Inpatient multidimensional management of treatment-resistant in somnia: Comprehensive treatment in an inpatient psychiatric unit

Twenty patients with severe chronic refractory insomnia underwent inpatient psychiatric treatment. All patients had Axis I and/or Axis II diagnoses, in most cases affective and substance use disorders as well as various personality disorders. An individualized combination of psychotherapeutic and behavioral techniques was directed primarily toward treating the underlying mental disorders. Fourteen patients received medication. In spite of the wellknown resistance of chronic insomniacs to conventional treatment efforts, 16 of the 20 patients achieved good nightly sleep while they improved in social interactions and overall quality of life and remained improved at six months’ follow-up. Thus, the inpatient psychiatric unit appears to be an ideal setting for the multidimensional management of treatment-resistant insomnia.