Annals of Indian Academy of Neurology
: 2010  |  Volume : 13  |  Issue : 2  |  Page : 94--102

Diagnosis and treatment of chronic insomnia

Sahoo Saddichha 
 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India

Correspondence Address:
Sahoo Saddichha
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore

Insomnia is a disorder characterized by inability to sleep or a total lack of sleep, prevalence of which ranges from 10 to 15% among the general population with increased rates seen among older ages, female gender, White population and presence of medical or psychiatric illness. Yet this condition is still under-recognized, under-diagnosed, and under-treated. This article aims to review the operational definitions and management of chronic insomnia. A computerized search on PubMed carried from 1980 to January 2009 led to the summarization of the results. There are several strategies to manage chronic insomnia. To initiate treatment, it is necessary to define it and differentiate it from other co-morbid psychiatric disorders. Non-pharmacologic strategies such as stimulus control therapy and relaxation and cognitive therapies have the best effect sizes followed by sleep restriction, paradoxical intention and sleep hygiene education which have modest to less than modest effect sizes. Among pharmacotherapeutic agents, non-benzodiazepine hypnotics are the first line of management followed by benzodiazepines, amitryptiline and antihistaminics. However, adequate trials of combined behavior therapy and pharmacotherapy are the best course of management.

How to cite this article:
Saddichha S. Diagnosis and treatment of chronic insomnia.Ann Indian Acad Neurol 2010;13:94-102

How to cite this URL:
Saddichha S. Diagnosis and treatment of chronic insomnia. Ann Indian Acad Neurol [serial online] 2010 [cited 2020 Apr 8 ];13:94-102
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