![]() ![]() Because insomnia may present with a variety of specific complaints and contributing factors, the time required for evaluation and management of chronic insomnia can be demanding for clinicians. In this guideline, an insomnia disorder is defined as a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment. “Insomnia” has been used in different contexts to refer to either a symptom or a specific disorder. Consistent risk factors for insomnia include increasing age, female sex, comorbid (medical, psychiatric, sleep, and substance use) disorders, shift work, and possibly unemployment and lower socioeconomic status. ![]() Insomnia symptoms occur in approximately 33% to 50% of the adult population insomnia symptoms with distress or impairment (general insomnia disorder) in 10% to 15%. Unless otherwise stated, “insomnia” refers to chronic insomnia, which is present for at least a month, as opposed to acute or transient insomnia, which may last days to weeks. The purpose of this clinical guideline is to provide clinicians with a practical framework for the assessment and disease management of chronic adult insomnia, using existing evidence-based insomnia practice parameters where available, and consensus-based recommendations to bridge areas where such parameters do not exist. 1 Insomnia may present with a variety of specific complaints and etiologies, making the evaluation and management of chronic insomnia demanding on a clinician's time. Insomnia is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment. Insomnia is the most prevalent sleep disorder in the general population, and is commonly encountered in medical practices.
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