Algorithms for the assessment and management of insomnia in primary care

Expert Opinion

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Authors: Donald Hilty, Julie S Young, James A Bourgeois, Sally Klein, et al

Published Date April 2009 Volume 2009:3 Pages 9 - 20

DOI: http://dx.doi.org/10.2147/PPA.S2670

Donald Hilty¹, Julie S Young¹, James A Bourgeois¹, Sally Klein², Kimberly A Hardin³

¹Department of Psychiatry and Behavioral Sciences; ²UC Davis Medical Center; ³Sleep Medicine Fellowship Training Program, University of California Davis, Sacramento, CA, USA

Abstract: Insomnia is a leading cause of sleep disturbance in primary care practice affecting >30% of people in the United States and can result in psychological and physiological consequences. We aim for a focused discussion of some of the underpinnings of insomnia and practical tips for management (eg, algorithms). A PubMed search was conducted using English language papers between 1997–2007, with the terms “sleep,” “insomnia”; “primary care” and “clinics”; “comorbid conditions”; “treatment” and “management.” Sleep, psychiatric and medical disorders significantly affect sleep, causing patient suffering, potentially worsening of other disorders and increasing the use of primary care services. We provide an outline for practical assessment and treatment of insomnia in primary care, including the strengths and weaknesses of medications.

Keywords: insomnia, primary care, depression, anxiety, sleep, disorder