Rebound insomnia is insomnia that occurs following discontinuation of sedative substances taken to relieve primary insomnia.

With primary insomnia, however, initial efforts should be psychologically based.

The condition, known as persistent primary insomnia, is believed to affect about 14 million people in this country, most over 40, and it is associated with a variety of health problems.

Studies support that larger amounts of cortisol released in the evening occurs in primary insomnia.

Patients with various disorders, including delayed sleep phase syndrome, are often mis-diagnosed with primary insomnia.

Panic disorder leads to 7 million years lost, obsessive-compulsive disorder 5.1, primary insomnia 3.6, and post-traumatic stress disorder 3.5 million DALYs.

Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions, with more durable results.

Cognitive behavioral therapy for treatment of chronic primary insomnia: A randomized controlled trial.

According to its manufacturer, it has been shown to be safe and effective for the short term treatment of primary insomnia in the elderly and safe in younger adults for 6-12 months.

Tasimelteon completed the phase III clinical trial in the United States for primary insomnia in 2010.