[Insomnia: A Practical Clinical and Therapeutic Approach]

Area of Science:

• Clinical Psychology
• Sleep Medicine
• Neurobiology

Background:

• Insomnia is a highly prevalent clinical condition with substantial mental, physical, and social impacts.
• The understanding of insomnia has evolved from a symptom to a distinct disorder with neurobiological underpinnings.

Purpose of the Study:

• To synthesize current evidence on insomnia diagnosis, pathophysiology, and management.
• To integrate cognitive perspectives and shared decision-making into clinical practice.
• To provide an updated, clinically oriented review.

Main Methods:

• Literature review of current evidence on insomnia.
• Synthesis of diagnostic criteria and perpetuating factors.
• Analysis of therapeutic strategies, including cognitive-behavioral therapy for insomnia (CBT-I) and pharmacotherapy.

Main Results:

• Diagnosis is clinical, assessing functional impact, perpetuating factors, and patient expectations.
• Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment.
• Sleep hygiene alone is insufficient; dysfunctional beliefs and shared decision-making are crucial for adherence and preventing chronicity.

Conclusions:

• Contemporary insomnia management requires an integrated, personalized, and person-centered approach.
• Treatment should combine educational strategies, psychotherapy (CBT-I), and rational pharmacotherapy.
• Shared decision-making is vital for optimizing treatment adherence and preventing chronic insomnia.