Monitoring
With insomnia, clinical assessment should be done every few weeks and/or every month until insomnia resolves, then every 6 months thereafter. Follow-up during the early stages of the treatment is important to assess the effectiveness of treatment, possible adverse reactions, dependence, tolerance, and the need for continuing treatment. It must be noted that repeated use of self-administered questionnaires and survey instruments help assess outcomes and determine the need for further treatment. Sleep onset latency, sleep duration, sleep satisfaction, and daytime functioning should be monitored. Re-evaluation should be considered for comorbid disorders when behavioral therapies, pharmacologic therapies, and combined treatments have been ineffective. Lastly, if there is no noted improvement, a referral to a sleep specialist should be considered.