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Case Report | DOI: https://doi.org/10.31579/2639-4162/342
Suresh Kishanrao, Physician & Public Health Consultant, Bengaluru &Visiting Professor of Practice KSRDRU, Karnataka,
*Corresponding Author: Suresh Kishanrao, Physician & Public Health Consultant, Bengaluru &Visiting Professor of Practice KSRDRU, Karnataka, Received date:
Citation: K. Suresh, (2026), Tackling Insomnia in Everyday Clinical Practic, J. General Medicine and Clinical Practice, 9(4); DOI:10.31579/2639-4162/342
Copyright: © 2026, K. Suresh. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 02 March 2026 | Accepted: 13 March 2026 | Published: 20 March 2026
Keywords: sleep; insomnia- acute & chronic; onset insomnia; maintenance insomnia.
Insomnia is defined as a condition in which a person finds it difficult to fall or stay asleep. Basically, classified as acute (short-term, days to weeks) and chronic (long-term 3+ months, or 3+ nights/week) types based on duration of suffering. It is a health disrupting condition, less often help sought professional help and when sought is under diagnosed despite leading to high healthcare utilization. It is more common in women, the elderly, young children and those with co-existing mental or physical ill-health or sedentary life. Chronic Insomnia’s outcomes include decreased quality of life, impairment in daytime functions, increased workplace accidents and production. Major risk factors for Insomnia include i) Psychiatric issues like depression & anxiety disorders, Parkinson’s disease & post-traumatic stress disorder (PTSD) ii) physical causes like chronic pain, cardiovascular diseases, obstructive sleep apnoea, metabolic disorders and other sleep disruptors are thyroid dysfunction, GERD & restless leg syndrome iii) Social / Lifestyle causes like Shift work, more exposure to screen like TV or mobile phones, lower socio-economic status, and sedentary lifestyle. Primary health care provider or family Physicians come across more cases in routine clinic. They must make all out efforts to improve sleep quality/duration & reduce daytime functions impairment. The key treatment approaches practices are: 1) non-pharmacological management mainly Cognitive Behavioural Therapy for Insomnia (CBTI) through education, stimulus control, sleep restriction, & cognitive restructuring- first-line treatment 2) Pharmacotherapy for short-term management or if CBT- is ineffective 3) A combined approach will be the best option in general practice.
Materials & Methods: This article is an attempt to consolidate the approaches to treat different causes of Insomnia taking anecdotes of 6 cases handled by general practitioners in smaller settings and 2 referrals to tertiary care /Mental health hospitals.
Abbreviations:
depression & anxiety disorders, Parkinson’s disease, PTSD =post-traumatic stress disorder, CBTI = Cognitive Behavioural Therapy for Insomnia, Benzodiazepines or Sedatives, Non-benzodiazepine Hypnotics, Melatonin Agonists
Insomnia is linked to decreased quality of life, impairment in daytime functions, increased workplace accidents, & high healthcare utilization. It is defined as a condition in which a person finds it difficult to fall or stay asleep. It is more common in women, the elderly, young children and those with co-existing mental conditions [1]. Insomnia is a highly prevalent, less often consulted and when consulted, underdiagnosed condition affecting health and quality of life of all individuals as per the literature search. In my personal experience as a family physician for last 58 years and public Health researcher for about 40 years, it affects roughly 10% of the adult population with chronic symptoms, & another 50% experience intermittent symptoms. About 30% of my patients and community surveys subjects reported at least one symptom of insomnia, while 15% reported daytime work capacity impairment. Prevalence increased with age and is higher in women than in men by about 25% (1.4 vs 2%). Insomnia often becomes chronic course, with about 40% persistence rate over a 5-year period [1,2]. Major risk factors for Insomnia include i) Psychiatric issues like depression & anxiety disorders, Parkinson’s disease & post-traumatic stress disorder (PTSD) ii) physical causes like chronic pain, cardiovascular diseases, obstructive sleep apnoea, metabolic disorders and other sleep disruptors are thyroid dysfunction, GERD & restless leg syndrome iii) Social/Lifestyle causes like Shift work, lower socio-economic status, and sedentary lifestyle [2,3].
