Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science




Professor Lawrence Herman



Purpose: Millions of adults seek treatment for insomnia disorder causing daytime dysfunction, and most seek care in the primary care setting. There are medical, psychological, and financial consequences without proper care. Evidence-based medicine (EBM) recommends cognitive behavioral therapy insomnia (CBT-I) as treatment, but it is often not applied. This review will analyze why CBT-I is usually not prescribed with possible improvement recommendations.

Method: A literature search from the PubMed database using the terms "sleep-wake disorder" "insomnia disorder" "evidence-based treatment for insomnia" "insomnia treatment barriers" "nonpharmaceutical therapy for insomnia" "benzodiazepines" and "primary care." The search yielded 17 relevant articles for this literature review within the past five years.

Results: Evidence-based research substantiates CBT-I as initial treatment.

Conclusion: Although insomnia disorder is prevalent and commonly treated by PCPs, evidence-based treatment, CBT-I, often is not prescribed. This article review will highlight why PCPs often disregard CBT-I and review reliable clinical techniques to improve the PCP's utilization of EBM treatments.

Keywords: Sleep-wake disorder, insomnia treatment barriers, benzodiazepines, primary care, evidence-based medicine.


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