- What are patient, caregiver, or family member experiences with and perspectives of treatment and management of insomnia?
Only patient perceptions were available for review, there were no relevant data on caregiver or family member experiences. Patients perceptions of and engagements with pharmacotherapy tend to vary in relation to nightly levels of fatigue, daytime responsibilities and social normalization of medical sleeping aids. While the duration and intensity of insomnia also plays a role, this review was unable to identify any consistent timeframes or severity levels that could serve as indicators. Rather, the use of pharmacotherapy tends to be informed by a certain level of pragmatism balancing need with desired outcomes. For instance, while several individuals perceived pharmacotherapy as the better choice due to its rapid relief, others were concerned with daytime side-effects and issues of long-term dependence or addiction. Some people living with insomnia also report trying alternatives to pharmacotherapy including cognitive behavioural therapy, mindfulness, exercise, relaxation, herbal remedies, or other complementary therapies. For many of these people, non-pharmacological treatment is viewed as a long-term solution that can address the underlying cause of insomnia and ultimately overcome the disorder. They appreciate that the personalized nature of these treatments helps them to adhere and obtain longer-term outcomes. Many patients appear to struggle when deciding on which treatment option to consider, and in their decision consider what is more important to them: a long-term outcome that addresses underlying factors in their insomnia or a quick short-term relief. By allowing themselves the time to sit with and listen to the patients lived experience of suffering, perhaps clinicians could help this decision become clearer.