When to use a drug for insomnia in adults

Before considering a drug for insomnia, comprehensively assess the patient to determine the type and impact of insomnia and identify contributing or causative factors. Often, a drug will not be required if:

• contributing or causative factors are effectively managed
• good sleep practices are encouraged
• relevant psychological and behavioural interventions are used.

Only consider using a drug to treat acute insomnia  if the following criteria are met:

• the likely benefits exceed the possible harms
• the patient is significantly distressed by lack of sleep, or significantly impaired by daytime sequelae
• nondrug interventions are impractical or unacceptable.

For chronic insomnia , in addition to meeting the above criteria for drug use for acute insomnia, only consider using a drug if cognitive behavioural therapy for insomnia (CBT-I) is ineffective or not preferred by the patient.

Avoid using a drug as sole treatment for insomnia—see Principles of treating insomnia in adults.