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lüll Non-pharmacological management of primary and secondary insomnia among older people: review of assessment tools and treatments Petit L; Azad N; Byszewski A; Sarazan FF; Power BAge Ageing 2003[Jan]; 32 (1): 19-25BACKGROUND: primary and secondary insomnia, especially among older adults, is frequently encountered by family physicians. Pharmacological interventions, although effective in some circumstances, can be detrimental in others. Non-pharmacological management of insomnia may allow the patients to self-administer the treatment. OBJECTIVES: review of published literature of assessment tools and treatments for primary and secondary insomnia. RESULTS: two frequently used self-reporting methods for obtaining sleep data are sleep diaries and Pittsburg Sleep Quality Index. A large amount of research supports the use of non-pharmacological treatments such as stimulus control, sleep restriction, sleep hygiene education, cognitive therapy, multi-component therapy and paradoxical intention. CONCLUSION: assessing the nature of insomnia by using an effective assessment tool and providing patients with a non-pharmacological treatment should be the first intervention for insomnia. It is shown that non-pharmacological treatments for primary and secondary insomnia are feasible and effective alternatives to the use of benzodiazepines, and that family physicians should consider these when managing older patients with insomnia.|Aged[MESH]|Anti-Anxiety Agents/administration & dosage/adverse effects[MESH]|Behavior Therapy/methods[MESH]|Benzodiazepines[MESH]|Cognitive Behavioral Therapy/methods[MESH]|Family Practice[MESH]|Health Behavior[MESH]|Humans[MESH]|Patient Education as Topic[MESH]|Self Care[MESH]|Sleep Initiation and Maintenance Disorders/etiology/*therapy[MESH] |