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Review
. 2023 Mar 15:7:27550834231156727.
doi: 10.1177/27550834231156727. eCollection 2023 Jan-Dec.

Insomnia in primary care: Considerations for screening, assessment, and management

Mari Yamamoto  1 , Christopher T Lim  2 , Heather Huang  3 , Margaret Spottswood  4   5 , Hsiang Huang  6   7
Affiliations
Review

Insomnia in primary care: Considerations for screening, assessment, and management

Mari Yamamoto et al. J Med Access. .

Abstract

Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.

Keywords: Sleep initiation and maintenance disorders; behavioral medicine; cognitive behavioral therapy for insomnia (CBT-I); insomnia; insomnia treatment; primary health care.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr C.T.L. reports receiving consulting fees from Aetna Inc., Lyra Health, and CVS Health. Drs C.T.L. and H.H. report receiving research funding from Humana Inc. Drs M.Y., H.H., and M.S. declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Insomnia treatment algorithm. CBT-I: cognitive behavioral therapy for insomnia.
See this image and copyright information in PMC

References

    1. Arroll B, Fernando A, III, Falloon K, et al.. Prevalence of causes of insomnia in primary care: a cross-sectional study. Br J Gen Pract 2012; 62(595): e99–e103. - PMC - PubMed
    1. Culpepper L. Insomnia: a primary care perspective. J Clin Psychiatry 2005; 66: 14–17. - PubMed
    1. Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry 1997; 154(10): 1417–1423. - PubMed
    1. Senthilvel E, Auckley D, Dasarathy J. Evaluation of sleep disorders in the primary care setting: history taking compared to questionnaires. J Clin Sleep Med 2011; 7: 41–48. - PMC - PubMed
    1. Ulmer CS, Bosworth HB, Beckham JC, et al.. Veterans affairs primary care provider perceptions of insomnia treatment. J Clin Sleep Med 2017; 13: 991–999. - PMC - PubMed

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