Personalized pharmacotherapy for treatment approaches focused at primary insomnia

The treatment of primary insomnia may be complex and clinically challenging. A comprehensive multidimensional evaluation with a thorough history and physical examination coupled with appropriate testing/imaging will facilitate development of a working diagnosis. Optimal treatment strategies of challenging cases typically involve interdisciplinary team approaches (including a sleep medicine specialist) providing multimodal approaches to treatment, including nonpharmacologic and pharmacologic strategies. A stepped care approach to treatment may serve as a useful guide for health care providers unfamiliar with sleep disturbance issues. Treatment plans based on sound medical judgment, clinical insight, and a thorough and global understanding of particular patient's comorbid conditions may lead to optimal patient-specific/patient-focused/patient centered personalized care.