Insomnia - goal of treatment97
- to lessen suffering
- to improve daytime function
Diagnosis and management of both the insomnia and, if present, its cause is important where possible. Traditionally, the treatment aim in primary insomnia has been to reduce insomnia symptoms alone. In secondary insomnia, the focus has been treatment of the associated condition hopefully leading to a resolution of the insomnia. However, as recently identified by the American Psychiatric Association3, it is often difficult to establish the precise nature of the relationship between the insomnia and a comorbid condition. Therefore management may need to be more mindful of both conditions, with the insomnia considered as a target for intervention rather than merely a symptom of another medical problem.
Non-pharmacological interventions are established as first-line therapy in the management of primary insomnia with behavioural and cognitive techniques being considered effective, especially when used in combination6351545779. Behavioural therapies, including sleep hygiene, sleep consolidation, stimulus control, relaxation therapy and cognitive behavioural therapy (CBT) have been demonstrated to be as effective as pharmacotherapy both in the short-term97507088 and in the long-term treatment of insomnia53.