Insomnia

Here is a 1999 article in AAFP on [|diagnosis and management of insomnia]. Please notify me if you find something better or more recent.

Simple handout on [|Good Sleep Hygiene].

The National Heart Lung Blood Institute has a big (60-page) [|English patient handout on insomnia], "You're Guide To Healthy Sleep".

__**" The Bottom Line'"**__ B.Miller MD Lasting more than a month = chronic insomnia May cause both cognitive and physical dysfunction
 * Definition** - impairement in sleep, quality or quantity, either falling asleep or ability to stay asleep

Primary = 50% (no other etiology found) Secondary = psych, anxiety, stress, OSA, drugs, shift work, etc
 * Etiology**

1) Good sleep hygiene - give patient sleeep hand out ( pt's rarely give up watching tv ) 2) Sleep relaxation techniques - meditation, controlled slow breathing,progressive muscle tightening then relax muscles 3) Medications - Trazadone (50-200mg qhs) tolerated well,very few interactions Benadryl (25-75 qhs) hangover common, freqquent tolerance, __don't use in elderly__ Non- Benzo's Ambien, helps falling and staying asleep) Sonata (usefull for middle of the night awakening)
 * Treatment**

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