New AASM Guidance on Combination Treatment for Chronic Insomnia

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.
In this Mind Moments episode, Todd Arnedt, PhD, professor of psychiatry and neurology at Michigan Medicine-University of Michigan, joins the podcast to discuss the recently published American Academy of Sleep Medicine clinical practice guideline on combination treatment for chronic insomnia disorder in adults. Arnedt explains the rationale behind formal recommendations for concurrent use of cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy, particularly as combination treatment becomes increasingly common in clinical practice.
The conversation reviews the evidence supporting CBT-I as the preferred foundational treatment approach, where combination therapy may offer advantages over pharmacotherapy alone, and how clinicians should think about factors such as symptom burden, treatment goals, access to CBT-I, and patient preference when selecting treatment strategies. Arnedt also outlines ongoing research gaps involving sequential treatment approaches, medication classes, long-term outcomes, and personalized insomnia care.
Looking for more Sleep Disorders discussion? Check out the NeurologyLive® Sleep Disorders clinical focus page.
Episode Breakdown:

1:15 – Why formal insomnia combination treatment guidance was needed

2:45 – Defining concurrent CBT-I and pharmacotherapy approaches

4:35 – Evidence supporting CBT-I as foundational insomnia treatment

7:15 – Situations where combination therapy may improve patient outcomes

7:50 – Neurology News Network

10:20 – Patient-specific factors influencing insomnia treatment selection

12:30 – Barriers involving CBT-I access, cost, and real-world implementation

16:55 – Research gaps surrounding sequencing, long-term outcomes, and personalization

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