Management of insomnia in primary care

Insomnia can have significant health and economic impacts. In contrast, sleep disturbance is common but does not usually affect daytime activity. Short-term approaches for acute insomnia are often appropriate. These include dealing with precipitating factors such as stress. Chronic insomnia has a high relapse and recurrence rate. It is best managed with cognitive behavioural therapy which includes sleep hygiene, stimulus control and sleep restriction. In primary care, brief behavioural therapy for insomnia is an accessible and effective management strategy. If there is no response, referral should be considered. Adjuvant use of drugs in insomnia may be appropriate in some cases. Prescription should be for a limited duration.