P038 Insomnia - Going backward to go forward

Background Although there are common features in people with insomnia, for each individual there are possible different contributing factors and pathophysiological processes; each needing specific tailoring of treatment. We aim to understand treatments undertaken prior to specialist referral, common features on presentation and contributing factors in individual cases identified as part of their assessment. Methods We will undertake a retrospective audit of consecutive patients presenting with insomnia to a single private practice with a high insomnia case-load. We are collecting demographic data, details of prior and current treatments, clinical characteristics at presentation, outcomes of investigations and classification insomnia sub-type using the International Classification of Sleep Disorders-2 (ICSD-2). Data will be descriptive to allow understanding of the type and nature of patients presenting with insomnia and a deconstruction of contributing factors to the presenting problem of insomnia. Progress to date Low-risk ethics approval submitted via St Vincent’s Human Research Ethics Committee. Literature review in progress. Intended outcome and impact The umbrella term “insomnia” belies its heterogeneity. Although there are common factors in most insomnia presentations, recognised in the simplification of diagnostic criteria in ICSD-3 and DSM 5, in managing individual patients it is also important to understand characteristics that are particular to the person. Whilst generic cognitive behavioural therapy for insomnia (CBTi) has been proven to be effective, in expert hands the response rate is still in the region of 60%, potentially reflecting a role for more tailored treatments for individuals to complement CBTi.