Abstract
Introduction: Prevalence of insomnia is higher in females and increases
with higher age. Besides primary insomnia, comorbid sleep disorders are
also common, accompanying different conditions. Considering the possible
adverse effects of commonly used drugs to promote sleep, a
nonpharmacologic approach should be preferred in most cases. Although
generally considered first-line treatment, the nonpharmacologic approach
is often underestimated by both patients and physicians. Objective: To
provide primary care physicians an up-to-date approach to the
nonpharmacologic treatment of insomnia. Methods: PubMed, Web of Science,
and Scopus databases were searched for relevant articles about the
nonpharmacologic treatment of insomnia up to December 2020. We
restricted our search only to articles written in English. Main Message:
Most patients presenting with sleep disorder symptoms can be effectively
managed in the primary care setting. Primary care physicians may use
pharmacologic and nonpharmacologic approaches, while the latter should
be generally considered first-line treatment. A primary care physician
may opt to refer the patient to a sleep medicine specialist for
refractory cases. Conclusions: This paper provides an overview of
current recommendations and up-to-date evidence for the nonpharmacologic
treatment of insomnia. This article emphasizes the importance of
cognitive-behavioral therapy for insomnia, likewise, exercise and
relaxation techniques. Complementary and alternative approaches are also
covered.