This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 46-year-old woman has difficulty in falling asleep and stayingasleep. The problem started after the birth of her second child15 years earlier in association with mild postpartum depression.Despite having had no recurrence of depression and no majorpsychosocial stressors, the patient requires two hours to fallasleep most nights, and on the occasions that she falls asleeprapidly, she . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
Cognitive Behavioral Therapies
Pharmacologic Therapies
Pharmacologic Therapy vs. Cognitive Behavioral Therapy
Areas of Uncertainty
Guidelines from Professional Societies
Summary and Recommendations
Source Information
From the Sleep Disorders Center and the Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minn.
Address reprint requests to Dr. Silber at the Mayo Sleep Disorders Center, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55902, or at msilber@mayo.edu.
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