Special Considerations in Insomnia Diagnosis and Management: Depressed, Elderly, and Chronic Pain Populations

Patients with insomnia who also have chronic pain or depression or who are elderly represent segmentsof the population that are particularly difficult to treat. These populations tend to be at higherrisk for experiencing difficulty sleeping and are more likely to experience chronic insomnia, sleepmaintenance problems, and/or nonrestorative sleep. Worsening insomnia may exacerbate othersomatic and psychological symptoms and vice versa. Conversely, there is evidence that appropriaterecognition and management of the sleep complaint may alleviate other symptoms related to the associatedcondition and help interrupt this vicious cycle.