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Abstract

People with insomnia experience difficulty falling asleep (sleep latency), wake throughout the night (sleep maintenance), or wake up earlier than desired (wake after sleep onset deficiency) (Perez & Salas, 2020). They do not sleep effectively, experience daytime fatigue, develop mood disorders, decrease their work efficiency, and increase their risk of physical harm due to reduced attention and concentration skills (Reynolds & Ebben, 2017). Cognitive-behavioral therapy for insomnia (CBT-I) provides gold-standard treatment for patients who have insomnia (Van Straten et al., 2018). The overwhelming evidence for this modality is well documented; however, there are many challenges in providing this therapy to the general public. The purpose of this quality improvement project is to develop a sustainable process for screening adult patients at their primary medical home via the validated insomnia severity index (ISI) tool. In this improvement project, all new patients received insomnia screening, and the appropriate patients received a referral for CBT-I treatment. Lastly, the patients completed a post-CBT-I ISI to substantiate no operational difference in receiving CBT-I in a medical home versus a behavioral health setting. Future studies within this setting will seek to determine the potential advantages of having CBT-I in the medical home, including having providers nearby, collaborative efforts with medication management, and opportunities to quickly expedite subsequent testing for medical conditions associated with chronic insomnia.

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