Insomnia is classified by duration into acute (short-term, days to weeks) and chronic (long-term 3+ months, or 3+ nights/week) types. Acute insomnia often stems from stress or life changes, while chronic insomnia is usually linked to underlying medical, mental health, or substance abuse or screen-time-related issues. Clinicians also recognize Insomnia as i) Onset Insomnia where the complaint is difficulty in falling asleep. ii) Maintenance Insomnia in which after initial falling sleep, it is difficult to stay asleep or wakes up too early [2]. As a primary health care provider or family Physicians come across more cases in routine clinic and must make all out efforts to improve sleep quality/duration and reduce daytime impairment as a primary goal of treatment. The key treatment approaches practices are: 1) non-pharmacological management mainly Cognitive Behavioural Therapy (CBT) through education, stimulus control, sleep restriction, & cognitive restructuring- first-line treatment 2) Pharmacological Management is used for short-term management or if CBT- is ineffective. A) Non-benzodiazepine Hypnotics, Zaleplon & Zaplon, B) Benzodiazepines, central nervous system (CNS) depressants known as sedatives, e.g., Diazepam (Valium), & Lorazepam (Ativan) C) Melatonin Agonists like Meloset, Noctura, Altonil and iii) General Advice & Hygiene iv) A combined approach will be the best option in general practice.
This article is an attempt to consolidate the approaches to treat Insomnia by general practitioners in smaller settings.
Case 1. Metabolic and Nutritional Causes: A 91-year-old male with long-term insomnia presented with severe sleep maintenance issues, to my clinic. After taking history some basic investigations were got done. He was having electrolyte imbalances- hypocalcaemia, & hypokalaemia and severe vitamin D deficiency. Once they were resolved his sleep maintenance issue was resolved in a weeks’ time.
Case 2. Comorbid Factors: A 66-year-old woman visited my clinic in January 2026 with complaints of experiencing sleep onset and maintenance insomnia. She also complained of increased daytime fatigue and reduced sleep quality linked to lifestyle stress and aging. Detailed examination revealed pallor, hypertension and a few investigations (ECG, Hb%, SPO2 and BP, Renal function tests and EF +60%) indicated Heart failure with Preserved Ejection Fraction (HFpEF). Standard CCF management was initiated, which included i) SGLT2 Inhibitors Empagliflozin tablet ii) ARNIs (Angiotensin Receptor-Neprilysin Inhibitors) - Sacubitril/valsartan iii) Beta-Blocker metoprolol succinate to avoid worsening heart block or fatigue iv) Mineralocorticoid Receptor Antagonists (MRAs) Eplerenone was used with strict monitoring of potassium and renal function v) Furosemide diuretic was used for symptom relief and to maintain euvolemia. In women with EF >50%, treatment focussed on diuretics for congestion, SGLT2 inhibitors (which show benefit in HFpEF), and strict blood pressure control. In women with EF >50%, treatment focuses on diuretics for congestion, SGLT2 inhibitors (which show benefit in HFpEF), and strict blood pressure control. Her CCF was managed well that led to resolve her sleep issue in about 2 weeks. Regular check-ups of renal function (creatinine) and electrolytes (potassium) were done, as she was on ARNI & MRA. After recovery she was advised to take Influenza and pneumonia vaccines and regular screening for frailty, cognitive impairment, and depression.
Case 3. Chronic Lifestyle-Related Insomnia: A 46-year-old woman with a history of executive-level work developed severe, chronic middle insomnia (waking 3+ times, 5+ nights per week) and daytime fatigue over 5 months, highlighting the impact of stressful, active lifestyles on all working day night. On weekends she had no such problem. Suggested to her to schedule her work such that an hour before dinner she stopped all official work and went for a walk with grownup children for half an hour walk and practice 4-7-8 sleep method. For the first 2 weeks she was prescribed Meloset (Melatonin Agonists) tablets an hour before bedtime and tapered over next 3 weeks. Over a period of next 4 months, she got used to changed routine and now is not having Insomnia.
