5 Key Takeaways

• 1

  Cognitive behavioral therapy for insomnia (CBT-I) is the preferred first-line treatment for chronic insomnia disorder in adults.

• 2

  Combination therapy of CBT-I and pharmacotherapy offers modest benefits over medication alone but not over CBT-I alone.

• 3

  Combination treatment may lead to small improvements in insomnia severity and sleep continuity but has slightly higher adverse effects.

• 4

  Pharmacotherapy alone is appropriate when CBT-I is unavailable or when patients cannot engage in behavioral interventions.

• 5

  The guideline emphasizes shared decision-making and tailoring treatment based on patient preferences and access to care.