Insomnia: A Primary Care Perspective
J Clin Psychiatry 2005;66(suppl 9):14-17
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Primary care physicians once considered insomnia a nuisance diagnosis with which they had little
concern. A complaint of insomnia is often brought to a physician’s attention as a last-minute secondary
complaint, which may be dismissed as unimportant by the physician. However, chronic insomnia
is prevalent, associated with a decrease in quality of life, and can be an exacerbating factor in other
psychiatric and medical conditions. Primary care physicians therefore should be aware of the signs of
insomnia and include the detection of it in the evaluation of patients who present with other complaints
or as part of annual physical examinations. Physicians can assess insomnia with tools they already
use, such as a patient’s initial history. If insomnia is detected, primary care physicians should
work with patients to educate them. Management necessitates the inclusion of education and patient
counseling about sleep hygiene and correction of dysfunctional beliefs and behaviors. It may also include
pharmacologic treatment, nonpharmacologic treatment, or a combination of both.