Abstract

Successful treatment of insomnia is a great opportunity for physisicians to improve patients’ quality of life. CManagement of chronic insomnia should be inter-professional, holistic and evidence-based. The initial steps in treatment of chronic insomnia
should involve nonpharmacologic strategies like proper sleep hygiene, behavioural modifications, and CBT (cognitive bahavioral
therapy). It is also important to emphasize that in most cases chronic insomnia can be evaluated and managed in a primary care setting and referral to a sleep specialist is usually not required.
CBT is an effective way to treat chronic insomnia, but it is not always available or sometimes it is not effective enough. In case pharmacologic treatment is indicated, patients’ symptoms, chronic health conditions and drugs` side effects and interactions should be considered. The goal of pharmacologic treatment is to reduce the psychologic and physical influence of insomnia on patients’ life and to avoid dysfunctional cognitive and behavioural response to insomnia symptoms. Sleep medications should be used short-term, in the smallest effective dose and patients should always be informed about the drugs` side effects and interactions. Drugs with shorter half-life should be preferred.
The effectiveness of insomnia treatment can be assessed using the ISI scale and the parameters like duration and quality of sleep, sleep onset time, patient’s satisfaction with sleep quality and daytime symptoms.