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George L. Muntingh, Michelle Viljoen
South African Family Practice | Vol 60, No 3 : May/June| a4878 | DOI: https://doi.org/10.4102/safp.v60i3.4878 | © 2019 George L. Muntingh, Michelle Viljoen | This work is licensed under CC Attribution 4.0
Submitted: 24 October 2019 | Published: 12 July 2018

About the author(s)

George L. Muntingh, Tygerberg Hospital Pharmacy, Tygerberg, South Africa
Michelle Viljoen, University of the Western Cape, South Africa

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Abstract

Insomnia is perhaps the most common type of sleep disorder in the family medicine population. It is best described as a persistent difficulty initiating or maintaining sleep, or a report of non-restorative sleep, accompanied by related daytime impairment. There is increasing evidence of a strong association between insomnia and various medical and psychiatric comorbidities. Diagnosis of insomnia and treatment planning rely on a thorough sleep history to address contributing and precipitating factors as well as maladaptive behaviours resulting in poor sleep. Cognitive behavioural therapy for insomnia (CBT-I) is the mainstay of treatment and is a safe and effective approach. The key challenge of CBT-I is the lack of clinicians to implement it. The newer generation nonbenzodiazepines (e.g. zolpidem) are used as first-line pharmacotherapy for chronic insomnia. Newer drugs active on targets other than the gamma-aminobutyric acid receptor are now available, but clear treatment guidelines are needed.

Keywords

insomnia; hypnotic; benzodiazepines; treatment

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