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 archive.

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 evaluation form and hit submit. You will be asked to enter your name and email address on the pre-test, evaluation and post-test. If you close your internet browser without completing the post test, you will have ONE more opportunity to complete. A score of 70% must be achieved on the post test to receive continuing education credits. If you do not pass the post test after two attempts, you will not be eligible to try again. Once you complete the evaluation form and score 70% or higher on your post test, you will automatically be given your certificate.

To print or save your certificate, you will need to click on the “download” button and either print or save.

 

Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This activity is supported by an educational grant from
Eisai

Description:
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

     

Faculty: David N. Neubauer, MD
Associate Professor
Department of Psychiatry and Behavioral Sciences
Johns Hopkins University School of Medicine

Disclosure:

Dr. Neubauer serves on an advisory board for Abbott Laboratories and Eisai. His presentation has been peer reviewed for any bias.
  Planning Committee:
Bill Williams, MD has no real or perceived financial relationships to disclose.
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 requirements.

This activity is supported by an educational grant from
Eisai

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 professional.

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