Case 4. Nocturnal media use linked Chronic Insomnia in a teenager: A 13-year-old boy was brought to the authors clinic in July 2025 with the complaints of with chronic insomnia and increased daytime sleepiness, disrupting his attention in the school resulting in steep fall in academic performance in 2025-25 compared to previous years. A detailed history revealed insomnia’s link to excessive nocturnal media use. The author alerted the parents and suggested a restriction on digital device usage after 9 pm led to a significant improvement in the sleep duration with no adverse event over 4 months. Throughout the 16-week treatment period, the total sleep time of the patient normalized, and the daytime sleepiness problem was resolved and scholastic performance returned to previous year’s level.
Case 5. Insomnia in a Web-Developer: Anand a 44-year-old web developer consulted the author with complaint of Insomnia over last 6 month. Detailed history indicated that long-term job stress and irregular, long hours resulted in "sleep work"—dreaming about work & inability to disconnect, ultimately hindering career advancement and causing persistent insomnia. A simple counselling with initial management of sleep problem with a Non-benzodiazepine Hypnotic, stopping digital exposure after 0900 PM and the 4-7-8 sleep method could get him rid of the problem in about 6 weeks’ time.
Case 6. Healthcare Professionals & Shift Work: Three young nurses in their early 20’s of a tertiary care hospital approached the author for a certificate to relieve them from Night duty. They reported since last 4 weeks they were on night duty of 0800 PM to 0800 AM with just one day break a week. On a detailed assessment they were with stress and appeared burnout due to sleep deprivation and high emotional demands. As they were working for almost 70-80 hrs of night duty every week and were a standard of working over 40 hours per week were prone for two-fold higher odds of insomnia.
Case 7. Insomnia due to Role Conflicts & Lack of Control: A Provincial services senior officer working for 8-10 hours day (compared to those working 35-40 hours), resulting in working >55 hours and his elder brother a teacher hardly working for 5-6 hrs day (less than 40 hrs a week). While the officer complained of Insomnia due to 3 high-stress roles, and the teacher complaining of lack of decision-making control as they were being drafted for non-teaching tasks by the district administration was finding it difficult to adjust to role conflicts combined with high demands created a "vicious circle" of stress-induced insomnia.
Case 8. Insomnia due to Digital arrest and loss of Money: A 55-year-old businessman consulted the author for Insomnia for 3-4 weeks in August 2025. The physical and mental examinations indicated no health issues, during the first week. He was put on benzodiazepine Hypnotics for a week. In his second visit he narrated that he recently lost about INR 50 Laksh due investment on web trading platform. The platform representative was forcing to invest more to recover the loss. The Cyber security is also investigating the case, and he is being summoned often for inquiry. Since he had no excess, money left, he was exploring to mobilize resource through loans. He was advised to stop trading and let the loss be absorbed instead of getting into much deeper debts. He had a few CBTI sessions in NIMHANS, Bengaluru. Fortunately, he took the advice positively and stopped trading since November 2025. Today he is more satisfied and his insomnia is resolved.
Insomnia is defined as a condition in which a person finds it difficult to fall or stay asleep. It is usually associated with significant impairment in daytime function & adversely affects the quality of life. It is more common in women, the elderly, young children and those with co-existing mental conditions like anxiety, depression or physical health conditions namely obstructive sleep apnoea, chronic pain, diabetes, cardiovascular disease, & Parkinson’s disease and other sleep disruptors are thyroid dysfunction, GERD & restless leg syndrome. It is linked to decreased quality of life, increased workplace accidents, & high healthcare utilization [1]. Insomnia is classified by duration into acute (short-term, days to weeks) and chronic (long-term, 3+ months, 3+ nights/week) types [2]. Acute insomnia often stems from stress or life changes, while chronic insomnia is usually linked to underlying medical, mental health, or substance-related issues.
Key Differences Between Acute and Chronic Insomnia
While Acute Insomnia Lasts for a few days to weeks and is caused due to Stress, traumatic events, work pressure, or environmental changes. It often resolves on its own or with improved sleep hygiene. On the other hand, Chronic Insomnia occurs at least three nights per week for three months or longer. The underlying causes include- anxiety, depression, chronic pain, medications, or other sleep disorders. It usually requires professional intervention, either Cognitive Behavioural Therapy for Insomnia (CBT-I) or pharmaco- therapy.
