Diagnosis and management of insomnia

The symptom of insomnia concerns not only psychiatrists, but other physicians as well. Most cases of insomnia resolve with the passage of time or when the underlying medical or psychiatric condition is treated. For situational insomnias or psychophysiologic insomnias, consider nonpharmacologic interventions before prescribing a sedative-hypnotic. When a sedative-hypnotic is indicated, the BZs are the drugs of choice because of their better margin of safety and lower potential for abuse. In most cases, limit the use of a sedative-hypnotic to several days to a few weeks.