Haymarket Medical Education’s Insomnia Working Group Publishes Updated Recommendations for Managing Insomnia Disorder in Primary Care in Primary Care Companion for CNS Disorders (Psychiatrist.com)

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“A 2023 Update on Managing Insomnia in Primary Care: Insights From an Expert Consensus Group” is the outcome of the March 2022 meeting of The Insomnia Working Group, a consensus panel of insomnia experts in primary care, psychiatry, and clinical research, that included a patient with insomnia.

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Monday, January 23, 2023
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Summary
Key Points: 
  • “A 2023 Update on Managing Insomnia in Primary Care: Insights From an Expert Consensus Group” is the outcome of the March 2022 meeting of The Insomnia Working Group, a consensus panel of insomnia experts in primary care, psychiatry, and clinical research, that included a patient with insomnia.
  • The panel convened to identify gaps in the recognition, diagnosis, and management of insomnia in primary care and to review new data on available and emerging insomnia treatments.
  • The January 24th article details evidence that treating insomnia disorder can result in improvements in comorbid illness and quality of life.
  • Panel members recommend that primary care clinicians proactively screen for evidence of insomnia, especially in patients presenting with medical or psychiatric illnesses.


On January 24, 2023, The Journal of Clinical Psychiatry - Primary Care Companion for CNS Disorders, will publish an article developed by Haymarket Medical Education in collaboration with a group of experts chaired by Russell Rosenberg, PhD, FAASM, chief science officer and CEO of NeuroTrials Research, Inc., on the management of insomnia disorder in the primary care setting.

“A 2023 Update on Managing Insomnia in Primary Care: Insights From an Expert Consensus Group” is the outcome of the March 2022 meeting of The Insomnia Working Group, a consensus panel of insomnia experts in primary care, psychiatry, and clinical research, that included a patient with insomnia. The panel convened to identify gaps in the recognition, diagnosis, and management of insomnia in primary care and to review new data on available and emerging insomnia treatments. The initiative was supported by an independent educational grant from Eisai.

The authors included Russell P. Rosenberg, PhD, FAASM, Chief Science Officer and CEO NeuroTrials Research Inc., Atlanta, GA, Ruth Benca, MD, PhD, Chair of Psychiatry and Behavioral Medicine at Wake Forest School of Medicine, Winston-Salem, NC, Paul Doghramji, MD, FAAFP, family practitioner at Collegeville Family Practice and Ursinus College, Collegeville, PA, and Thomas Roth, PhD, founder of the Sleep Disorders and Research Center at the Henry Ford Hospital, and Clinical Professor, Department of Psychiatry, University of Michigan College of Medicine, Ann Arbor, MI. They concluded that despite being highly prevalent, having a profound negative effect on daytime functioning and overall health in, and occurring comorbidly, but typically not secondary to, multiple medical and psychiatric illnesses, insomnia is underrecognized and undertreated in primary care settings.

The January 24th article details evidence that treating insomnia disorder can result in improvements in comorbid illness and quality of life. Panel members recommend that primary care clinicians proactively screen for evidence of insomnia, especially in patients presenting with medical or psychiatric illnesses.

Dr. Rosenberg stated, “The data demonstrating a relationship between insomnia disorder and significant medical disorders is growing, suggesting that clinicians need to take insomnia disorder seriously.”

The panel also recommends lifestyle strategies and sleep hygiene techniques, as well as cognitive behavioral therapy for insomnia; however, these interventions may need to be included as part of a broader therapeutic strategy. Effective treatment combines pharmacologic and nonpharmacologic strategies aimed at a personalized approach to reducing time to sleep onset, maintaining sleep for an adequate duration, and preventing early awakening, while improving daytime function. Recent developments in the insomnia disorder treatment arena have led to the development of a new class of drugs, the dual orexin receptor antagonists, with a new mechanism of action that have shown efficacy and safety in insomnia disorder.

“It is important to understand that insomnia and conditions such as chronic pain and depression have a bidirectional relationship. Thus, for example, to optimize treatment and prevent relapse of depression, an improvement in sleep is critical,” said Dr. Roth.

The article is currently embargoed and will be published on Psychiatry.com at 4 am Central on January 24, 2023.

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