HCPLive: Focusing on the pharmacologic setting of insomnia, experts consider when it is best to initiate therapy.

There seems to be a negative association with medications for insomnia and when I talk to hesitant patients, I’d say, “Well, if you had hypertension, you wouldn’t be hesitant to take a medication to lower your blood pressure. You have insomnia, why are you hesitant to take a medication for that?” And I think there’s some pejorative association with falls, maybe daytime residual adverse effects with some of these treatments that we use. There’s been some cross-sectional studies associating treatment with dementing illness, although from my perspective that story has not been told. Nothing definitive there. And it may well, in fact, be in the sleep difficulty. That’s the problem. Not the treatment for it. Thus, I think oftentimes, we have a patient there in front of us, they have an insomnia complaint and you’re at the point where it’s time to begin to consider medical treatment and they’re hesitant I think for a lot of those reasons.

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