chapter  6
Insomnia
ByThomas L. Schwartz
Pages 27

People with insomnia cannot initiate sleep, maintain sleep, or have non-restorative sleep as their main complaint. For the novice prescriber attempting to treat an adult with insomnia, it is essential to know the basics of the available guidelines that exist to help provide a high level of care. In regard to heritability, 55% of patients with childhood-onset insomnia can identify one family member with sleep difficulties compared to 39% of patients with an onset of insomnia in adulthood. In treating insomnia, there are five classes of medications frequently used and several off-label pharmacological approaches that may be considered within the standard of care. Insomnia is the sentinel symptom of a new mania episode, so it is warranted to use a highly efficacious hypnotic that more often guarantees restoration of sleep.