Fig. 3.

Categories of failed a) all insomnia treatments and b) pharmacologic insomnia treatments at intake.

Abbreviations: OTC — over the counter; CBT — cognitive-behavioral therapy; SSRI — selective serotonin reuptake inhibitor; SSNRI — selective serotonin and norepinephrine reuptake inhibitor.

Footnote:

^aPatients suffered from insomnia for an average of 10 years and reported multiple attempts at insomnia treatment [mean 4.48 (3.61–5.34)].

^bOTC supplements and herbal remedies.

^cEducation from books, articles, magazines, etc.

^dCBT does not refer to CBT-I. No patient was introduced to or attempted CBT-I.

^eMeditation, acupuncture, other alternative therapies.

^fBenzo: lorazepam, alprazolam, clonazepam, triazolam, temazepam; SSRI & SSNRI: sertraline, escitalopram, fluoxetine, duloxetine, paroxetine; OTC supplement: melatonin, 5-htp; Sedating anti-depressant: mirtazapine, doxepin, trazodone; Z drug: eszopiclone, zolpidem; Gaba agonist: gabapentin; Antihistamine: diphenhydramine, chlorpheniramine, doxylamine; Muscle relaxant: baclofen, chlorzoxazone; Illicit drugs: tetrahydrocannabinol (THC).