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Chronic insomnia: Finding a comprehensive treatment program

Many patients in psychotherapy complain of the inability to fall asleep or maintain sleep.

Discuss the following:
Finding a comprehensive treatment program for patients suffering from insomnia when traditional psychotherapy and or medications is of no help.
Looking for a specific therapeutic treatment plan that will successfully deal with the sometimes debilitating syndrome known as insomnia.

Solution Preview

Initial Intake: When a patient presents with a complaint of chronic insomnia it is prudent and necessary to take a thorough patient history. As you can see on the attachment, we begin by getting the patient's identification. Name, address, and contact number. We then record their vital statistics, age, sex, height and weight. We then ask the patient to describe in their own words what their chief complaint is. The history of the present illness is to establish how long the patient believes he or she has suffered from insomnia. We also want to find out the patient has a past history of bouts of insomnia as well as any family history of sleep disorders. The social history is important because it tells us something of the patient's lifestyle and how that could be contributing to their chief complaint. For example, we ask them about their alcohol use, when they normally go to bed, what time they get up, do they nap, etc. We also need to get a list of medications the patient is taking because these can often cause sleep disturbance. Finally, we make a preliminary diagnosis using the International Classification of Sleep Disorders, 2nd ed. Diagnostic and Coding Manuel. This manuel is akin to the DSM IV for psychological disorders.

Our next step is to begin a behavioral approach to monitoring ...

Solution Summary

This post discusses the issue of finding a comprehensive treatment program that can help patients suffering from this disorder when traditional psychotherapy and or medications are of no benefit. [880 words]