Article May 1, 2004

The Changing Perspective on Chronic Insomnia Management

Andrew D. Krystal, MD

J Clin Psychiatry 2004;65(suppl 8):20-25

Article Abstract

A particular challenge in the treatment of insomnia is management of chronic insomnia, which occursin a substantial portion of the population. A number of factors suggest the importance of identifyingthis condition as distinct from short-term insomnia in clinical practice and treating these 2 entitiesdifferently. Yet, there is no consensus about how to make this distinction or how to manage patientsbeyond the short term. Clinicians have been without guidance as to how to address the significantchallenges associated with treating patients long term with any of the currently available treatments.In recent years, however, new studies have suggested the emergence of a changing perspective on themanagement of chronic insomnia. These studies have begun to provide an empirical basis for makingdecisions in the treatment of patients with chronic insomnia. They suggest that clinical practice isevolving toward an improved capacity to treat insomnia, with treatments that can safely lead to sustainedefficacy.