Helping patients who say they cannot sleep - Practical ways to evaluate and treat insomnia

Insomnia is a very common and easily treated condition. It may be the prese nting symptom of many other medical conditions and usually is not a sign of psychological or psychiatric illness. Untreated, in somnia can cause signi ficant economic hardship, morbidity, and mortality, and it may be a risk fa ctor for development of depression or anxiety. Actigraphy and sleep logs ar e essential tools in evaluating insomnia. Their use usually results in a sp ecific causal diagnosis, with effective therapeutic implications. Treatment includes both pharmacologic and behavioral interventions.