The state of insomnia and emerging trends.
Recent research into the pathophysiology of insomnia has brought a shift in the approach to treatment. Insomnia rarely occurs in isolation and is typically comorbid with other conditions. Rather than simply treating the primary disorder, whereby symptoms of insomnia may go unaddressed, now there is a push to acknowledge the existence of chronic insomnia as a disorder that itself merits treatment. This recognition is due to the identification of pathophysiologic changes and associated morbidity, which can be substantial. Insomnia patients have increased risk for psychiatric disorders, especially depression, anxiety, decreased quality of life, increased healthcare utilization and costs, drug/alcohol abuse, decreased occupational performance, and increased falls/accidents. Current management patterns explore non-nightly or discontinuous hypnotic treatment - non-nightly flexible, non-nightly semiflexible, non-nightly fixed, and flexible timing - which deviates from past trends of continuous dosing with hypnotics. These trends reflect a change from considering insomnia a symptom to treating insomnia as a disorder.
Roth
Thomas
T
Xcenda, 1528 Preston St, Salt Lake City, UT 84108, USA.
Franklin
Meg
M
Bramley
Thomas J
TJ
D001569:Benzodiazepines / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008329:Managed Care Programs; D011788:Quality of Life; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology* / Q000628:therapy*
D006993:Hypnotics and Sedatives; D001569:Benzodiazepines