The Current State of Insomnia Care

Neomi Shah, MD, MPH, MSC is the System Vice Chair of Medicine for Faculty Affairs in the Department of Medicine at Mount Sinai. She believes that the current care for individuals with insomnia, a sleep disorder characterized by difficulties falling and staying asleep and drowsiness during the day, is subpar.

One tool that has been used to treat insomnia is online cognitive behavioral therapy (CBT). Recently, advances in online cognitive behavioral therapy (CBT) have seen progress in the last 12 months. CBT is a type of psychological treatment that entails working closely with a mental health professional to identify unhelpful thinking patterns and learn how to better approach life's challenges. This type of counseling encourages individuals to recognize and modify their negative thought processes, leading to improved well-being. While CBT has been advancing as a treatment method for insomnia, the biggest barrier to providing evidence-based care is that most institutions do not have psychologists as part of a multidisciplinary sleep team, as payors do not cover CBT-I.

In an interview with HCPLive, Dr. Shah discussed the importance of focusing on behavioral treatments for insomnia, such as Cognitive Behavioral Therapy-Insomnia (CBT-I), as the primary intervention for patients with insomnia. In addition to increased access to behavioral treatments for insomnia, Dr. Shah highlighted the importance of focusing on the impact of irregular and short sleep duration on mental health and cardiovascular outcomes during the upcoming year. She also noted that one of the major problems that arise is the early school start times for adolescents.

To help patients improve insomnia symptoms, Dr. Shah suggests making lifestyle adjustments based on recommendations from the physician. While these changes may not always be easy to adopt, the benefits of doing so are multiple.

For improved screening practices for insomnia, Dr. Shah recommends asking about sleep duration and sleep timing, as most adults need 8 hours of sleep per night and need to sleep in alignment with their circadian rhythm. Rather than prescribing sleeping aids, it is important to look for correctable etiologies that are typically related to behavioral and mental health.

References:

Grossi, G. (2023, January 22). The Current State of Insomnia Care According to Neomi Shah, MD. HCPLive. Retrieved January 25, 2023, from https://www.hcplive.com/view/current-state-of-insomnia-care-according-to-neomi-shah