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Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies

About the Course:

Chronic insomnia disorder, which affects 6-10% of the population, is diagnostically characterized by ongoing difficulties with initiating or maintaining sleep occurring at least three times per week, persisting for at least 3 months, and associated with daytime impairment. While chronic insomnia is often considered a condition primarily related to impaired sleep, the disorder can also adversely affect domains of physical and mental health, quality of life, and daytime function, which highlights the importance of treating the multidimensional sleep disorder. Owing to misperceptions about the safety and effectiveness of treatment options, many individuals with insomnia may not seek professional treatment, and alternatively use ineffective home remedies or over-the-counter medications to improve sleep. Some physicians may even believe that insomnia is remediated by simply having the patient “get more sleep”. Unfortunately, treatment of insomnia is not always that simple. The disorder’s complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes. This narrative review provides a summary of the diagnostic criteria and pathophysiology of insomnia and its subtypes. Further, this review emphasizes new and emerging nonpharmacologic and pharmacologic treatments for chronic insomnia, including recent enhancements in approaches to cognitive behavioral therapy for insomnia (CBT-I) and the new dual orexin receptor antagonist (DORA) pharmacologics. These advances in treatment have expanded the treatment options and are likely to result in improved outcomes in patients with chronic insomnia.

This course is based on the reading-based online article, Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies created by Russell Rosenberg, Ph.D. et al. in 2021.

Publication Date:

Neuropsychiatr Dis Treat. 2021 Aug 6;17:2549-2566

Course Material Authors

Course Material Authors authored the material only, and were not involved in creating this CE course. They are identified here for your own evaluation of the relevancy of the material this course is based on.

Russell Rosenberg, Ph.D.

Russell Rosenberg, Ph.D. is currently the chief science officer and CEO of NeuroTrials Research, Inc. and the director of the Atlanta School of Sleep Medicine and Technology in Atlanta, GA. Dr. Rosenberg obtained his doctorate in clinical and research psychology from Ohio State University in Columbus, OH, and received specialized training in sleep disorder medicine and research at Rush Presbyterian – St. Luke’s Medical Center in Chicago, IL. Dr. Rosenberg, who has 30 years of experience in clinical sleep medicine and research, is a board-certified sleep specialist and a fellow of the American Academy of Sleep Medicine. Dr. Rosenberg’s current research interests include narcolepsy and insomnia. He has given presentations on a variety of sleep disorders around the United States, as well as in Asia and Europe. He has also authored several book chapters and numerous journal articles on sleep disorders. Dr. Rosenberg is a past Chairman of the Board of Directors and spokesperson for the National Sleep Foundation (NSF) and has appeared frequently on local and national news shows including the Today Show, Good Morning America, Fox News, Headline News, CNN, NPR, and MSNBC.

Leslie Citrome, MD, MPH

Leslie Citrome, MD, MPH, is Clinical Professor of Psychiatry and Behavioral Sciences at New York Medical College in Valhalla, New York and has a private practice in Pomona, New York. He is a member of the Board of Directors of the American Society of Clinical Psychopharmacology and the Mental Health Association of Rockland County. Dr. Citrome was the Founding Director of the Clinical Research and Evaluation Facility at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, and after nearly 2 decades of government service as a researcher in the psychopharmacological treatment of severe mental disorders, Dr. Citrome is now engaged as a consultant in clinical trial design and interpretation. He is a frequent lecturer on the quantitative assessment of clinical trial results using evidence-based medicine. Dr. Citrome graduated from the McGill University Faculty of Medicine and completed a residency and chief residency in psychiatry at New York University. His primary research interests have centered on psychopharmacologic approaches to schizophrenia, bipolar disorder, major depressive disorder, the management of treatment-refractory schizophrenia, and the management of aggressive and violent behavior. Dr. Citrome has authored or coauthored more than 400 research reports, reviews, chapters, and abstracts in the scientific literature. He serves as Editor-in-Chief for the International Journal of Clinical Practice and is on the editorial board of 9 other medical journals. He has lectured extensively throughout the United States, Canada, Europe, and Asia. Dr. Citrome is the author of the book, Handbook of Treatment-Resistant Schizophrenia, published in 2013 by Springer Healthcare.

Christopher L. Drake, Ph.D.

Christopher L. Drake, Ph.D. is a graduate of the Pennsylvania State University and received his PhD in Clinical Psychology from Bowling Green State University in 2001. He is a licensed Clinical Psychologist with board certification in sleep medicine and behavioral sleep medicine. Dr. Drake was appointed Section Head of Sleep Research for Henry Ford Health System in 2014 and is a Professor in the Department of Psychiatry and Behavioral Neuroscience at Wayne State University School of Medicine. Dr. Drake is funded by the National Institute of Mental Health to study the effects of insomnia treatment on the prevention of depression and by the National Institute of Nursing Research for his work on behavioral treatments for insomnia. He has been Principal investigator on more than 20 foundation, industry, and NIH grants since 2004. Dr. Drake has authored over 150 publications, has served on the Board of Directors of the Sleep Research Society and is a former Chairman of the National Sleep Foundation.

Course Creator

Elizabeth Mosco, Ph.D., PMH-C, CPLC

Elizabeth Mosco, Ph.D. is a licensed psychologist in Reno, NV. She opened a private practice
after 10 years of conducting home-based assessment and therapy with the VA Sierra Nevada
Health Care System. Dr. Mosco’s clinical interests include maternal mental health, older adults,
and third wave cognitive behavioral therapies.

Recommended For:

Counselors, marriage and family therapists, psychologists and social workers. This course is appropriate for all levels of knowledge.

Course Objectives:

  1. Recognize the types of insomnia, the general trend of insomnia symptoms over time, and the physiological and mental impacts of chronic insomnia.

  2. Describe the Three Factor model of insomnia.

  3. Summarize the efficacy of cognitive behavioral therapy for insomnia (CBT-I).

  4. Summarize the major pharmalogic treatments for insomnia, in particular, the newest class of medication and identify its mechanism of action.

Course Material

References are listed at the end of the article.

PubMed Article

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Course Number 103210
1.5 credit hour
Log in for credit hours relevant to your licensure.

  • Reading-Based Online
Exam Fee: $8.96 No exam fee with a membership package!

No Cost Materials

4.7 out of 5
40 members have taken this course

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