Intended for healthcare professionals

Clinical Review State of the Art Review

Advances in the management of chronic insomnia

BMJ 2016; 354 doi: (Published 06 July 2016) Cite this as: BMJ 2016;354:i2123

Chinese translation


  1. Margaret Kay-Stacey, assistant professor of neurology1,
  2. Hrayr Attarian, professor of neurology1
  1. 1Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to: M Kay-Stacey margaret-stacey{at}


Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients’ health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these treatments. However, in recent years, alternative ways of providing these behavioral therapies that make them more widely available have been investigated. Drugs also play an important role in the treatment of insomnia and new drugs have been introduced as options for treating patients with sleep initiation and sleep maintenance insomnia. In this review, we will discuss advances in the past six years in both non-pharmacologic and pharmacologic treatments for patients with chronic insomnia. We will also review the controversies surrounding some of the current drug treatments, as well as the role that technology and personal activity monitoring devices may play in treating insomnia.


  • Contributors: Both authors contributed equally to this review. MK-S wrote the introductory paragraphs and the pharmacological treatments while HA wrote the non-pharmacological treatments and the controversies over sedative hypnotic use. Each author reviewed the other’s work and agreed with its content and format. Both authors are guarantors and accept full responsibility for the work and the decision to publish.

  • Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: none.

  • Provenance and peer review: Commissioned; externally peer reviewed.

  • No patients were asked for input in the creation of this article.

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