title: The changing perspective on chronic insomnia management.
abstract: A particular challenge in the treatment of insomnia is management of chronic insomnia, which occurs in a substantial portion of the population. A number of factors suggest the importance of identifying this condition as distinct from short-term insomnia in clinical practice and treating these 2 entities differently. Yet, there is no consensus about how to make this distinction or how to manage patients beyond the short term. Clinicians have been without guidance as to how to address the significant challenges associated with treating patients long term with any of the currently available treatments. In recent years, however, new studies have suggested the emergence of a changing perspective on the management of chronic insomnia. These studies have begun to provide an empirical basis for making decisions in the treatment of patients with chronic insomnia. They suggest that clinical practice is evolving toward an improved capacity to treat insomnia, with treatments that can safely lead to sustained efficacy.
authors.affiliation: Duke University Medical Center, Durham, NC, USA. krystal@phy.duke.edu
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Krystal
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000145:classification / Q000188:drug therapy / Q000628:therapy*; D009626:Terminology as Topic; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006634:Histamine H1 Antagonists; D006993:Hypnotics and Sedatives