining sleep, accompanied by symptoms such as irritability or fatigue during wakefulness. Clinicians may be reluctant to address insomnia because of its many potential causes, unfamiliarity with behavioral treatments, and concerns about pharmacologic treatments. Importance Insomnia is one of the most prevalent health concerns in the population and in clinical practice. ![]()
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