Overcoming Barriers to the Diagnosis and Treatment of Insomnia

LEARNING OBJECTIVES
• Apply evidence-based diagnostic guidelines for patients who have clinical features consistent with insomnia
• Use evidence-based guidelines to develop comprehensive treatment
plans that include cognitive-behavioral therapy, pharmacologic treatment, and combination therapies to achieve optimal outcomes
• Identify basic elements of cognitive behavioral therapy for insomnia
• Differentiate among medications FDA-approved for treating insomnia
by discussing mechanism of action, safety, efficacy, and use

Insomnia, defined as difficulty initiating or maintaining sleep with associated daytime consequence, is 1 of 7 sleep-wake disorders according to the International Classification of Sleep Disorders, 3rd edition (ICSD-3). Insomnia is common, particularly among older adults.
The estimated prevalence varies based on the criteria, ranging from 22% using DSM-IVTR, 15% using Research Diagnostic Criteria/ICSD-2, and 4% using ICD-10 criteria.

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