RT Journal
A1 Morin CM
T1 COgnitive behavioral therapy alone and with medication for persistent insomnia—reply
JF JAMA
JO JAMA
YR 2009
FD September 9
VO 302
IS 10
SP 1053
OP 1054
DO 10.1001/jama.2009.1284
UL http://dx.doi.org/10.1001/jama.2009.1284
AB 
It is generally preferable to minimize exposure to hypnotic drugs, particularly if CBT is available and patients achieve adequate treatment response with this approach. However, CBT is not always available, and not all patients respond to this intervention. Hence, sleep medication, which may be the most readily available treatment, should be seen as a rescue and short-term therapy for acute insomnia resulting from stressful life events or major changes in schedule. Its role and efficacy in long-term management of insomnia remains controversial and poorly documented.2 While additional research is needed to validate optimal treatment algorithms, current evidence suggests that CBT should be the first-line therapy for chronic insomnia, and medication should be considered only for patients who do not respond or cannot follow this therapeutic regimen.