Insomnia in primary care: Considerations for screening, assessment, and management

Author:

Yamamoto Mari1ORCID,Lim Christopher T2,Huang Heather3,Spottswood Margaret45,Huang Hsiang67

Affiliation:

1. Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA

2. Department of Psychiatry, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

3. Departments of Internal Medicine and Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

4. Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA

5. Community Health Centers of Burlington, Burlington, VT, USA

6. Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA

7. Harvard Medical School, Boston, MA, USA

Abstract

Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.

Publisher

SAGE Publications

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