Insomnia

Insomnia is a common complaint with potentially significant medical and psy chologic complications. In some cases insomnia presents as a symptom of ano ther underlying medical, psychiatric or environmental condition. In these c ases, management of insomnia depends on accurate diagnosis and successful t reatment of the underlying condition. In other cases, insomnia is a primary disorder requiring direct treatment. Pharmacologic treatments include nonp rescription medications, sedating tricyclic antidepressants, benzodiazepine s and related drugs. Behavior management methods that may be administered i n the office setting include stimulus control therapy, sleep restriction th erapy and sleep hygiene education. Although prescription medications and be havior therapy have similar short-term efficacy, behavior interventions are recommended as the first line of treatment for primary insomnia because of their greater safety and long-term efficacy.