Do your patients tell you they have a hard time falling asleep or staying
asleep; that they wake up during the night; or that they have difficulty
getting back to sleep once they wake up? Do they also complain of being tired
all day? Have they also tried over-the-counter medications or alcohol but still
cannot sleep? Since as many as 30 – 40 percent of Americans report
insomnia each year,1 this is not an unusual complaint to be reported
by your patients.
Sleep problems are a significant public health issue, as they have an impact
on many health conditions. Since 20 – 33 percent of the patients in a
provider's practice may have a complaint of sleep disturbance, it is important
for primary care physicians (PCP) to fully evaluate the situation. Sleep
problems could signify a previously undiagnosed chronic medical condition, or
they could impact the treatment of other conditions such as chronic pain,
cardiovascular and neurological conditions. Sleep disturbances may negatively
affect mood, anxiety, and post-traumatic stress disorder2 and are
now included in the DSM-5 as a distinct mental health disorder. For these
reasons, fostering effective sleep is a shared responsibility of both medical
and behavioral health providers and, when properly addressed, can improve
health as well as quality of life.
Treatment options
Your patients may ask for medication to help them sleep, but research has
shown that medications are not the most effective treatment for chronic
insomnia.3 While there are many non-pharmacologic treatments
available for insomnia, research has found that Cognitive Behavioral Therapy
(CBT) is effective for treating insomnia.4
With this information in mind, Magellan Healthcare, Inc. (Magellan) has
developed a web-based and confidential CBT program for insomnia, known as
RESTORETM. Magellan RESTORETM is a free mobile app that
you and your patient can download from your smartphone or tablet. The program
contains seven modules, which are intended to be completed by your patient
weekly. Each module takes 20 to 50 minutes to complete and should be done as
one session. The RESTORETM program contains patient resources as
well as a sleep diary. The entire program is done in the privacy of the
patient's own home. Another important aspect of the program is the report
section, which is based on the modules and sleep diary. This is a valuable
tool that the patient can share with you.
AmeriHealth and Magellan continue to collaborate to provide education and
resources to our network providers. You can find more information and resources
for patient management on our website for AmeriHealth Pennsylvania and for AmeriHealth New Jersey. Resources are also available on the
NaviNet® web portal under Health and Wellness in the
Administrative Tools & Resources section.
1National Heart, Lung and Blood
Institute. "Your guide to healthy sleep." National Institutes of Health.
2011. Available from: https://www.nhlbi.nih.gov/files/docs/public/sleep/healthy_sleep.pd
f.
2Roth, T. "Comorbid insomnia: current
directions and future challenges." The American Journal of Managed Care.
2009. 15:S6-S13. Available from: http://www.ajmc.com/journals/supplement/2009/2008-12-vol15-n1Suppl
/A228_09feb_Roth_S6toS13/.
3Maglione, M; Maher, AR; Hu, J; Wang, Z;
Shanman, R; Shekelle, PG; Roth, B; Hilton, L; Suttorp, MJ; Ewing, BA; Motala,
A; Perry, T. "Off-Label Use of Atypical Antipsychotics: An Update." Agency
for Healthcare Research and Quality. 2011. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22132426.
4American Academy of Sleep Medicine.
"Online Cognitive Behavioral Therapy is Effective in Treating Chronic
Insomnia." June 1, 2009. Available from: http://www.aasmnet.org/articles.aspx?id=1295.
Magellan Healthcare, Inc. manages mental health and
substance abuse benefits for most AmeriHealth members.
NaviNet is a registered trademark of NaviNet, Inc.