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A 2023 Update on Managing Insomnia in Primary Care: Insights From an Expert Consensus Group
Russell P Rosenberg1,2, Ruth Benca3, Paul Doghramji4,5
1NeuroTrials Research, Inc, Atlanta, Georgia.
The Primary Care Companion for CNS Disorders
|January 27, 2023
Summary
Insomnia disorder is common but often overlooked. Optimal management requires a comprehensive, individualized approach combining behavioral strategies and pharmacotherapy, addressing gaps in current recognition and treatment.
Area of Science:
- Sleep Medicine
- Psychiatry
- Primary Care
Background:
- Insomnia disorder is highly prevalent yet frequently underdiagnosed and undertreated.
- It is increasingly recognized as a distinct disorder, not solely a symptom of other conditions.
- Subtypes of sleep disturbance and comorbidities necessitate a tailored therapeutic strategy.
Purpose of the Study:
- Evaluate current insomnia disorder management.
- Identify gaps in recognition and treatment.
- Develop educational recommendations for primary care providers.
Main Methods:
- Convened an Insomnia Working Group with experts in primary care, psychiatry, and research.
- Reviewed data on available therapies, including recent medication approvals.
- Incorporated patient perspectives and shared best practices for multimodal treatment.
Main Results:
- Common pharmacotherapies for insomnia carry risks of adverse effects, including next-day impairment.
- Dual orexin receptor antagonists offer a novel pharmacologic option.
- Multimodal treatment integrating lifestyle, behavioral, and pharmacologic strategies is optimal.
Conclusions:
- A comprehensive, individualized approach is crucial for effective insomnia disorder management.
- Addressing maladaptive thoughts and behaviors related to sleep is key.
- Pharmacotherapy selection should be based on patient-specific factors and complaints.
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