Chronic Insomnia Pharmacological Treatment: Practice Guideline

According to the International Classification of Sleep Disorders (Third Edition), Insomnia is defined as

  • either trouble initiating or maintaining sleep, 
  • associated with daytime consequences, and
  • not attributable to environmental circumstances or inadequate opportunity to sleep.

Insomnia is defined as chronic when:

  • >3 months duration with
  • at least 3 times/week

Although CBT-I is the first line treatment for chronic insomnia, it is clinically relevant to have the knowledge of recommended medications for various types of insomnia. 

Let’s begin by answering this clinically relevant question:

Which of the following medication is recommended for both Sleep Onset and Sleep Maintenance insomnia?

Answer: Temazepam.

  • Note that Trazodone is not recommended fo either sleep onset or sleep maintenance insomnia.

Psychiatry Education Forum Academy’s next video discussion has summarized the most recent practice guidelines released by the American Academy of Sleep Medicine for the pharmacological management options for chronic insomnia in adults:

This video discussion will answer the following clinically relevant questions:

  1. Medications indicated for Sleep Onset Insomnia.
  2. Medications indicated for Sleep Maintenance Insomnia.
  3. Medications indicated for both Sleep Onset & Maintenance Insomnia.
  4. Which medications should be avoided for chronic insomnia.

The topic will be summarized in the following table for ease of understanding:

Here is the Summary Slide for SUVOREXANT:

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