What is the best treatment for chronic insomnia?
The American College of Physicians has just published the results of a careful review of all of the research in this area.
The preferred treatment for insomnia is cognitive behavioral therapy (CBTi) which we offer through this website – read about it at the bottom of this page.
In their review, ACP notes that overall many frequently prescribed medications have quite poor evidence supporting their effectiveness.
Low-to-moderate quality evidence demonstrated that doxepin, suvorexant (Belsmora), eszopiclone (Lunesta), zolpidem (Ambien), and extended-release zolpidem (Ambien XR) each improved total sleep time (by approximately 15–45 minutes).
The other medications that are commonly prescribed do not have adequate evidence to support their effectiveness.
Better quality evidence supports the effectiveness of CBTi in improving multiple aspects of sleep quality.
CBTi can be given in individual therapy, group therapy or using an online program (of which SHUTi is the one most frequently recommended and the one we provide access to).
Qaseem A et al. Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med 2016 May 3; [e-pub]. (http://dx.doi.org/10.7326/M15-2175)
Brasure M et al. Psychological and behavioral interventions for managing insomnia disorder: An evidence report for a clinical practice guideline by the American College of Physicians. Ann Intern Med 2016 May 3; [e-pub]. (http://dx.doi.org/10.7326/M15-1782)