Abstract

Advancements in the study of refractory insomnia suggest a paradigm shift in modern treatment methodologies towards diversification and personalization. Traditional pharmacotherapies, such as benzodiazepines, are noted for their dependency risks. However, new-age drugs like Dexmedetomidine are garnering attention for their safety profile and protective effects on sleep architecture. Cognitive Behavioral Therapy (CBT), as a non-pharmacological intervention, has proven effective, though it requires long-term engagement. Anesthesia-induced sleep therapy, an innovative approach, has demonstrated potential in treating insomnia. Multimodal treatments that integrate pharmacological, non-pharmacological, and novel methods, such as stellate ganglion block and Enhanced External Counterpulsation (EECP), offer comprehensive treatment strategies. However, the long-term safety and side effects of these emerging therapies remain areas for further investigation. Future research should focus more on evaluating the combined effects and safety of these treatments, exploring various therapeutic combinations and personalized approaches. This will aid in a deeper understanding of the long-term outcomes and mechanisms of these emerging therapies, thereby facilitating the provision of more effective and safer treatment options for refractory insomnia.

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