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The Treatment of Comorbid Insomnia

Published online by Cambridge University Press:  07 November 2014

W. Vaughn McCall
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Extract

There are many new findings in the area of comorbid insomnia. Almost 50% of all cases of chronic insomnia are due to a mental disorder, with depressive illness explaining the majority of cases related to mental disorder (Slide 1). Other common causes of comorbid, or secondary, insomnia include chronic respiratory disease such as asthma and chronic obstructive pulmonary disease, chronic pain, degenerative neurological disease, and some medications such as glucocorticoids and serotonin reuptake inhibitors. A general principle of management of insomnia related to mental or medical disorders is that the principal disorder must be fully treated as part of the insomnia treatment plan. If there is an offending medication, it must be discontinued if possible.

Type
Expert Panel Supplement
Information
CNS Spectrums , Volume 14 , Issue S13: The Sleep Cycle: A Four Stage Educational Initiative in Insomnia , December 2009 , pp. 10 - 12
Copyright
Copyright © Cambridge University Press 2009

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References

1.Buysse, DJ, Reynolds, CF 3rd, Hauri, PJ et al. , Diagnostic condordance for DSM-IV sleep disorders: a report from the APA/NIMH DSM-IV field trial. Am J Psychiatry. 1994;151:1351–1360.Google Scholar
2.Ford, DE, Kamerow, DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262(11):1479–1484.CrossRefGoogle ScholarPubMed
3.Weissman, M, Bland, R, Canino, G et al. , Cross-national epidemiology of major depression and bipolar disorder. JAMA. 1996;276:293–299.CrossRefGoogle ScholarPubMed
4.McCall, WV, Reboussin, BA, Cohen, W. Subjective measurement of insomnia and quality of life in depressed inpatients. J Sleep Res. 2000;9:43–48.CrossRefGoogle ScholarPubMed
5.Nierenberg, AA, Keefe, BR, Leslie, VC et al. , Residual symptoms in depressed patients who respond acutely to fluoxetine. J Clin Psychiatry. 1999;60:221–225.CrossRefGoogle ScholarPubMed
6.Standards of Practice Committee of the American Sleep Disorders Association. Practice Parameters for the use of polysomnography in the evaluation of insomnia. Sleep. 1995;18:55–57.Google Scholar
7.Asnis, GM, Chakraburtty, A, DuBoff, EA et al. , Zolpidem for persistent insomnia in SSRI-treated depressed patients. J Clin Psychiatry. 1999;60:668–676.CrossRefGoogle ScholarPubMed
8.Ji, J, Liu, WJ, Chen, ZQ et al. , Effects of paroxetine with or without zolpidem on depression with insomnia: a multi-center randomized comparative study. Zhonghua Yi Xue Za Zhi. 2007;87:1585–1589.Google ScholarPubMed
9.Fava, M, McCall, V, Krystal, A et al. , Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder. Biol Psychiatry. 2006;59:1052–1060.CrossRefGoogle ScholarPubMed
10.Krystal, A, Fava, M, Rubens, R et al. , Evaluation of eszopiclone discontinuation after cotherapy with fluoxetine for insomnia with coexisting depression. J Clin Sleep Med. 2007;3:48–55.Google ScholarPubMed