#5 Treatment of Chronic Insomnia

What's the Proof?

Insomnia is one of the most common conditions encountered in primary care. In this episode, Drs. Scott & Robertson explore the evidence-based management of chronic insomnia, with some surprising revelations along the way!
Additionally, Episode #4 on Probiotics for the Prevention of Antibiotic-Associated Diarrhea provoked a lot of debate, and the What's the Proof team lets you in on the conversation.
Episode Outline:

• Follow-up discussion on probiotics and CDI prevention 00:53
• Cognitive Behavioral Therapy for Insomnia (CBT-I) 08:09
• Review of AASM and ACP clinical practice guidelines for insomnia medications 09:52
• Potential harms of sedative hypnotics 17:16
• How to handle the "Oh, by the way" request for sleep meds 23:00
• New data on dual-orexin receptor antagonists 25:30

Links from this episode:

• Effect of antibiotic stewardship on incidence of CDI https://pubmed.ncbi.nlm.nih.gov/28629876/
• Declining use of medications for insomnia https://pubmed.ncbi.nlm.nih.gov/35818727/
• Hypnotics’ associated with mortality or cancer https://pubmed.ncbi.nlm.nih.gov/22371848/
• SUNRISE 2 https://pubmed.ncbi.nlm.nih.gov/32585700/
• Daridorexant for insomnia https://pubmed.ncbi.nlm.nih.gov/35065036/
• AASM Insomnia Guideline https://jcsm.aasm.org/doi/10.5664/jcsm.6470#d45835e1
• ACP Insomnia Guideline https://www.acpjournals.org/doi/10.7326/m15-2175
• Simplified sleep restriction for insomnia https://pubmed.ncbi.nlm.nih.gov/26212846/

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Credits:

• Hosts: Bobby Scott, MD, FAAFP; Sandy Robertson, PharmD; Dawn Caviness, MD, BSN
• Production & Cover Art: Bobby Scott, MD, FAAFP
• Music: Twisterium, MondayHopes, Muzaproduction, and SergeQuadrado from Pixabay