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Waking Up to Insomnia: What’s New in the World of ...
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The document provides an overview of updates in the field of hypnotic medications for the treatment of insomnia. It highlights the high prevalence of insomnia, noting that approximately 30% of the general population experiences it, with a significant portion suffering from daytime functional impairment. The document outlines the diagnostic criteria for insomnia disorder from the DSM-5 and discusses the associated functional and health-related consequences, including depression, hypertension, and an increased risk of suicidality.<br /><br />A key focus is on the various treatments available for insomnia, split into behavioral and pharmacological approaches. Cognitive Behavioral Therapy for Insomnia (CBT-i) is highlighted as the gold standard for behavioral treatment, with evidence from multiple studies supporting its efficacy. The document discusses sleep hygiene practices, including 'dos' and 'don'ts' to improve sleep habits.<br /><br />Pharmacologically, the document details different classes of sleep medications, including benzodiazepine receptor agonists, melatonin receptor agonists, and dual orexin receptor antagonists. Potential adverse effects of these medications are noted, particularly their impact on vulnerable populations such as the elderly or those with respiratory compromises. The document also examines the role of complementary and alternative medicine approaches, such as tai chi and yoga, though these have mixed evidence of efficacy.<br /><br />Given the complexity of insomnia and its treatment, the document emphasizes a personalized approach to therapy, considering patient-specific factors and the pharmacodynamics and pharmacokinetics of medications. Regular follow-ups are advocated for monitoring treatment effectiveness and adjusting therapies as necessary. Finally, it promotes an integrated treatment strategy combining cognitive-behavioral techniques with pharmacological treatments to manage insomnia effectively.
Keywords
insomnia
hypnotic medications
Cognitive Behavioral Therapy
pharmacological treatments
DSM-5
sleep hygiene
benzodiazepine receptor agonists
melatonin receptor agonists
dual orexin receptor antagonists
integrated treatment strategy
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