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Disease Management Clinical Decisions

Insomnia Care: An Integrated Approach

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Release Date:   August 1, 2017
Expiration Date:   August 1, 2020

Estimated Time of Completion:   1 hour, 15 minutes


Each lesson in the Disease Management Clinical Decisions series is designed to provide a comprehensive review of the clinical presentation, diagnostic tests, differential diagnosis, and management strategies for a specific case or cases related to the topic. It also provides questions and multiple-choice answers related to the clinical management of the case along with the rationale for the correct answer. Throughout this case-based lesson, you may proceed to the next question once you answer the question correctly.

After completing the CME activity, the evaluation, and the registration forms, you will have an opportunity to print your CME certificate for your records.

Learning Objectives

  1. Define criteria for chronic insomnia, incidence, and the effect of predisposing factors.
  2. Summarize the two-process model of sleep regulation and discuss the importance of each process in designing treatment strategies for chronic insomnia.
  3. Use the recommended timing of polysomnography to clarify comorbid sleep disturbances in patients with the complaint of chronic insomnia.
  4. Describe the various behavioral therapeutic approaches to treating chronic insomnia.
  5. Compare the complexities of using sleep medications versus behavior-based therapies.
  6. Compare and contrast modes of action, indications, effectiveness, and side effect profiles of sleep medications.

Target Audience

Directed to primary care physicians including family practitioners and internists.


The Cleveland Clinic Foundation Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Participants claiming CME credit from this activity may submit the credit hours to the American Osteopathic Association for Category 2 credit.

Activity Director and Faculty

Activity Director

Alexander Duart Rae-Grant, MD
Clinical Associate Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Director of Resident and Student Education
Mellen Center for Multiple Sclerosis Treatment and Research
Cleveland Clinic
Cleveland, OH


Douglas E. Moul, MD, MPH, FAASM, FAPA
Senior Sleep Psychiatrist, Staff Physician
Sleep Disorders Center
Cleveland Clinic
Cleveland, OH

Michele Drerup, PsyD, CBSM
Associate Professor of Medicine
Cleveland Clinic Lerner College of Medicine
    of Case Western Reserve University
Director of Behavioral Sleep Medicine
Staff, Sleep Disorder Center
Cleveland Clinic
Cleveland, OH

CME Disclaimer

The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable for any decision made or action taken in reliance upon the information provided through this CME activity.


In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias.

The following faculty have indicated that they have no relationship which, in the context of their presentation, could be perceived as a potential conflict of interest:

Alexander Duart Rae-Grant, MD
Douglas E. Moul, MD, MPH
Michele Drerup, PsyD

This CME activity was produced by The Cleveland Clinic Foundation
Center for Continuing Education.