Friday, September 03, 2010

New Guidelines For Insomnia: British Report Rounds Up The Research

Recognizing that...
"Sleep disorders are common in the general population and even more so in clinical practice, yet are relatively poorly understood by doctors and other health care practitioners,"
... the British Association for Psychopharmacology (BAP) on Tuesday released guidelines for the diagnosis and treatment of insomnia and other sleep disorders. The recommendations do not address sleep problems from apnea/hypopnea, restless legs, narcolepsy, and other conditions:

British Association For Psychopharmacology Consensus Statement On Evidence-Based Treatment Of Insomnia, Parasomnias And Circadian Rhythm Disorders, Journal of Psychopharmacology, Sept, 2010

The guidelines emphasize that insomnia should be diagnosed and treated because it is associated with increased risk for depression, anxiety, and cardiovascular disorders.

Treatments included:1
  • Cognitive behavioral therapy (CBT). This is talk therapy which "consists of sessions with a therapist that focus on helping you change your habits and thoughts in a way that helps you sleep."2 It is considered so effective and long lasting (compared to drugs) that BAP says it should be offered as first-line treatment.
  • Hypnotic drugs (sleeping pills). BAP recommends that efficacy, safety, duration of action, and history of substance abuse or dependence be considered. They also say patients should take breaks from these meds every 3 or 6 months to reduce risk of dependency.
  • Antidepressants.
  • Antipsychotic drugs. Because of adverse effects and possible abuse these aren't indicated as first-line treatment for sleep disorders.
  • Antihistamines (Sominex, Nytol). These have a limited role and can cause drowsiness.
Other treatments noted for special populations included:
  • Hormone therapy for women after menopause
  • Melatonin
  • Scheduled light exposure
  • Behavioral strategies
Do you suffer from insomnia? What have you found helpful?

1New Guidelines Issued For Insomnia And Other Sleep Disorders, Medscape, Sept 2 2010
2 Talking Therapy ‘Best Option For Insomnia’, WebMD, Sept 2 2010