Back to Journals » Nature and Science of Sleep » Volume 2

Management of insomnia: update and new approaches

Authors Unbehaun T, Spiegelhalder K, Hirscher V, Riemann D

Published 28 July 2010 Volume 2010:2 Pages 127—138


Review by Single anonymous peer review

Peer reviewer comments 3

Thomas Unbehaun, Kai Spiegelhalder, Verena Hirscher, Dieter Riemann

Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany

Abstract: Insomnia is the most prevalent sleep disorder worldwide. A number of studies evaluated the efficacy of pharmacological and nonpharmacological treatment approaches. To obtain long-term effects in the management of chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) is the treatment of first choice, encompassing education about sleep and sleep hygiene, sleep restriction, stimulus control, relaxation techniques, and cognitive strategies to combat nocturnal ruminations. Short-term effects can easily be achieved by the administration of hypnotic drugs. Gaining access to all types of treatment can still be considered a problem, especially CBT-I seems to be available only at specialized centers but not in general health care. New approaches to treatment delivery seem to be necessary to provide adequate care for patients who may seek help or have not entered the health care system yet. Internet-based treatment options and stepped-care models might be feasible options for the future. Otherwise, the direct and indirect costs associated with insomnia might further increase for our societies, in addition to the personal impact on aspects of quality of life and impaired daytime functioning for each individual with insomnia. Besides, well-established psychological and pharmacological treatment options, alternative treatments like acupuncture might constitute new nonpharmacological possibilities. Randomized controlled studies are needed to evaluate the efficacy of this and other new approaches to treat insomnia.

Keywords: treatment, access, pharmacological, CBT-I

Creative Commons License © 2010 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.