Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies

Russell Rosenberg,1 Leslie Citrome,2 Christopher L Drake3 1Neurotrials Research, Atlanta, GA, USA; 2Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USA; 3Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USACorrespondenc...

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Autores principales:	Rosenberg R, Citrome L, Drake CL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	dual orexin receptor antagonists cognitive behavioral therapy-insomnia insomnia subtype hypnotic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f490083eeb1142abb967d7432bfdb646
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spelling	oai:doaj.org-article:f490083eeb1142abb967d7432bfdb6462021-12-02T16:16:09ZAdvances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies1178-2021https://doaj.org/article/f490083eeb1142abb967d7432bfdb6462021-08-01T00:00:00Zhttps://www.dovepress.com/advances-in-the-treatment-of-chronic-insomnia-a-narrative-review-of-ne-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Russell Rosenberg,1 Leslie Citrome,2 Christopher L Drake3 1Neurotrials Research, Atlanta, GA, USA; 2Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USA; 3Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USACorrespondence: Russell RosenbergNeurotrials Research, 5887 Glenridge Drive, Suite 400, Atlanta, GA, 30328, USATel +1 404 851 9934Email rrosenberg@neurotrials.comAbstract: Chronic insomnia disorder, which affects 6– 10% of the population, is diagnostically characterized by ongoing difficulties with initiating or maintaining sleep occurring at least three times per week, persisting for at least 3 months, and associated with daytime impairment. While chronic insomnia is often considered a condition primarily related to impaired sleep, the disorder can also adversely affect domains of physical and mental health, quality of life, and daytime function, which highlights the importance of treating the multidimensional sleep disorder. Owing to misperceptions about the safety and effectiveness of treatment options, many individuals with insomnia may not seek professional treatment, and alternatively use ineffective home remedies or over-the-counter medications to improve sleep. Some physicians may even believe that insomnia is remediated by simply having the patient “get more sleep”. Unfortunately, treatment of insomnia is not always that simple. The disorder’s complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes. This narrative review provides a summary of the diagnostic criteria and pathophysiology of insomnia and its subtypes. Further, this review emphasizes new and emerging nonpharmacologic and pharmacologic treatments for chronic insomnia, including recent enhancements in approaches to cognitive behavioral therapy for insomnia (CBT-I) and the new dual orexin receptor antagonist (DORA) pharmacologics. These advances in treatment have expanded the treatment options and are likely to result in improved outcomes in patients with chronic insomnia.Keywords: dual orexin receptor antagonists, cognitive behavioral therapy-insomnia, insomnia subtype, hypnoticRosenberg RCitrome LDrake CLDove Medical Pressarticledual orexin receptor antagonistscognitive behavioral therapy-insomniainsomnia subtypehypnoticNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 2549-2566 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dual orexin receptor antagonists cognitive behavioral therapy-insomnia insomnia subtype hypnotic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	dual orexin receptor antagonists cognitive behavioral therapy-insomnia insomnia subtype hypnotic Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Rosenberg R Citrome L Drake CL Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
description	Russell Rosenberg,1 Leslie Citrome,2 Christopher L Drake3 1Neurotrials Research, Atlanta, GA, USA; 2Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USA; 3Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USACorrespondence: Russell RosenbergNeurotrials Research, 5887 Glenridge Drive, Suite 400, Atlanta, GA, 30328, USATel +1 404 851 9934Email rrosenberg@neurotrials.comAbstract: Chronic insomnia disorder, which affects 6– 10% of the population, is diagnostically characterized by ongoing difficulties with initiating or maintaining sleep occurring at least three times per week, persisting for at least 3 months, and associated with daytime impairment. While chronic insomnia is often considered a condition primarily related to impaired sleep, the disorder can also adversely affect domains of physical and mental health, quality of life, and daytime function, which highlights the importance of treating the multidimensional sleep disorder. Owing to misperceptions about the safety and effectiveness of treatment options, many individuals with insomnia may not seek professional treatment, and alternatively use ineffective home remedies or over-the-counter medications to improve sleep. Some physicians may even believe that insomnia is remediated by simply having the patient “get more sleep”. Unfortunately, treatment of insomnia is not always that simple. The disorder’s complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes. This narrative review provides a summary of the diagnostic criteria and pathophysiology of insomnia and its subtypes. Further, this review emphasizes new and emerging nonpharmacologic and pharmacologic treatments for chronic insomnia, including recent enhancements in approaches to cognitive behavioral therapy for insomnia (CBT-I) and the new dual orexin receptor antagonist (DORA) pharmacologics. These advances in treatment have expanded the treatment options and are likely to result in improved outcomes in patients with chronic insomnia.Keywords: dual orexin receptor antagonists, cognitive behavioral therapy-insomnia, insomnia subtype, hypnotic
format	article
author	Rosenberg R Citrome L Drake CL
author_facet	Rosenberg R Citrome L Drake CL
author_sort	Rosenberg R
title	Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
title_short	Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
title_full	Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
title_fullStr	Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
title_full_unstemmed	Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies
title_sort	advances in the treatment of chronic insomnia: a narrative review of new nonpharmacologic and pharmacologic therapies
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/f490083eeb1142abb967d7432bfdb646
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Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies

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