Chronic Insomnia

Abstract

Chronic insomnia afflicts millions of people in the United States. It is associated with decreased quality of life, accidents, several comorbid conditions, increased morbidity, and substantial direct and indirect costs. Chronic insomnia is a multifactorial and individualized disorder. Its etiology may be cognitive or physiologic in nature (or both), and is more often than not associated with a comorbid condition, complicating its recognition, evaluation, and treatment. Effective nonpharmacotherapeutic (cognitive-behavioral therapy for insomnia) and pharmacotherapeutic (hypnotic medications) treatment modalities are available. Treatment of chronic insomnia can make a significant improvement in quality of life, and may also be associated with an improvement in comorbid conditions.

An Examination of the Relationship Between Insomnia and Tinnitus: A Review and Recommendations

“…In contrast, when one assesses the general population for more sustained symptoms lasting at least a month, the prevalence of insomnia is reduced to only a 10% rate. 42 We suspect that the diagnosis of insomnia will be reserved for only a minority of tinnitus patients who have insomnia. As our review points out, the literature has not critically answered how frequently tinnitus patients develop a diagnosis of insomnia resulting from their physical disorder.…”

Office Evaluation of the “Tired” or “Sleepy” Patient

“…The September 2009 issue of Seminars in Neurology discussed treatment of specific sleep disorders in more detail. [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] When tiredness is caused by hypersomnia and supported by an abnormal MSLT, a trial of stimulant or wake-promoting medications is usually indicated when treatment of the underlying cause of the hypersomnia fails or is incompletely effective. The American Academy of Sleep Medicine published practice parameters for treatment of hypersomnia in 2007.…”