FDA labeling also states that patients with insomnia that does not remit within seven to 10 days of treatment should be re-evaluated. The FDA has approved medications for short-term use (four to five weeks) and patients should not continue taking them for extended periods of time. This should include discussing the benefits, harms, and costs of medications. If CBT-I alone is unsuccessful, ACP recommends that doctors use a shared-decision making approach with their patients to decide whether drug therapy should be added to treatment. Cognitive behavioral therapy can be conducted through individual or group therapy sessions, telephone or web-based modules, and/or self-help books. Sleep medications can be associated with serious adverse effects.”ĬBT-I consists of a combination of treatments that include cognitive therapy around sleep, behavioral interventions such as sleep restriction and stimulus control, and education such as sleep hygiene (habits for a good night’s sleep). “Although we have insufficient evidence to directly compare CBT-I and drug treatment, CBT-I is likely to have fewer harms. “Cognitive behavioral therapy for insomnia is an effective treatment and can be initiated in a primary care setting,” said ACP President Wayne J. Philadelphia, - Cognitive behavioral therapy for insomnia (CBT-I) should be the first-line treatment for adults with chronic insomnia, the American College of Physicians (ACP) recommends in a new evidence-based clinical practice guideline published today in Annals of Internal Medicine. CBT-I combines cognitive therapy around sleep with a variety of behavioral therapies
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