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Algorithms for the assessment and management of insomnia in primary care

Authors Hilty D, Young JS, Bourgeois JA, Klein S, Hardin KA

Published 9 April 2009 Volume 2009:3 Pages 9—20


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

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