title: [Clinical Problems before Initiating Pharmacotherapy for Insomnia].
abstract: Insomnia is one of the most common complaints of psychiatric patients. Educational approaches for mental health always recommend early detection and intervention for insomnia. However, too much emphasis on insomnia may lead to overdiagnosis and overtreatment. Psychiatrists are often accused of overprescribing hypnotics to patients with sleep disturbance. This drug is difficult to discontinue due to factors associated with both patients and prescribers. In order to prevent the unneccessary administration of hypnotics, clinicians should evaluate both the sleep quality and daytime activities of patients. A sleep diary may help this process. Clinicians should prescribe hypnotics only when a patient's sleep disturbance is neither a part of the symptoms of major psychiatric disorders nor sleep-wake schedule disorders, and is not a consequence of inadequate lifestyle behavior. The reasonable goal of hypnotic treatment should be set in advance, and then pharmacological and psychosocial interventions for insomnia should be initiated.
authors.forename: Jun'ichi
authors.initials: J
authors.lastname: Semba
mesh_terms: D000368:Aged; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives