Release Date: Wednesday, August 2, 2017  

Expiration Date: Thursday, August 2, 2018

Educational Overview
Insomnia is a widely-prevalent disorder, with up to 40% of adults experiencing some symptoms and approximately 10% with a clinical diagnosis. Although insomnia is a prevalent and serious problem, it is underdiagnosed and undertreated. The impact of insomnia is substantial, resulting in reduced quality of life and increasing risk of comorbid conditions, such as depression, anxiety, obesity, type 2 diabetes, and cardiovascular disease. Recently, there have been several advances in the understanding of sleep physiology, including the role of orexin in controlling the sleep-wake cycle. A better understanding of the pathophysiology of sleep disorders has led to new research in identifying targets for possible treatment. In particular, orexin receptor antagonists offer a unique mechanism of action and have been shown to be an effective option in managing insomnia. Appropriate management of insomnia requires clinicians to have a thorough understanding of current medications available and how they can be used in a patient-centric manner to best meet their needs and preferences. This program will provide an overview of the current understanding of the sleep-wake cycle and how disruptions to that cycle can cause sleep disorders. The mechanism and clinical implications of orexin receptor antagonists as part of the insomnia management plan will also be discussed.

Target Audience
This continuing medical education activity is planned to meet the needs of sleep specialists who are involved in the diagnosis, evaluation, and treatment of patients with insomnia. These include physicians, researchers, sleep technologists, and other professionals who specialize in sleep medicine, neurology, psychology, psychiatry, and neurophysiology.

Learning Objectives
Upon completing this activity, participants will be able to:

  • Understand the latest advancements in the pathophysiology of sleep disorders
  • Recognize the latest non-pharmacologic and pharmacologic approaches in controlling the sleep-wake cycle
  • Evaluate the use of orexin receptor antagonists in the management of insomnia

Educational Format

This Online Presentation is divided into 4 episodes:

Normal Sleep Physiology and Its Implications in Insomnia Pathophysiology
Phyllis C. Zee, MD, PhD

Personalization of Insomnia Therapy:
Matching Treatment with Patient Needs

Andrew Krystal, MD, MS

Unique Role of Orexin Receptor Antagonists in Insomnia Management: Mechanism and Clinical Implications
Thomas Roth, PhD

Learning By Sharing: Q and A



Phyllis C. Zee, MD, PhD

Benjamin and Virginia T. Boshes Professor in Neurology
Director Center for Circadian and Sleep Medicine
Northwestern University Feinberg School of Medicine
Chicago, IL

Andrew Krystal, MD, MS

Ray and Dagmar Dolby Distinguished Professor of Psychiatry and Neurology
Vice Chair of Research
University of California San Francisco School of Medicine
San Francisco, CA
Professor of Psychiatry and Behavioral Sciences
Duke University School of Medicine
Durham, NC

Thomas Roth, PhD

Sleep Disorders and Research Center
Henry Ford Hospital
Detroit, MI





This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Center for Independent Healthcare Education and Vemco MedEd, LLC. Center for Independent Healthcare Education (Center) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Center for Independent Healthcare Education designates this Enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For questions regarding the accreditation of this activity, please contact us at


Method of Participation and Instruction for Credit

  1. Review the entire CME information including target audience, learning objectives, and disclosures.
  2. Review each episode.
  3. Complete the Post Test, Evaluation, and Credit Application Form.
  4. Please note that to receive credit you must achieve a score of at least 70%.
  5. Certificate of Credit will be emailed within 4 weeks of successful completion of the activity.


Disclosure of Conflicts of Interest
In accordance with policies set forth by the Accreditation Council for Continuing Medical Education (ACCME), Center for Independent Healthcare Education requires all faculty members and spouses/significant others with an opportunity to affect the content of a continuing education activity to disclose any relevant financial relationships during the past 12 months with commercial interests. A commercial interest is any entity producing, marketing, reselling or distributing health care goods or services consumed by or used on patients. Relationships with commercial interests and conflicts of interest resulting from those relationships must be revealed to the audience and resolved prior to the activity.

Relevant relationships include roles such as speaker, author, consultant, independent contractor (including research), employee, investor, advisory committee member, board member, review panelist, and investigator. If a potential speaker or author indicates a possible conflict of interest, the conflict will be resolved by choosing another speaker or author for that topical area, or the slides, handouts, and/or monograph will be reviewed and approved by a qualified commercially-disinterested peer.

Phyllis C. Zee, MD, PhD has relevant financial relationships with the following commercial interests:
            Advisory Board: Merck & Co., Inc., Eisai Inc., Philips
            Research Support: Philips, Google, Jazz Pharmaceuticals
            Stock Options: Teva Pharmaceuticals, Express Scripts 
Dr. Zee does not discuss off-label uses of any products.



Andrew Krystal, MD has relevant financial relationships with the following commercial interests:
            Advisory Board: Merck & Co., Inc., Janssen
            Consultant: Neurocentria, Pernix, Neurocrine, Atentiv
            Research Support: NIH, Jazz Pharmaceuticals, Respirex, Janssen
Dr. Krystal discusses the following off-label uses: Off-label use of medications to treat insomnia such as tricyclic antidepressants, trazodone, prazosin.


Thomas Roth, PhD has relevant financial relationships with the following commercial interests:
Consultant: Pfizer, Inc., Ferrer, Merck & Co., Inc., Jazz Pharmaceuticals,
            Flamel, Pernix, Novartis, Actelion, SEQ.
Speakers Bureau: Merck & Co., Inc., Pernix
Dr. Roth does not discuss the off-label uses of any products.

No other speakers, authors, planners or content reviewers have any relevant financial relationships to disclose.

Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias. Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

There is no fee to participate in this activity.

Hardware/Software Requirements
Microsoft Internet Explorer, Mozilla Firefox, Apple Safari or Google Chrome with the QuickTime Plug-in
Note: Please disable any “pop-up blocker” features.

Adobe® Reader version 7 or above to view PDF files (If you do not have Adobe® Reader, you can download it for free from
Adobe Flash Player version 10 or above to view multimedia content (If you do
not have Adobe Flash Player, you can download it for free from

Connection Speed
Cable, DSL, or better of at least 300 kbps

System Check
Please e-mail any questions or concerns to

Copyright Statement
Copyright © 2017 Vemco MedEd, LLC. All Rights Reserved. Permission for accreditation use granted to Center for Independent Healthcare Education.

Privacy Policy

Joint Providership
This activity is jointly provided by Center for Independent Healthcare Education and Vemco MedEd.

Commercial Support

This activity is supported by an educational grant from Merck & Co., Inc.



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