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Sleep Med Clin. 2019 Jun;14(2):253-265. doi: 10.1016/j.jsmc.2019.01.006. Epub 2019 Mar 29.

Cognitive Behavioral Therapies for Insomnia and Hypnotic Medications: Considerations and Controversies.

Author information

1
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Room S303, Pharmacy and Bank Building (A15), Science Road, Camperdown Campus, Sydney, NSW 2006, Australia; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada.
2
École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada.
3
École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. Electronic address: cmorin@psy.ulaval.ca.

Abstract

Insomnia is a costly health problem, where management has remained suboptimal despite advances in the understanding and treatment of the condition. This article provides an overview of the evidence-based treatment options of insomnia, looking at short-term and long-term therapeutic outcomes for cognitive behavioral therapies and pharmacologic therapies. Key issues of treatment delivery and implementation are highlighted at the patient and health system levels, and novel approaches for combining and sequencing treatment to maximize therapeutic outcomes for insomnia are discussed. The impact of recent updates of major clinical guidelines and future research directions for the field are discussed.

KEYWORDS:

Cognitive behavioral therapy for insomnia; Combination therapy; Pharmacotherapy; Stepped care; Treatment preference; Treatment sequencing

PMID:
31029191
DOI:
10.1016/j.jsmc.2019.01.006
[Indexed for MEDLINE]

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