Insomnia

“Insomnia is a common problem among patients who present to family physicians, resulting in lost productivity, decreased quality of life, and increased morbidity. Consequences of insomnia include fatigue, mood disturbances, and problems related to employment and relationships.”
Am Fam Physician. 2009;79:125-130


A review of studies of nonpharmacologic interventions for insomnia has shown these interventions produce reliable, sustained improvements in sleep patterns without the need to resort to medications. Medication may be necessary for immediate symptom relief. Additionally, cognitive psychotherapy has been shown to produce reliable and sustained improvements in sleep patterns of patients with insomnia.Insomnia results from a variety of causes. Often, misconceptions and worry about sleep, as well as many sleep-disruptive habits, serve important roles in causing and main-taining insomnia problems. When this is the case, behavioral therapies designed to address these causes are often required to eliminate the sleep difficulties. Cognitive Behavior Therapy for insomnia has multiple components, including cognitive psychotherapy, sleep hygiene, stimulus control, relaxation therapy, and therapies relevant to sleep efficiency. The goals of cognitive psychotherapy are to identify the patient’s dysfunctional beliefs concerning sleep, to challenge the validity of these beliefs, and to replace them with substitutes allowing better adaptation. Stimulus control therapy helps patients to associate the bedroom with sleep and sex only and going to bed only when a person is tired. “Because of its sustained effects, nonpharma-cologic therapy may be more cost-effective than pharmacotherapy.”
Am Fam Physician. 2009;79:125-130


“Anxiety often manifests as a physical

symptom like pain, fatigue, or inability

to sleep, so it’s not surprising that one

out of five patients who come to a

doctor’s office with a physical

complaint have anxiety.”

Kurt Kroenke, M.D.