eMedicine Specialties > Psychiatry > Adult

Primary Insomnia: Follow-up

Author: Catherine McVearry Kelso, MD,, Assistant Professor of Internal Medicine, Virginia Commonwealth University; Medical Director, Hospice and Palliative Care, Hunter Holmes McGuire VA Medical Center, Richmond
Coauthor(s): Angela Gentili, MD, Director of Geriatrics Fellowship Program, Associate Professor, Department of Internal Medicine, Virginia Commonwealth University Health System and McGuire Veterans Affairs Medical Center; Antony Fernandez, MD, FRCPsych (UK), Associate Professor, Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University; Acting Director, Sleep Disorders Clinic, McGuire Veterans Affairs Medical Center, Richmond
Contributor Information and Disclosures

Updated: Jun 5, 2009

Follow-up

Further Inpatient Care

Inpatient care is not usually required unless significant medical or psychiatric comorbidity exists.

Further Outpatient Care

Effective treatment for insomnia consists of a dual approach using nonpharmacologic techniques and appropriate use of hypnotic agents.

Patients need to be observed closely and have regular follow-up visits to review response, adverse effects, and to assure safe and appropriate use of the medications.

Deterrence/Prevention

Proper attention to sleep hygiene may prevent the development of psychophysiological insomnia.

Complications

Sleep disturbance is a reliable indicator of psychological ill health, physical ill health, or both. A report of disturbed sleep from the patient signals the need for further evaluation and close monitoring.

Prognosis

In some patients, improvement in sleep leads to an improved quality of life.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Aparna Ranjan, MD and Kirk L Nelson, MD to the development and writing of this article.



More on Primary Insomnia

Overview: Primary Insomnia
Differential Diagnoses & Workup: Primary Insomnia
Treatment & Medication: Primary Insomnia
Follow-up: Primary Insomnia
Multimedia: Primary Insomnia
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Further Reading

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Keywords

sleeplessness, sleep disturbance, sleep apnea, psychophysiological insomnia, learned insomnia, behavioral insomnia, idiopathic insomnia, stress-related insomnia, sleep state misperception, persistent psychophysiological insomnia, sleep disorder

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Contributor Information and Disclosures

Author

Catherine McVearry Kelso, MD,, Assistant Professor of Internal Medicine, Virginia Commonwealth University; Medical Director, Hospice and Palliative Care, Hunter Holmes McGuire VA Medical Center, Richmond
Catherine McVearry Kelso, MD, is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Geriatrics Society, and American Society for Bioethics and Humanities
Disclosure: Nothing to disclose.

Coauthor(s)

Angela Gentili, MD, Director of Geriatrics Fellowship Program, Associate Professor, Department of Internal Medicine, Virginia Commonwealth University Health System and McGuire Veterans Affairs Medical Center
Angela Gentili, MD is a member of the following medical societies: American Geriatrics Society
Disclosure: Nothing to disclose.

Antony Fernandez, MD, FRCPsych (UK), Associate Professor, Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University; Acting Director, Sleep Disorders Clinic, McGuire Veterans Affairs Medical Center, Richmond
Antony Fernandez, MD, FRCPsych (UK) is a member of the following medical societies: American Society of Addiction Medicine
Disclosure: Nothing to disclose.

Medical Editor

Jennifer S Morse, MD, Assistant Clinical Professor, Department of Psychiatry, University of California at San Diego
Jennifer S Morse, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, Aerospace Medical Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Iqbal Ahmed, MBBS, Professor, Department of Psychiatry, John A Burns School of Medicine, University of Hawaii
Iqbal Ahmed, MBBS is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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