Vikas Jain, MD, FAASM, FAAFP, CCSH, CPE

A panelist discusses the importance of obtaining a comprehensive sleep history before prescribing medication for chronic insomnia and highlights the growing role of dual orexin receptor antagonists as a safer, first-line treatment option with fewer adverse effects compared with older sleep medications like benzodiazepines.

A panelist discusses the use of dual orexin receptor antagonists as a first-line treatment for chronic insomnia due to their efficacy in improving sleep without the risks of dependence or cognitive issues, while also noting their effectiveness in patients with psychophysiologic insomnia and the importance of managing patient expectations regarding their use.

A panelist discusses the strong efficacy and tolerability of dual orexin receptor antagonists (DORAs) for insomnia, noting their minimal adverse effects compared with older medications like benzodiazepines. DORAs are now seen as a first-line treatment option due to their favorable balance of safety and effectiveness, although insurance coverage can influence their availability.

A panelist discusses how dual orexin receptor antagonists (DORAs) offer a novel approach to treating insomnia by reducing wakefulness rather than inducing sedation, highlighting the importance of patient education on their gradual onset, distinct mechanism, and the need for consistent use to achieve long-term benefits.

A panelist discusses how managing chronic insomnia requires setting realistic patient expectations around gradual improvement, emphasizing consistent effort over time, and using both clinical tools and patient feedback to assess progress toward more restorative sleep.

A panelist discusses how managing chronic insomnia requires a comprehensive, multifaceted approach that integrates behavioral interventions like CBT-I with pharmacologic treatments, guided by thorough sleep assessments and tailored to each patient’s specific sleep patterns and comorbid conditions.

Closing their discussion on insomnia, panelists share final thoughts and advice for community physicians.

Expert panelists share their excitement for novel agents that may impact the insomnia treatment landscape.

A brief review of the unmet needs in insomnia management, particularly access to treatment and daytime functioning.

Practical considerations for selecting a particular agent or class when treating a patient with insomnia.

Shared insight on the pharmacologic treatment landscape of insomnia, with a focus on mainstay drug classes.

Focusing on the pharmacologic setting of insomnia, experts consider when it is best to initiate therapy.

Panelists review suboptimal over-the-counter medications that patients may use to manage insomnia.

A brief discussion on the use of mind and body practices to aid in the management of insomnia.

Expert perspectives on the benefits of and limitations to cognitive behavioral therapy for insomnia.

Focusing on treatment options for insomnia, experts consider the added value of sleep hygiene.

Panelists discuss the broad range of impact insomnia has on a patient’s health and quality of life.

A brief review of the value of polysomnography, or sleep studies, in diagnosing patients with insomnia.

A panel of experts break down the myriad of insomnia causes, discussing prevalence amid different patient populations.

Considerations for how to optimally work up and diagnose patients with insomnia.

Shared insight on how daytime functioning has become part of the insomnia treatment paradigm.

Expert perspectives on how patients may present differently with acute vs chronic insomnia.