Text adapted from: "The adult patient with a sleep disorder," in Psychiatry in primary care by Dora Zalai, M.R. Goolam Hussain and Colin Shapiro (CAMH, 2019).
For pharmacotherapies used in Canada to treat sleep disorders, see table below. Consider pharmacotherapy for chronic insomnia when CBT-I is not available, when treatment was not effective or when the patient prefers pharmacotherapy.
Evidence suggests that insomnia with objective short sleep duration has primarily biological roots (e.g., genetics and physiological hyperarousal) and may respond better to biological treatments, whereas insomnia with objective normal sleep duration has primarily psychological roots and may respond better to psychological interventions alone (CBT techniques).
The efficacy of hypnotics is comparable to that of CBT-I for the acute treatment of insomnia; however, the effects dissipate after the hypnotic is discontinued, whereas improvements made through CBT-I are maintained after the patient completes treatment.