Sleep neurology: pearls and pitfalls

Chronic insomnia affects approximately 10% of adults.

• Multiple sleep disorders, such as obstructive sleep apnoea and restless legs syndrome, are often under-recognised and misdiagnosed.
• Cognitive behavioural therapy for insomnia is the recommended first-line treatment, yet access to this therapy is limited.
• There is a tendency to initiate medications prematurely for sleep disorders, despite the availability of effective non-pharmacological treatments.
• Emerging therapies, including dual orexin receptor antagonists and orexin-based treatments, could enhance management of insomnia and narcolepsy but need careful implementation.
• Improper use of medications, especially dopamine agonists for restless legs syndrome, may lead to worse health outcomes.

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