ABSTRACT
This chapter describes the range of treatment strategies available to the healthcare professional in the treatment and management of poor sleep. These can be broadly divided into pharmacological and non-pharmacological approaches. The chapter explores the range of psychobehavioural and cognitive approaches for the treatment and management of the person with insomnia. It then describes the various drug treatments. The original sleeping drugs, barbiturates, were very toxic and very dangerous in overdose. As a result, they were replaced by the benzodiazepine (BZD) drugs in the 1960s along with advances in pharmacology. There are some significant "problem factors" with BZDs, namely toxicity, tolerance, dependence, rebound insomnia, withdrawal, and hangover effects; the chapter discusses these in detail. Cognitive behavioural therapy for insomnia (CBTi) comprises a raft of interventions that have been amalgamated into an intervention programme for the treatment of insomnia. The elements of CBTi include: psychoeducation, sleep hygiene, relaxation training, stimulus control therapy, paradoxical intention, bright light therapy, and sleep restriction therapy.
