Insomnia: Assessment and Management in Primary Care Am Fam
Physician. 1999 Jun 1;59(11):3029-3038. Patients with insomnia
may experience one or more of the following problems: difficulty
falling asleep, difficulty maintaining sleep, waking up too
early in the morning and nonrefreshing sleep. In addition,
daytime consequences such as fatigue, lack of energy, difficulty
concentrating and irritability are often present. Approximately
10 percent of adults experience persistent insomnia, although
most patients do not mention it during routine office visits.
Asking sleep-related questions during the general review of
systems and asking patients with sleep complaints to keep a
sleep diary are helpful approaches in detecting insomnia.
Behavior and pharmacologic therapies are used in treating
insomnia. Behavior approaches take a few weeks to improve sleep
but continue to provide relief even after training sessions have
ended. Hypnotic medications are safe and effective in inducing,
maintaining and consolidating sleep.