Chronic insomnia: diagnosis and non-pharmacological management

#### What you need to know Surveys of adults show that 13-33% of the adult population have regular difficulty either getting to sleep or staying asleep.1 2 3 Insomnia is dissatisfaction with sleep quantity or quality with one of more of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening. The sleep disturbance causes significant distress or impairment of functioning. There may be a feeling of having been awake all night even when getting some sleep. People with comorbid disorders of physical or mental health, such as depression, have higher rates of insomnia. Depression and sleep disturbance are the first and third most common psychological reasons for patient encounters in general practice.4 Untreated, insomnia increases the risk of development or exacerbation of anxiety, depression, hypertension, and diabetes.5 6 This article outlines current concepts in insomnia and provides up to date information on treatment. Most people will experience sleep disturbance or acute insomnia at some point in any given year. This often occurs around predictable times of stress or when sleep patterns are disrupted, such as with travel, busy periods at work, illness, or emotional upset. While people may be distressed about sleep loss during acute insomnia, once the trigger factors are removed, sleep usually returns to normal. Insomnia becomes chronic when someone has difficulty either getting to sleep or staying asleep for at least three nights a week (not necessarily every night) for at least three months and is distressed by their sleep symptoms. …