Relief from situational insomnia. Pharmacologic and other options

Although most adults in the United States experience insomnia from time to time, many minimize the problem and fail to seek treatment. This occurs despite accumulating evidence that lack of sleep can seriously impair work performance, reflex response, cognitive abilities, and sense of well-being. Physicians should routinely inquire into a patient's sleep habits and be attuned to complaints of insomnia. A good working partnership between physician and patient may prevent complications of insomnia (eg, overconcern with the condition, demoralization, misuse of drugs and alcohol, disturbances of the circadian sleep-wake cycle), which might otherwise perpetuate and exacerbate the problem. Patients with situational insomnia can usually be treated by their primary care physician, who can offer thoughtful approaches to nonpharmacologic and pharmacologic treatment. In cases of chronic insomnia, referral to a sleep specialist or other authority may be advisable.