Some Clinicians describe Insomnias as i) Onset Insomnia where the complaint is difficulty in falling asleep. ii) Maintenance Insomnia in which after initial falling sleep, it is difficult to stay asleep or wakes up too early [2]. Other academic classification looks Insomnia as i) Primary Insomnia, where it is not linked to any other health condition ii) Comorbid / Secondary Insomnia in which there is some other medical or psychiatric conditions [2].
Behavioural insomnia of childhood: Behavioral insomnia of childhood (BIC) affects up to 30% percent of children. A general practitioner may identify three types; 1) BIC sleep-onset results from special conditions at bedtime, such as learning to go to sleep by being rocked or holding a toy close to chest or having a parent nearby as a child falls asleep ii) BIC limit-setting, involves a child’s refusal to go to bed and repeated attempts to put off going to sleep by seeking attentions like asking for a drink, to go to the bathroom, or for a parent to read them a story or see a comic on the TV or mobile. Such child may refuse to go back to sleep even after they wake up iii) BIC combined type is a combination of sleep-onset & limit-setting BIC. BIC is usually resolved by creating a healthy sleep routine or learning self-soothing or relaxation techniques.
In a study of One hundred children (52 male & 48 female) a total of 19 (19%) children were found to have sleep disturbances. Among these children, 15 (15%) had bedtime resistance, 25 (25%) had sleep-onset delay, 15 (15%) had sleep deprivation, 9 (9%) had sleep anxiety, 30 (33.7) had night waking, 58 (59.2%) had parasomnias (bruxism, enuresis, nightmares, and night arousal), 21 (48.8) had sleep-disordered breathing, & 31 (31%) daytime sleepiness [9]. In the age group of 4–8 years, sleep disturbances were predominantly more in females compared to males. Among total sleep disturbances, the maximum disturbances were seen in the form of parasomnias, bedtime resistance leading to excessive daytime sleepiness [7].
In another a hospital based descriptive study among 1024 children visiting the paediatric outpatient departments of Madras medical college, Chennai and Al-Ameen medical college and hospital, Vijayapura over a period of 1 year from March 2022 to March 2023 reported Out of 1164 questionnaires, 1024 {88.97%, 497 (48.54%) boys & 527 (51.46%) girls0} were filled completely and returned. Of the 1024, 403 {(39.36%) 211 (52.36%) boys and 192 (47.64%) girls had one or more sleep related problem. Insomnia was more among boys than girls statistically significant at 5% level. Sleep disorders were predominantly found in the age group of 7-10 years among which most common sleep related disorder was nocturnal enuresis and sleepwalking [8].
In another recent cross-sectional analytical study from January to April 2024 among 600 children aged 6–12 years enrolled in five urban private schools in Srinagar; the prevalence of clinically significant sleep disturbance was 42.3%. Mean daily screen-time was 3.1 ± 1.4 hours. Sleep disturbance showed a significant dose–response relationship with increasing screen exposure. Screen use within one hour of bedtime emerged as the strongest predictor, followed by daily screen-time exceeding three hours, smartphone gaming, bedroom device availability, and low parental monitoring [9].
Financial problems, Unemployment & Insomnia: Financial problems particularly among the unemployed and lower-income groups, are strongly associated with a high prevalence of insomnia’ Financial dependency and debt contribute significantly to sleep disorders. Research highlights that economic stress, coupled with factors like age and lack of health insurance, severely impacts sleep quality [5].
