Primary care approach in insomnia Insomnide birinci basamak yaklaşimi


Özer C., ŞAHİN E. M. , Daǧdeviren N., Artürk Z.

SENDROM, vol.13, no.10, pp.73-77, 2001 (Refereed Journals of Other Institutions) identifier

  • Publication Type: Article / Review
  • Volume: 13 Issue: 10
  • Publication Date: 2001
  • Title of Journal : SENDROM
  • Page Numbers: pp.73-77

Abstract

Almost all the people have sleep problems in their lives. Sometimes they are serious and decrease the quality of life. In primary care one third of the patients have difficulties in sleeping and nearly half of these patients are chronically ill. In some patients with insomnia, no etiologic factor can be find but in many cases medical or psychiatric disorders are the cause of insomnia. All physicians must incorporate sleep related questions into the general review of the systems. Patients with sleep disorder will be requested to use sleep diary. In the diary all the day-time and the night-time activities and sleep related factors will be noted. Difficulty falling asleep, difficulty maintaining sleep, waking up too early in the morning, sleep that is not refreshing are the probable symptoms in insomnia. Two general approaches are available in the treatment of primary or persisting insomnia: Behaviour and pharmacologic. Hipnotic medications are effective in inducing, maintaining and consolidating sleep. In patients with insomnia that is associated with psychiatric disorders or history of substance abuse, antidepresssants are to be preferred. Behaviour treatment changes sleep habits, dysfunctional beliefs and reduces autonomic arousal. A few weeks of therapy is necessary before sleep improves with behavior approaches, but the relief continues. Behavior and pharmacologic treatment are compatible and may be combined to maintain relief.