title: Chronic insomnia.
abstract: OBJECTIVE
  This article provides an overview of current strategies for evaluating and treating patients who experience chronic insomnia.
  
  
  RESULTS
  The US Food and Drug Administration (FDA) has approved several medications for the treatment of insomnia that incorporate a variety of pharmacodynamic and pharmacokinetic properties, thus allowing the development of a customized therapeutic approach. FDA-approved medications include γ-aminobutyric acid-modulating benzodiazepine receptor agonists, a melatonin receptor agonist, and a histamine receptor agonist. Psychological and behavioral techniques combined as cognitive-behavioral therapy also have been shown to be effective in the treatment of chronic insomnia.
  
  
  CONCLUSIONS
  Insomnia is the most common sleep disturbance and represents a chronic condition for many people. Difficulty falling asleep and maintaining sleep are highly prevalent problems in patients with neurologic disorders. Multiple factors typically contribute to insomnia. Accordingly, a rather broad approach to evaluating patients is warranted. Evidence-based guidelines support the use of cognitive and behavioral strategies and selected medications in the treatment of patients with chronic insomnia.
authors: Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Box 151, Baltimore, MD 21224, USA. neubauer@jhmi.edu
authors: David N
authors: DN
authors: Neubauer
mesh_terms: D015928:Cognitive Behavioral Therapy; D018755:GABA Agonists / Q000627:therapeutic use; D017442:Histamine Agonists / Q000627:therapeutic use; D006801:Humans; D044094:Receptors, Melatonin / Q000819:agonists; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D018755:GABA Agonists; D017442:Histamine Agonists; D044094:Receptors, Melatonin