Psychiatry AdvisorInsomnia Treatment in Primary Care: Expert Panel Recommendations

Insomnia is often underrecognized and undertreated in primary care settings. A panel of experts convened by Haymarket Medical Education emphasizes the importance of considering comorbid medical and psychiatric illnesses in patients with insomnia and recommends proactive screening and personalized treatment strategies.

As a psychiatrist, neurologist, or other sleep disorder professional, you may often be on the front lines of managing insomnia, a condition that is increasingly prevalent yet remains underrecognized in primary care settings. A recent report by a panel of experts provides crucial insights and recommendations to enhance our approach to this pervasive sleep disorder:

• Insomnia significantly impacts daytime functioning and overall health, yet remains underrecognized in primary care.
• Comorbid medical and psychiatric illnesses are common in patients with insomnia and should be considered in treatment decisions.
• Primary care clinicians should proactively screen patients for insomnia, especially those with a medical or psychiatric condition.
• Personalized treatment strategies combining healthy lifestyle habits and well-monitored medication use can lead to optimal outcomes.
• Nonpharmacologic strategies, including lifestyle changes, sleep hygiene techniques, and cognitive behavioral therapy (CBT), are recommended as first-line treatment.
• Pharmacologic therapies, including benzodiazepines, benzodiazepine receptor agonists, dual orexin receptor antagonists (DORAs), and off-label use of certain medications, may be necessary for some patients.
• Over-the-counter (OTC) agents, supplements, and medical marijuana are also considered in the treatment of insomnia.