Raman Malhotra, MD: Increasing the Attention on Insomnia


The associate professor of neurology at Washington University in St. Louis spoke to the need to improve the awareness for insomnia, which remains one of the most common sleep disorders.

“Many would argue that insomnia is more common than obstructive sleep apnea, but unfortunately, I think most patients who have problems either getting to sleep or staying asleep at night will self-medicate.”

Obstructive sleep apnea (OSA) is often pointed to as an under-diagnosed and under-treated sleep disorder, and is considered widely prevalent, with some estimates claiming it occurs in approximately 3 to 7% of adult men and 2 to 5% of adult women in the general population.1 Additionally, the challenges faced by patients in adherence and treatment with continuous positive airway pressure (CPAP) can often dominate the conversations about unmet needs in sleep.

However, for sleep specialists such as Raman Malhotra, MD, associate professor of neurology, Washington University in St. Louis, and board of directors, American Academy of Sleep Medicine, another disorder that requires just as much attention is insomnia. Many of these patients turn to self-medication with over-the-counter therapies or illicit drugs and alcohol, he said, and when they do see non-sleep specialists for these sleep issues, they can be prescribed medications that carry habit-forming risks.

In this interview with NeurologyLive, Malhotra offered some insight into the available nonpharmacologic therapeutics for insomnia, such as cognitive behavioral therapy, and detailed a number of other advances that have been made in the care of patients with sleep disorders in the past several years.

1. Pubnjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008 Feb 15; 5(2): 136–143. doi: 10.1513/pats.200709-155MG
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