What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder?
Insomnia is a significant, highly prevalent, persistent public health problem but often remains undiagnosed and untreated. Current treatment practices are not always evidence-based. When insomnia is comorbid with anxiety or depression, treatment often targets that comorbid condition with the expecta...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1975 |
| _version_ | 1797615055944024064 |
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| author | Charles M. Morin Suzanne M. Bertisch Rafael Pelayo Nathaniel F. Watson John W. Winkelman Phyllis C. Zee Andrew D. Krystal |
| author_facet | Charles M. Morin Suzanne M. Bertisch Rafael Pelayo Nathaniel F. Watson John W. Winkelman Phyllis C. Zee Andrew D. Krystal |
| author_sort | Charles M. Morin |
| collection | DOAJ |
| description | Insomnia is a significant, highly prevalent, persistent public health problem but often remains undiagnosed and untreated. Current treatment practices are not always evidence-based. When insomnia is comorbid with anxiety or depression, treatment often targets that comorbid condition with the expectation that improvement of the mental health condition will generalize to sleep symptoms. An expert panel of seven members conducted a clinical appraisal of the literature regarding the treatment of insomnia when comorbid anxiety or depression are also present. The clinical appraisal consisted of the review, presentation, and assessment of current published evidence as it relates to the panel’s predetermined clinical focus statement, “<i>Whenever chronic insomnia is associated with another condition, such as anxiety or depression, that psychiatric condition should be the only focus of treatment as the insomnia is most likely a symptom of the condition</i>”. The results from an electronic national survey of US-based practicing physicians, psychiatrists, and sleep (N = 508) revealed that >40% of physicians agree “at least somewhat” that treatment of comorbid insomnia should focus solely on the psychiatric condition. Whereas 100% of the expert panel disagreed with the statement. Thus, an important gap exists between current clinical practices and evidence-based guidelines and more awareness is needed so that insomnia is treated distinctly from comorbid anxiety and depression. |
| first_indexed | 2024-03-11T07:21:04Z |
| format | Article |
| id | doaj.art-ebfc98c38e8d4cab8ea88d47597e6308 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:21:04Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ebfc98c38e8d4cab8ea88d47597e63082023-11-17T08:00:55ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01125197510.3390/jcm12051975What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder?Charles M. Morin0Suzanne M. Bertisch1Rafael Pelayo2Nathaniel F. Watson3John W. Winkelman4Phyllis C. Zee5Andrew D. Krystal6Department of Psychology, Brain Research Centre, Laval University, Quebec, QC G1V 0A6, CanadaDepartment of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USADepartment of Psychiatry and Behavioral Sciences, Stanford University Sleep Medicine Center, Redwood City, CA 94305, USADepartment of Neurology, University of Washington School of Medicine, Seattle, WA 98195, USADepartment of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Neurology, Center for Circadian and Sleep Medicine, Northwestern University, Evanston, IL 60611, USADepartments of Psychiatry and Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA 94158, USAInsomnia is a significant, highly prevalent, persistent public health problem but often remains undiagnosed and untreated. Current treatment practices are not always evidence-based. When insomnia is comorbid with anxiety or depression, treatment often targets that comorbid condition with the expectation that improvement of the mental health condition will generalize to sleep symptoms. An expert panel of seven members conducted a clinical appraisal of the literature regarding the treatment of insomnia when comorbid anxiety or depression are also present. The clinical appraisal consisted of the review, presentation, and assessment of current published evidence as it relates to the panel’s predetermined clinical focus statement, “<i>Whenever chronic insomnia is associated with another condition, such as anxiety or depression, that psychiatric condition should be the only focus of treatment as the insomnia is most likely a symptom of the condition</i>”. The results from an electronic national survey of US-based practicing physicians, psychiatrists, and sleep (N = 508) revealed that >40% of physicians agree “at least somewhat” that treatment of comorbid insomnia should focus solely on the psychiatric condition. Whereas 100% of the expert panel disagreed with the statement. Thus, an important gap exists between current clinical practices and evidence-based guidelines and more awareness is needed so that insomnia is treated distinctly from comorbid anxiety and depression.https://www.mdpi.com/2077-0383/12/5/1975sleep disturbancestreatmentpharmacologicalcognitive-behavioral therapy comorbiditypsychiatricdepression |
| spellingShingle | Charles M. Morin Suzanne M. Bertisch Rafael Pelayo Nathaniel F. Watson John W. Winkelman Phyllis C. Zee Andrew D. Krystal What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? Journal of Clinical Medicine sleep disturbances treatment pharmacological cognitive-behavioral therapy comorbidity psychiatric depression |
| title | What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? |
| title_full | What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? |
| title_fullStr | What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? |
| title_full_unstemmed | What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? |
| title_short | What Should Be the Focus of Treatment When Insomnia Disorder Is Comorbid with Depression or Anxiety Disorder? |
| title_sort | what should be the focus of treatment when insomnia disorder is comorbid with depression or anxiety disorder |
| topic | sleep disturbances treatment pharmacological cognitive-behavioral therapy comorbidity psychiatric depression |
| url | https://www.mdpi.com/2077-0383/12/5/1975 |
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