Insomnia: diagnosis & treatment

How to effectively assess and manage an adult patient with insomnia, including the management of chronic insomnia disorder.

Insomnia can occur as an acute, recurrent or chronic problem. Chronic insomnia often occurs with comorbid medical or psychiatric illness (e.g. obstructive sleep apnoea or depression).

Cognitive behavioural therapy for insomnia is often successful in treating insomnia.

Comorbid conditions also need to be addressed. In some situations, both non-pharmacological and pharmacological strategies are required to manage insomnia.

Learning objectives:

• Be aware of the presentation of sleep disorders in primary care.
• Understand the diagnosis of chronic insomnia disorder.
• Be able to identify key questions to ask patients about their sleep.
• Be able to name first-line treatment options for chronic insomnia.
• Be aware of the components of cognitive behavioural therapy for insomnia and brief behavioural therapy for insomnia.
• Be able to name brief approaches for chronic insomnia that could be used.
• Understand the basic principles of sleep restriction/bedtime restriction therapy.
• Understand when sleep restriction/bedtime restriction therapy may not be appropriate.
• Understand the basic principles of stimulus control therapy.
• Understand when to seek specialist advice regarding sleep issues in patients.

Acknowledgements

This course was reviewed and updated by Dr Karen Falloon, with thanks to the Australasian Sleep Association’s (GP education subcommittee) for reviewing the updates and to Dr Alex Sweetman for providing video content.