Evaluating and Managing Insomnia: Non-pharmacological Treatments

Abstract

For about 40% of Americans, Insomnia is a major health issue that often leads to fatigue, reduced immunity, and dangerous driving. A good night sleep is essential for functioning and performance. It also influences mood, cognition, concentration, fatigue, and healing. Insomnia may be related to medical and psychiatric disorders, shift work, stimulants, travel, anxiety, pain, and other problems (e.g., poor sleep environment). People with insomnia (e.g., difficulty falling asleep, frequent awakenings and daytime drowsiness) tend to rely on alcohol, drugs, and other remedies. Insomnia may reflect sleep apnea or other medical or mental health disorders that require evaluation as well as poor sleep hygiene. Insomnia can be brief, episodic or chronic. Unfortunately, many people assume that insomnia is normal and do not report it to the nurse or seek treatment. Sleep deprivation impairs the person's physical, mental, and cardiac functioning. Often insomnia is treated with medications which may have side effectives or be habit forming. Individuals with insomnia need evaluation of the precipitants of insomnia, education about sleep hygiene, and information about non-pharmacological treatments. In clinic and hospital settings, nurses are in a pivotal position to identify sleep problems, educate patients, and refer them for follow up.