Effective Ways to Manage Insomnia:
Improving Outcomes though Optimal Treatment Strategies
A continuing medical education
activity provided by NAMCP and AAMCN
This activity is an archive from the live session from the 2020
Spring Managed Care Forum. If you participated in the live session,
you are not eligible for continuing education credits from this
This activity is valid from July 1, 2020 to July 1, 2021
Instructions for CME/NCPD: Complete the pre-test, listen to the
audio and view the slides, complete the post test, complete the
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will have ONE more opportunity to complete. A score of 70% must be
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If you do not pass the post test after two attempts, you will not be
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score 70% or higher on your post test, you will automatically be
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This activity is intended for healthcare professionals practicing in
managed care environments.
This activity is supported by
an educational grant from
Insomnia is a sleep disorder which makes it difficult to fall asleep
or stay asleep, even when a person has the chance to do so. This can
affect a person’s sleep so much that they still feel tired after
they wake up. Insomnia can also make you feel like you're the only
one still awake while the rest of the world sleeps. It can sap your
energy level, affects you mood, and causes stress with your health,
work performance and quality of life. The dangers of insomnia can
affect more than just a person’s mood as people and if not treated
properly can lead to other effects such as anxiety, depression,
irritability, concentration problems, memory problems, poor immune
system function, and reduced reaction time. Many adults experience
acute insomnia, which can lasts for days or weeks and is usually the
result of stress or a traumatic event in one’s life. There are some
people that experience chronic insomnia which is long term and can
lasts for a month or more. There are 60 million Americans affected
by the disease. About 25% of Americans experience acute insomnia
each year with around 10% experiencing chronic insomnia.
There are a number of different approaches to the diagnosis of
insomnia although there is no definitive test for it. Tools used for
diagnosing the disease include a sleep log, which tracks the details
of a person’s sleep, sleep inventory of sleeping patterns, blood
tests and undergoing a sleep study. These tests will help determine
the level of insomnia and what treatment plan should be utilized.
Insomnia continues to be underdiagnosed and undertreated. Several
experiencing insomnia try self-treatment with alcohol or
over-the-counter products containing first-generation
antihistamines, but that gives varying and underwhelming results.
For these patients with poor results, identifying sleep hygiene
issues can raise awareness of sleep patterns that need to be
changed. Cognitive behavioral therapy has proven efficacy as
first-line treatment for insomnia. This can include stimulus control
therapy, relaxation techniques, and sleep restriction. However,
there are some patients that do not respond to nonpharmacologic
treatments and they need to supplement a patient’s nonpharmacologic
treatment with a pharmacologic agent. The risks of the pharmacologic
agent need to be balanced with its benefits, and the patient’s age
and sleep pattern should be taken into account when selecting the
optimal dose. The risk of side effects from these therapies
continues to be examined as the pills can become addictive and if
not taken properly can play a large role in the lack of proper
adherence to the medications taken. There are new treatments that
are in clinical trials, including a dual orexin receptor antagonist,
which will help regulate sleep by dampening wakefulness without
stopping the ability to awaken the external stimuli.
Upon completion of this
activity, participants will be able to:
Describe the pathophysiology and
prevalence of insomnia to help inform treatment decisions
Analyze the clinical data for the
safety and efficacy profiles in recently approved therapies
Assess effective treatment goals for
insomnia and how each can improve patient outcomes
Examine the most recent guideline
recommendations for proper insomnia management
Explore the current barriers of care
associated with managing insomnia, including patient adherence
and untreated insomnia
||David N. Neubauer, MD
Department of Psychiatry and Behavioral Sciences
Johns Hopkins University School of Medicine
Neubauer serves on an advisory board for Abbott
Laboratories and Eisai. His presentation has been peer
reviewed for any bias.
MD has no real or perceived financial relationships to
Jeremy Williams has no real or perceived financial
relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no real or perceived
financial relationships to disclose.
NAMCP and/or the presenter
has copyright or has received permissions for use of
materials provided in this activity.
Accreditation & Designation
This activity has been planned and implemented in accordance with
the accreditation requirements and policies of the Accreditation
Council for Continuing Medical Education (ACCME) through the joint
providership of the National Association of Managed Care Physicians
(NAMCP) and American Association of Managed Care Nurses (AAMCN). The
National Association of Managed Care Physicians is accredited by the
ACCME to provide continuing medical education for physicians.
NAMCP designates this enduring material for a maximum of 1 AMA
PRA Category 1 credit(s)TM. Each
physician should claim credit commensurate with the extent of their
participation in the activity.
The American Association of Managed Care Nurses is accredited as a
provider of nursing continuing professional development by the
American Nurses Credentialing Center's Commission on Accreditation.
Nurses who complete this activity and achieve a passing score will
receive 1 hour in nursing continuing professional development.
This activity has been approved by the American Board of Managed
Care Nursing for 1.0 contact hours toward CMCN recertification
This activity is supported by
an educational grant from
NAMCP and/or this website does not
provide medical advice, diagnosis or treatment. NAMCP does not
endorse or imply endorsement of the content on any linked website.
This website is to be used as an informational resource. With any
health related concern, consult with your physician or healthcare
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