Advances in the management of chronic insomnia

BMJ. 2016 Jul 6;354:i2123. doi: 10.1136/bmj.i2123.

Abstract

Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients' health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these treatments. However, in recent years, alternative ways of providing these behavioral therapies that make them more widely available have been investigated. Drugs also play an important role in the treatment of insomnia and new drugs have been introduced as options for treating patients with sleep initiation and sleep maintenance insomnia. In this review, we will discuss advances in the past six years in both non-pharmacologic and pharmacologic treatments for patients with chronic insomnia. We will also review the controversies surrounding some of the current drug treatments, as well as the role that technology and personal activity monitoring devices may play in treating insomnia.

Publication types

  • Review

MeSH terms

  • Cognitive Behavioral Therapy*
  • GABA Agents / therapeutic use*
  • Humans
  • Prevalence
  • Relaxation Therapy*
  • Severity of Illness Index
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Therapy, Computer-Assisted*
  • Treatment Outcome
  • gamma-Aminobutyric Acid / therapeutic use*

Substances

  • GABA Agents
  • gamma-Aminobutyric Acid