Yamamoto Mari, Lim Christopher T, Huang Heather, Spottswood Margaret, Huang Hsiang
Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Department of Psychiatry, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
J Med Access. 2023 Mar 15;7:27550834231156727. doi: 10.1177/27550834231156727. eCollection 2023 Jan-Dec.
Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.
失眠,包括失眠症,在初级保健机构中是一种常见但常被忽视的主诉。它是各种医学和精神疾病诊断的危险因素,且与高昂的医疗保健费用相关。虽然失眠认知行为疗法(CBT-I)是失眠症的一线治疗方法,但获得CBT-I治疗的机会有限。本文提供了一种在初级保健环境中筛查、评估和治疗失眠的实用方法,倡导采用人群健康方法。作者回顾了CBT-I的作用、共病的治疗以及针对患有失眠症的初级保健患者的药物治疗建议。此外,作者强调了技术在改善失眠症护理可及性方面的潜在效用。