Household financial hardship primarily affects the mental and physical health of children, with adolescence being a particularly vulnerable period for emotional and sleep-related issues. A study of the elderly in an urban health centre in India found a 64.9% prevalence of insomnia, strongly associated with financial dependency, being unemployed, and having stressful life events. High levels of sleep disorders (14%) are found among hundreds of my clients who are unemployed, and the problem gets resolved once they get a job and start earning. Financial stress and high cost of education have been identified as contributors to sleep disturbances among students in India, especially in private medical institutions. Heads of the families complain of chronic Insomnia due to that rising household debt and reliance on unsecured personal loans led by increased stress,
A community survey-based on interviewing more than 30,000 respondents across 13 markets, indicates that while sleep is increasingly recognised as essential to well-being, a significant gap remains between awareness and action. The survey found that nearly half (49%) of Indian respondents struggle to fall asleep at least three times a week. While one in two respondents said they would seek help immediately if they had sleep disturbances, most either postpone action or continue to live with poor sleep. Women are more likely than men to take proactive steps, with 58% seeking help compared to 41.92% of men [5]
Insomnia among elderly Population: In cross-sectional study conducted in a rural and an urban area of Delhi taking 115 participants from each area using systematic random sampling and using a semi-structured questionnaire for data collection. Out of 230 participants, 121 (52.6%) were females and 109 (47.4 %) were males. Insomnia was more prevalent in the elderly participants of rural area (95%) while just 5% were in the urban population, a statistically significant association with the locality of the participants (p-value <0>
Diagnosis: A Primary health care provider must make a good analysis of the types, triggers of Insomnia using the program in annexure1. Then asses the home remedies already tried before planning individualised treatment plan. Despite its high prevalence, many individuals with insomnia do not seek or receive treatment. Acute insomnia often resolves, but if left untreated, it may become chronic, with a 27% relapse rate after treatment.
Key Differences Between Acute and Chronic Insomnia
While Acute Insomnia Lasts for a few days to weeks and is caused due to Stress, traumatic events, work pressure, or environmental changes. It often resolves on its own or with improved sleep hygiene. On the other hand, Chronic Insomnia occurs at least three nights per week for three months or longer. The underlying causes include- anxiety, depression, chronic pain, medications, or other sleep disorders. It usually requires professional intervention, either Cognitive Behavioural Therapy for Insomnia (CBT-I) or pharmaco- therapy.
Some Clinicians describe Insomnias as i) Onset Insomnia where the complaint is difficulty in falling asleep. ii) Maintenance Insomnia in which after initial falling sleep, it is difficult to stay asleep or wakes up too early [2]. Other academic classification looks Insomnia as i) Primary Insomnia, where it is not linked to any other health condition ii) Comorbid / Secondary Insomnia in which there is some other medical or psychiatric conditions [2].
Behavioural insomnia of childhood: Behavioral insomnia of childhood (BIC) affects up to 30% percent of children. A general practitioner may identify three types; 1) BIC sleep-onset results from special conditions at bedtime, such as learning to go to sleep by being rocked or holding a toy close to chest or having a parent nearby as a child falls asleep ii) BIC limit-setting, involves a child’s refusal to go to bed and repeated attempts to put off going to sleep by seeking attentions like asking for a drink, to go to the bathroom, or for a parent to read them a story or see a comic on the TV or mobile. Such child may refuse to go back to sleep even after they wake up iii) BIC combined type is a combination of sleep-onset & limit-setting BIC. BIC is usually resolved by creating a healthy sleep routine or learning self-soothing or relaxation techniques.
In a study of One hundred children (52 male & 48 female) a total of 19 (19%) children were found to have sleep disturbances. Among these children, 15 (15%) had bedtime resistance, 25 (25%) had sleep-onset delay, 15 (15%) had sleep deprivation, 9 (9%) had sleep anxiety, 30 (33.7) had night waking, 58 (59.2%) had parasomnias (bruxism, enuresis, nightmares, and night arousal), 21 (48.8) had sleep-disordered breathing, & 31 (31%) daytime sleepiness [9]. In the age group of 4–8 years, sleep disturbances were predominantly more in females compared to males. Among total sleep disturbances, the maximum disturbances were seen in the form of parasomnias, bedtime resistance leading to excessive daytime sleepiness [7].
In another a hospital based descriptive study among 1024 children visiting the paediatric outpatient departments of Madras medical college, Chennai and Al-Ameen medical college and hospital, Vijayapura over a period of 1 year from March 2022 to March 2023 reported Out of 1164 questionnaires, 1024 {88.97%, 497 (48.54%) boys & 527 (51.46%) girls0} were filled completely and returned. Of the 1024, 403 {(39.36%) 211 (52.36%) boys and 192 (47.64%) girls had one or more sleep related problem. Insomnia was more among boys than girls statistically significant at 5% level. Sleep disorders were predominantly found in the age group of 7-10 years among which most common sleep related disorder was nocturnal enuresis and sleepwalking [8].
