Nonpharmacologic strategies in the management of insomnia

Many psychiatric patients have significant sleep disturbance. Insomnia should be addressed directly even when comorbid with a psychiatric disorder. Nonpharmacologic treatments are effective and especially well suited for long-term management of sleep problems. Although the techniques themselves are fairly straightforward, they work best when applied with the kind of clinical insight and experience that psychiatrists regularly draw on in their practices. This article briefly reviews the evaluation of insomnia, with the aim of eliciting clinical material sufficiently comprehensive to inform the choice of treatment, and provides a practical overview of the basic nondrug approaches to insomnia, emphasizing what the clinician and the patient may expect from their application.