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Overview of insomnia in palliative care

Jeremy M Hirst, MD
Scott A Irwin, MD, PhD
Section Editors
Susan D Block, MD
Ruth Benca, MD, PhD
Deputy Editor
Diane MF Savarese, MD


Insomnia is a condition of impaired sleep, with difficulties in initiating or maintaining sleep, and/or experiencing sleep as nonrestorative and unrefreshing, despite having the appropriate opportunity for sleep to occur [1]. It is a very common medical complaint in primary care patients and the same is true for patients in palliative care, which is illustrated by studies that report the prevalence of insomnia is over 60 percent [2-4]. Insomnia is associated with multiple consequences that have a negative impact on quality of life and the ability to perform normal functions. In addition, insomnia is a strong predictor of the development of psychiatric disorders. (See "Overview of insomnia", section on 'Consequences'.)

In the context of palliative care, insomnia often co-exists with other symptoms, such as pain, depression, and anxiety and the presence of one often exacerbates the other, contributing to a decrease in quality of life [5]. Patients receiving palliative care may vary in terms of their functional status and where they are in their personal trajectory in a chronic illness. As a result, the approach and treatment to insomnia in these patients should be individualized. An overview and the general treatment approach to insomnia as well as an overview of palliative care and the assessment of patients in palliative care are discussed separately.

(See "Overview of insomnia".)

(See "Benefits, services, and models of subspecialty palliative care".)

(See "Overview of managing common non-pain symptoms in palliative care" and "Overview of comprehensive patient assessment in palliative care".)


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Literature review current through: Sep 2016. | This topic last updated: Oct 21, 2016.
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