Psychiatry
Insomnia Management
NICE NG215 / CKS — diagnose, exclude secondary causes, CBT-I first-line, pharmacotherapy short-term only.
Source: NICE NG215 (2022); CKS
Step 1 of ~4
info
Assess
Insomnia disorder: difficulty falling / staying asleep / early waking, ≥3 nights/week for ≥3 months + daytime impairment despite adequate opportunity.
Exclude secondary causes:
• Mental health: depression, anxiety, PTSD, mania, psychosis.
• Sleep disorders: OSA (snore, witnessed apnoea, daytime sleepiness — STOP-BANG), restless legs, parasomnias.
• Physical: pain, COPD, heart failure, GORD, urinary frequency.
• Substances: caffeine, alcohol, nicotine, opioids, stimulants, beta-blockers, steroids, decongestants.
• Circadian rhythm disorders: shift work, jet lag, delayed sleep phase.
Sleep diary + Pittsburgh Sleep Quality Index.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Tolbutamide · First-generation sulfonylurea (short-acting)
- Lorazepam (Elderly — Short-Term Use) · Benzodiazepine
- Ethambutol · Antitubercular — First-Line TB (RIPE Regimen, 'E')
- Pyrazinamide · Antitubercular — First-Line TB (RIPE Regimen, 'P')
- Ethinylestradiol with levonorgestrel · Combined oral contraceptive (2nd-generation progestogen — first-line)
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF
Decision support only. Always apply local guidelines and clinical judgement.