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Insomnia is one of the most common medical complaints, generating over 5 million office visits per year in the US alone. Symptoms of insomnia occur in one-third to one-half of adults in the US, and are more prevalent among women and older adults.3-7 In patients with coexisting psychiatric illnesses, the incidence approaches 50% to 75%.3,8 About 1 in 10 adults has chronic insomnia – symptoms that occur at least 3 times per week for at least 3 months.9 Among patients with chronic insomnia, up to one-third suffer daytime consequences.
Although hypnotic medications have been considered the cornerstone of insomnia therapy for decades11, recent guidelines recommend cognitive behavioral therapy as the initial treatment for chronic insomnia. In the last 10 years, new drugs have entered the marketplace for insomnia treatment: a melatonin receptor agonist, ramelteon (Rozerem®), the orexin receptor antagonist, suvorexant (Belsomra®),12 and low-dose doxepin (SilenorTM). Over-the-counter medications (eg, antihistamines, melatonin supplements) and other prescription medications used off label are also sought-after remedies for insomnia.
This issue focuses on updated recommendations for the management of insomnia in adults. The importance of advocating for behavioral changes (sleep hygiene and stimulus control) prior to medication use is highlighted. The medications that may be used in addition to behavioral therapy are reviewed. When advising patients, providers should take an active role in discussing medication benefits and risks, including appropriate medication choice, duration of use, tolerance, side effect management, and drug interactions...
This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.
Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.
The Rx Consultant is a publication of Continuing Education Network, Inc.
ACPE Universal Activity Number: 0428-0000-17-002-H01-P
Chief Editor and CE Administrator
Terry M. Baker, PharmD
Tracy Farnen, PharmD
James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Associate Clinical Professor
Richard Ron Finley, B.S. Pharm.,R.Ph.
Consult Pharmacist Aging and Adult Health Services
Julio R. Lopez, PharmD, FCSHP
Adjunct Clinical Professor
Assistant Clinical Professor
Visiting Associate Professor and Lecturer
Pamela Mausner, MD
Helen Berlie, Pharm.D. CDE, BCACP
Ambulatory Care Specialist - Diabetes
Senior Editorial Advisor
Gerard Hatheway, PharmD, PhD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD
Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners
Meuleman, RN, C, MS
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