In another recent cross-sectional analytical study from January to April 2024 among 600 children aged 6–12 years enrolled in five urban private schools in Srinagar; the prevalence of clinically significant sleep disturbance was 42.3%. Mean daily screen-time was 3.1 ± 1.4 hours. Sleep disturbance showed a significant dose–response relationship with increasing screen exposure. Screen use within one hour of bedtime emerged as the strongest predictor, followed by daily screen-time exceeding three hours, smartphone gaming, bedroom device availability, and low parental monitoring [9].
Financial problems, Unemployment & Insomnia: Financial problems particularly among the unemployed and lower-income groups, are strongly associated with a high prevalence of insomnia’ Financial dependency and debt contribute significantly to sleep disorders. Research highlights that economic stress, coupled with factors like age and lack of health insurance, severely impacts sleep quality [5].
Household financial hardship primarily affects the mental and physical health of children, with adolescence being a particularly vulnerable period for emotional and sleep-related issues. A study of the elderly in an urban health centre in India found a 64.9% prevalence of insomnia, strongly associated with financial dependency, being unemployed, and having stressful life events. High levels of sleep disorders (14%) are found among hundreds of my clients who are unemployed, and the problem gets resolved once they get a job and start earning. Financial stress and high cost of education have been identified as contributors to sleep disturbances among students in India, especially in private medical institutions. Heads of the families complain of chronic Insomnia due to that rising household debt and reliance on unsecured personal loans led by increased stress,
A community survey-based on interviewing more than 30,000 respondents across 13 markets, indicates that while sleep is increasingly recognised as essential to well-being, a significant gap remains between awareness and action. The survey found that nearly half (49%) of Indian respondents struggle to fall asleep at least three times a week. While one in two respondents said they would seek help immediately if they had sleep disturbances, most either postpone action or continue to live with poor sleep. Women are more likely than men to take proactive steps, with 58% seeking help compared to 41.92% of men [5]
Insomnia among elderly Population: In cross-sectional study conducted in a rural and an urban area of Delhi taking 115 participants from each area using systematic random sampling and using a semi-structured questionnaire for data collection. Out of 230 participants, 121 (52.6%) were females and 109 (47.4 %) were males. Insomnia was more prevalent in the elderly participants of rural area (95%) while just 5% were in the urban population, a statistically significant association with the locality of the participants (p-value <0>
Diagnosis: A Primary health care provider must make a good analysis of the types, triggers of Insomnia using the program in annexure1. Then asses the home remedies already tried before planning individualised treatment plan. Despite its high prevalence, many individuals with insomnia do not seek or receive treatment. Acute insomnia often resolves, but if left untreated, it may become chronic, with a 27% relapse rate after treatment.
Insomnia is increasingly common across all healthcare settings, including smaller clinics and primary care practices. Sleep is a vital biological process, with Stage 3 non-REM (deep) sleep plays a key role in brain restoration, healing, and metabolic balance. Digital screen exposure is strongly and independently associated with sleep disturbances among school-aged children, remotely working class and IT software professional. Targeted interventions focusing on evening screen restriction, reduced screen duration, and improved parental monitoring may substantially improve paediatric sleep health. An understanding of the physiology of sleep is critical to a paediatrician and primary care physician’s ability to effectively and confidently counsel patients about sleep. Improving deep sleep can often be achieved through simple, practical measures such as regular physical activity, adequate fibre intake, avoiding caffeine and alcohol near bedtime, maintaining consistent sleep timing, and creating a calm, sleep-friendly environment. Treatments for bedtime problems & night waking are efficacious and durable. Pharmacotherapy for insomnia has a role for short-term management or if CBT-I is ineffective and hypnotic agents are among the frequently prescribed medications in India. The decision to treat chronic insomnia disorder with long-term hypnotics should be individualized and balance the potential risks of continuing hypnotic medication use with the risks of untreated persistent insomnia and associated functional limitations
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I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.
Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Mercy Grace, Editorial Coordinator of Obstetrics Gynecology and Reproductive Sciences, We would like to express our gratitude for your help at all stages of publishing and editing the article. The editors of the magazine answer all the necessary questions and help at every stage. We will definitely continue to cooperate and publish other works in the Obstetrics Gynecology and Reproductive Sciences! Best wishes from, Alla Konstantinovna Politova,
