New Guidance on Chronic Insomnia Treatment

Experts recommend CBT-I as first-line therapy, with combination treatment reserved for selected patients

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Cognitive behavioral therapy for insomnia (CBT-I) is the preferred first-line treatment for chronic insomnia disorder in adults.
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Combination therapy of CBT-I and pharmacotherapy offers modest benefits over medication alone but not over CBT-I alone.
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Combination treatment may lead to small improvements in insomnia severity and sleep continuity but has slightly higher adverse effects.
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Pharmacotherapy alone is appropriate when CBT-I is unavailable or when patients cannot engage in behavioral interventions.
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The guideline emphasizes shared decision-making and tailoring treatment based on patient preferences and access to care.

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