Cognitive behavior therapy for chronic insomnia.
Approximately 20% of patients presenting in general medical settings have severe and persistent insomnia. Studies consistently find that trouble initiating and maintaining sleep are independent risk factors for medical and psychiatric morbidity, but insomnia is often underdetected and undertreated in primary care settings. Cognitive-behavioral treatment approaches for chronic insomnia and related sleep disorders have been shown to be effective in various patient populations. This article reviews the most common cognitive-behavioral interventions for insomnia, and discusses their efficacy and durability. Possible adaptations for the integration of these approaches into primary care settings and a description of the emerging field of behavioral sleep medicine as a resource for health care providers treating patients with chronic insomnia are also presented.
Smith
Michael T
MT
Johns Hopkins School of Medicine, Department of Psychiatry, Behavioral Medicine Research Laboratory and Clinic, Baltimore, Maryland, USA. msmith62@jhmi.edu
Neubauer
David N
DN
D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D020920:Dyssomnias / Q000150:complications; D006801:Humans; D010353:Patient Education as Topic; D011320:Primary Health Care; D012064:Relaxation Therapy; D012892:Sleep Deprivation / Q000150:complications; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000628:therapy*