![]() Various neurotransmitters act as a kind of messenger service between neurons in the brain during the sleep-wake cycle. While he’s not an advocate for using medication as a first line treatment for insomnia, Rosenberg said he sometimes recommends it as an effective short term strategy. But this can backfire because marijuana use is sometimes a contributor to chronic insomnia. “It’s important to stay informed about the use of nonprescription drugs to make sure they aren’t actually making things worse.”įor example, Rosenberg said many patients are turning to marijuana in hopes of better shuteye, especially as it is legalized and decriminalized in many states. “Clinicians should educate patients about the risks and benefits of over-the-counter options, including herbal remedies and supplements,” Rosenberg said. However, patients often reach for over-the-counter remedies instead, sometimes without mentioning it to their doctor. Medication can be used along with CBT, Rosenberg explained. For example, changing negative thought patterns related to depression and anxiety can increase a patient’s chances of getting to sleep and staying asleep. It’s a behavior change technique that involves non-drug approaches such as sleep hygiene, relaxation, and cognitive strategies to improve sleep. The new guidelines recommend trying a combination of lifestyle changes, improved sleep habits, and cognitive behavioral therapy (CBT) before trying a sleeping aid or in combination with the aid.ĬBT is the first line of treatment recommended by major sleep organizations, Rosenberg said. “But it could partly be due to the anxiety around contracting the disease.” Nonpharmacologic Therapies “We don’t exactly know the relationship between a viral infection like COVID, and sleep and insomnia,” Rosenberg admitted. It’s common for patients who toss and turn on a regular basis to be diagnosed with comorbidities like depression, cardiovascular disease, or in more recent history, COVID-19. But the relationship between insomnia and other medical conditions is complex and “can go both ways as sort of a chicken-and-egg thing,” Rosenberg explained. Managing slumber habits can be hugely beneficial in dealing with physical and psychological outcomes across the board. By Rosenberg’s estimate, somewhere around 17 percent of patients have insomnia that rises to the clinical level of insomnia disorder.Ĭlinicians shouldn’t make light of sleep troubles, Rosenberg said. Prescription Sleep Meds May Up Risk of Dementia by 79% in White Seniorsīad Dreams and Nightmares Preceding Suicidal BehaviorsĪlmost 50 percent of primary care patients experience insomnia, but only 30 percent of them mention the issue to their physician, and only six percent seek medical help for difficulties sleeping. The Insomnia Working Group, led by Rosenberg, met in March 2022 to review data on available therapies and share evidence-based practices for helping people get a better night’s sleep.Ī 2023 Update on Managing Insomnia in Primary Care “Insomnia is a highly prevalent problem that’s often under-treated and oftentimes under-recognized,” said Russell Rosenberg, MD, the chief science officer of NeuroTrials Research, Atlanta School of Sleep Medicine.Īny time a patient has difficulty falling or staying asleep, insufficient sleep duration, early waking, or next-day impairment on a regular basis, it’s time to consider a targeted, individualized approach to therapy. Insomnia should be considered a distinct disorder rather than a secondary symptom of another medical or psychiatric illness, says the author of a new consensus guideline on managing insomnia in primary care (recently published in The Primary Care Companion for CNS Disorders). Pharmacological solutions should be short term and watch out for negative side effects.Consider non-pharmacological solutions first and be sure to monitor patients for over-the-counter sleep aid use.Somewhere around 17 percent of patients have insomnia that rises to the clinical level of insomnia disorder and many more have regular problems with poor sleep.The Insomnia Working Group reviewed data on available therapies to develop evidence-based practices for helping people get a better night’s sleep. ![]() Clinical Relevance: Insomnia is a distinct disorder that clinicians should discuss with patients and help manage if necessary
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