PMID: 19298103Mar 28, 2009

Current and new thinking in the management of comorbid insomnia

The American Journal of Managed Care
David N Neubauer

Abstract

Insomnia occurs predominantly in conjunction with a medical or psychiatric illness. New thinking regarding the treatment of comorbid insomnia has moved the field away from practices that called for treating the comorbid condition to resolve the coexisting insomnia to one in which the insomnia is treated as a separate condition. Although 10 medications currently are approved by the US Food and Drug Administration for the treatment of insomnia, only 2, eszopiclone and zolpidem, have been evaluated for efficacy in patients with chronic comorbid insomnia. Studies suggest clear benefits in comorbid insomnia. Nonpharmacologic treatments, such as cognitive behavioral therapy, sleep hygiene, and relaxation training, have also been investigated for comorbid insomnia, with studies suggesting these approaches may be effective either alone or in conjunction with medications. While behavioral issues should be optimized, clinicians need to customize treatments for patients with comorbid insomnia based on coexisting medical and psychiatric morbidities, age, medical history, current medications, and lifestyle issues.

Related Concepts

Zolpidem
Chronic Disease
Sleeplessness
Insomnia homeopathic medication
Psychiatry Specialty
Comorbidity
Transient Insomnia
Eszopiclone

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