Integrating Modern Concepts of Insomnia and its Contemporary Treatment into Primary Care
| Autor: | Paul P. Doghramji |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Referral medicine.medical_treatment MEDLINE Comorbidity Disease Quality of life (healthcare) Risk Factors Sleep Initiation and Maintenance Disorders mental disorders medicine Humans Hypnotics and Sedatives GABAergic Neurons Psychiatry Depression (differential diagnoses) Neurotransmitter Agents Orexins Cognitive Behavioral Therapy Primary Health Care business.industry Neuropeptides Intracellular Signaling Peptides and Proteins Primary care physician General Medicine medicine.disease Cognitive behavioral therapy Chronic Disease Quality of Life business |
| Zdroj: | Postgraduate Medicine. 126:82-101 |
| ISSN: | 1941-9260 0032-5481 |
| DOI: | 10.3810/pgm.2014.09.2802 |
| Popis: | Insomnia affects one-third of the adult population. Ten percent of adults surveyed in America consider it a serious problem. Chronic insomnia is associated with poor quality of life and the potential for various psychiatric and medical conditions, notably depression and cardiovascular disease. Since most patients with insomnia are unlikely to disclose obvious sleeping difficulties, the first step in diagnosing and managing patients is having a high index of suspicion in patients with specific complaints, comorbidities, and risk factors. This is followed by a complete evaluation of the patient's medical and physical history to determine if the insomnia is primary or comorbid with another disease. The management of insomnia should consider the extent of impairment associated with the disorder, as well as duration, causes, and comorbidities. In some cases, referral to a specialist is warranted. Recently, there have been new definitions of insomnia proposed; elucidation of the role of orexin-mediated hyperarousal brain neural pathway in the sleep-wake cycle; and new drugs available that target this system. Thus, a review and update for today's primary care physician is warranted. |
| Databáze: | OpenAIRE |
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