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Patients with this relatively uncommon form of insomnia have a marked propensity to underestimate sleep duration and overestimate wakefulness relative to polysomnographic measures.
May 15, 2017 Issue
Treatment of Chronic Insomnia in Adults: ACP Guideline [Practice Guidelines]
The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, distress, and dysfunction.
Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.
Loud snoring, gasping during sleep, morning headache, and daytime sleepiness can predict sleep apnea. Learn which sleep study is the diagnostic standard, and which positive airway pressure therapy is first-line treatment.
Suvorexant effectively increases total sleep time and decreases time to sleep onset. Because of its risk of abuse, significant incidence of next-day impairment, and high cost, it should be reserved for use in patients for whom other insomnia therapies, such as cognitive behavior therapy and lifestyle changes, have failed.
A five-component approach to changing patients' beliefs and behaviors surrounding sleep is effective, at least in the short term, in getting persons to fall asleep and stay asleep, although total sleep time is not increased.
Nonpharmacologic behavioral interventions are effective and recommended as an initial approach to the treatment of chronic insomnia. Learn more about the varying approaches.
An oral appliance does not improve daytime sleepiness or other measures of a good night's sleep. It does, however, decrease apnea scores, snoring, and restless legs. Although not studied, these improvements may be valuable for bed partners who sleep each night enduring patients' lower limb restlessn...
The American College of Physicians (ACP) has developed a guideline to assist physicians in choosing the best initial treatment for adults with Obstructive Sleep Apnea (OSA). Management is based on type and severity of symptoms and on patient education about the benefits vs. adverse effects associated with the treatment options.
Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance. Obstructive sleep ...