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Hypnotic Medications as an Adjunct Treatment to Cognitive Behavioral Therapy for Insomnia
Paul Barkopoulos1, Joshua Hyong-Jin Cho2
1Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Insomnia Clinic, Cousins Center for Psychoneuroimmunology, University of California Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA, 90025, USA; Cedars Sinai Medical Center, 8700 Beverly Blvd #2900A, Los Angeles, CA, 90048, USA.
Abstract:
Cognitive behavioral therapy for insomnia (CBT-I) is the universally recommended treatment of choice for insomnia disorder based on its safety and posttreatment durability of benefit. However, CBT-I does not help all patients achieve remission. The second most evidence-based treatment, hypnotic pharmacotherapy (PCT), does not resolve perpetuating factors of insomnia, resulting in potential waning of benefit and dependence. This article presents a rationale that supports consideration of hypnotic augmentation of CBT-I (COMB), along with a review of select randomized controlled trials relevant to clinical decision-making.
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