• Cognitive Behavioral Training to
    Implement the PAP NAP


    ONLINE TRAINING - CEU Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.
  • IRT
    Imagery Rehearsal Therapy


    ONLINE TRAINING - CEU Credit Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.
  • New Pathways for Chronic Insomnia
    Sleeping Pills or Sleeping Test?


    ONLINE TRAINING - CEU Credit Offered

    Presented by Author and Sleep Specialist Barry Krakow, M.D.

Recent Research: In the News

Pharmacotherapy Failure in Chronic Insomnia Patients



Published in the Mayo Clinic Proceedings
Pharmacotherapeutic Failure in a Large Cohort of Patients With Insomnia Presenting to a Sleep Medicine Center and Laboratory: Subjective Pretest Predictions and Objective Diagnoses

Persistent insomnia in chronic hypnotic users pres... [J Nerv Ment Dis. 2010] - PubMed result

Chronic insomnia patients may fail pharmacotherapy. We reviewed charts on 137 chronic insomnia patients new to our sleep medical center who reported persisting insomnia despite long-term usage of pharmacotherapy. We examined 4 areas: (1) patient views on encounters with prescribing physicians; (2) self-reported medication efficacy; (3) treatment-seeking goals; and (4) completion of a sleep medicine workup. Insomnia chronicity averaged 13 years; use of prescription medication for sleep averaged 3.81 years. Encounters with prescribing physicians yielded few options beyond drugs. Drug efficacy was not optimal for most of these patients. Sleeping better or drug-free were their chief goals. Subjective and objective sleep measures confirmed moderately severe residual insomnia as well as fair to poor waking impairment and quality of life. Sleep workup revealed high rates of maladaptive behavioral influences (96%), psychiatric complaints (89%), and obstructive sleep apnea (71%). In chronic insomnia patients who failed pharmacotherapy, comorbid mental and physical factors indicated a sleep disturbance comp


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