Multimodal Optimized Treatment for Insomnia Framework (MOTIF): A Better Strategy for the Optimal Prescription of Hypnotics
Cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment for insomnia, offering durable improvements in sleep and a favorable safety profile. Nevertheless, some patients do not achieve adequate relief with CBT-I alone and may struggle to stop taking sleep medications....
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Sleep Medicine
2025-06-01
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| Series: | Sleep Medicine Research |
| Subjects: | |
| Online Access: | http://sleepmedres.org/upload/pdf/smr-2025-02873.pdf |
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| Summary: | Cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment for insomnia, offering durable improvements in sleep and a favorable safety profile. Nevertheless, some patients do not achieve adequate relief with CBT-I alone and may struggle to stop taking sleep medications. The current guidelines restrict hypnotic use to short durations, despite that, many clinicians are prescribing hypnotics to patients longer. The Multimodal Optimized Treatment for Insomnia Framework (MOTIF) addresses these gaps by stratifying patients according to their ability to sleep without medications and their preferences with regard to pharmacological interventions. Within this framework, CBT-I is primarily recommended for individuals who can sleep without medications. For those who cannot sleep without medications, MOTIF supports the use of optimized minimal-dose of hypnotics. MOTIF aims to reduce unnecessary use of medications, strengthen patient–clinician collaboration, and improve long-term outcomes for patients with insomnia who do not respond to standard CBT-I approaches. |
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| ISSN: | 2093-9175 2233-8853 |