The definitions and diagnoses of insomnia vary widely. Problem sleep is a prominent symptom of many somatic and emotional illnesses. 1 Risk factors for insomnia include older age, female gender, shift work, and comorbid medical or psychiatric conditions. Approximately one-third of all people will suffer from chronic insomnia at some point in their lifetime, and one-tenth of them will have significant daytime impairment as a result. Chronic insomnia is associated with impairments in many aspects of interpersonal difficulties, quality of life, substance abuse, cognition, risk of psychiatric disease, work-related problems, and accident proneness. * Corresponding author: Steven Lippmann, MD, University of Louisville School of Medicine, 401 E Chestnut St, Ste 610, Louisville, KY 40202 ( sleep is necessary for normal function and is essential for physical and psychological health. © Copyright 2016 Physicians Postgraduate Press, Inc.ĪDepartment of Family Medicine, North Memorial Hospital, University of Minnesota, MinneapolisīUniversity of Minnesota and Regions Hospital, Minneapolis-St PaulĬDepartment of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky This article reports the results of a literature search related to pharmacotherapy for insomnia and presents 4 clinical vignettes with corresponding treatment options. Frequently, there are multiple coexisting medical and psychiatric conditions, drug interactions, concern regarding use of habit-forming sleep aids, and paucity of time in office visits to discuss management of sleep difficulties. Pharmacotherapy for insomnia in primary care settings can be challenging.
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