Abstract
Introduction:Prevalence of insomnia is higher in females and increases with higher
age. Besides primary insomnia, comorbid sleep disorders are also common,
accompanying different conditions. Considering the possible adverse
effects of commonly used drugs to promote sleep, a nonpharmacologic
approach should be preferred in most cases. Although
generally considered first-line
treatment, the nonpharmacologic approach is often underestimated by both
patients and physicians.
Objective: To provide primary care physicians an up-to-date
approach to the nonpharmacologic treatment of insomnia.
Methods: PubMed, Web of Science, and Scopus databases were
searched for relevant articles about the nonpharmacologic treatment of
insomnia up to November 2020. We restricted our search only to articles
written in English.
Main message: Most patients presenting with sleep disorder
symptoms can be effectively managed in the primary care setting. Primary
care physicians may use pharmacologic and nonpharmacologic approaches,
while the latter should be generally considered first-line treatment. A
primary care physician may opt to refer the patient to a sleep medicine
specialist for refractory cases.
Conclusions: This paper provides an overview of current
recommendations and up-to-date evidence for the nonpharmacologic
treatment of insomnia. This article emphasizes the importance of
cognitive-behavioral therapy for insomnia, likewise, exercise and
relaxation techniques. Complementary and alternative approaches are also
covered.