This is the second of a two part article on a problem based approach to insomnia. The first article provided the general practitioner with the background and methodology of the guideline formulation process. It also included recommendations on diagnosis and differential diagnosis of insomnia. In this article, the guideline covers recommendations on the diagnostic and therapeutic options for patients with insomnia. © 2003 Blackwell Publishing Asia and Wonca

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This article describes the 3-year residency training program for Family Medicine specialists in the Philippines. Although the training is hospital based, 50% of the time is spent in ambulatory care, mainly in the clinic run by the Family Medicine department at the base hospital outpatient section and in the community. Contents of the program have been clarified with the review of the definitive competencies of family physicians. Learning strategies adhere to the principles of adult learning -supervised, experiential and participatory. Assessment is both formative, with feedback mechanisms, and summative, for determination of promotion to the next level and graduation.

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Background: Insomnia is noted to occur in 10-40% of patients seen in primary care practice. It has a number of daytime consequences and affects quality of life. Furthermore, it may herald an underlying psychiatric or other medical comorbidity. As such, any primary care physician should be equipped with a simple problem-based approach for this problem. Methods: A technical research committee of the Department of Family and Community Medicine-Family Medicine Research Group of the Philippine General Hospital developed recommendations after performing a thorough review of the medical literature using a Medline search. Articles retrieved were appraised and validated and used as evidence for the various recommendations made.Recommendations: This is the first of a two part article. In this article, the guideline covers recommendations on the definition and differential diagnosis. In the second article, diagnostic examinations and therapeutic options for patients with insomnia will be covered.