Insomnia is highly prevalent, has associated daytime consequences
which impair job performance and quality of life, and is associated
with increased risk of comorbidities including depression. These
practice parameter provide recommendations regarding behavioral and
psychological treatment approaches, which are often effective in primary
and secondary insomnia. These recommendations replace or modify
those published in the 1999 practice parameter paper produced by the
American Sleep Disorders Association. A Task Force of content experts
was appointed by the American Academy of Sleep Medicine to perform a
comprehensive review of the scientific literature since 1999 and to grade
the evidence regarding non-pharmacological treatments of insomnia.
Recommendations were developed based on this review using evidencebased
methods. These recommendations were developed by the Standards
of Practice Committee and reviewed and approved by the Board
of Directors of the American Academy of Sleep Medicine. Psychological
and behavioral interventions are effective in the treatment of both chronic
primary insomnia (Standard) and secondary insomnia (Guideline). Stimulus
control therapy, relaxation training, and cognitive behavior therapy
are individually effective therapies in the treatment of chronic insomnia
(Standard) and sleep restriction therapy, multicomponent therapy (without
cognitive therapy), biofeedback and paradoxical intention are individually
effective therapies in the treatment of chronic insomnia (Guideline). There
was insufficient evidence to recommend sleep hygiene education, imagery
training and cognitive therapy as single therapies or when added to
other specific approaches. Psychological and behavioral interventions are
effective in the treatment of insomnia in older adults and in the treatment
of insomnia among chronic hypnotic users (Standard).