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A clinical algorithm for diagnosis and treatment of insomnia in adults: an updated review

Published online by Cambridge University Press:  31 October 2024

Habibolah Khazaie ,
Amir Sharafkhaneh ,
Ali Zakiei Open the ORCID record for Ali Zakiei [Opens in a new window]  and
Earl Charles Crew
Habibolah Khazaie
Affiliation:
Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Amir Sharafkhaneh
Affiliation:
Department of Medicine, Baylor College of Medicine, Houston, TX 77004, USA
Ali Zakiei*
Affiliation:
Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Earl Charles Crew
Affiliation:
Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
*
Corresponding author: Ali Zakiei; Email: [email protected]
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Abstract

Difficulty falling asleep and/or maintaining sleep are common complaints in patients visiting medical clinics. Insomnia can occur alone or in combination with other medical or psychiatric disorders. Diagnosis and management of insomnia at times are perplexing. This updated study review aimed at a clinical algorithm for diagnosis and treatment of insomnia in adults. We developed an easy-to-apply algorithm to diagnose and manage insomnia that can be used by general practitioners and non-sleep specialists. To this end, our team reviewed the previous studies to determine the prevalence, evaluation, and treatment of insomnia. We used the results to develop a clinical algorithm for diagnosing and managing insomnia.

Insomnia occurs in a short (less than 3 months duration) or chronic form (≥3 months duration). Insomnia management includes both pharmacological and non-pharmacological interventions. There is ample research evidence for the impact of a variety of non-pharmacological treatments, but both types of treatments can be used for each patient. If there are any contradictions in the diagnosis process, therapists should use objective instruments, such as polysomnography, but they should not be in a hurry to use these instruments.

Keywords

Clinical algorithmdiagnosisinsomniareviewsleep disorderstreatment
Type
Guidelines
Information
CNS Spectrums , Volume 29 , Issue 5 , October 2024 , pp. 463 - 473
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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