Sleep Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 106551 - 106551
Published: May 1, 2025
Language: Английский
Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)
Published: Nov. 28, 2023
Summary Progress in the field of insomnia since 2017 necessitated this update European Insomnia Guideline. Recommendations for diagnostic procedure and its comorbidities are: clinical interview (encompassing sleep medical history); use questionnaires diaries (and physical examination additional measures where indicated) (A). Actigraphy is not recommended routine evaluation (C), but may be useful differential‐diagnostic purposes Polysomnography should used to evaluate other disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders, etc.), treatment‐resistant (A) indications (B). Cognitive‐behavioural therapy as first‐line treatment chronic adults any age (including patients with comorbidities), either applied in‐person or digitally When cognitive‐behavioural sufficiently effective, a pharmacological intervention can offered Benzodiazepines (A), benzodiazepine receptor agonists daridorexant low‐dose sedating antidepressants (B) short‐term (≤ 4 weeks). Longer‐term these substances initiated some cases, considering advantages disadvantages Orexin antagonists periods up 3 months longer cases Prolonged‐release melatonin ≥ 55 years Antihistaminergic drugs, antipsychotics, fast‐release melatonin, ramelteon phytotherapeutics are Light exercise interventions adjunct therapies
Language: Английский
Citations
250
Journal of Sleep Research, Journal Year: 2022, Volume and Issue: 31(4)
Published: April 22, 2022
Summary Insomnia disorder comprises symptoms during night and day that strongly affect quality of life wellbeing. Prolonged sleep latency, difficulties to maintain early morning wakening characterize complaints, whereas fatigue, reduced attention, impaired cognitive functioning, irritability, anxiety low mood are key daytime impairments. is well acknowledged in all relevant diagnostic systems: Diagnostic Statistical Manual the American Psychiatric Association, 5th revision, International Classification Sleep Disorders, 3rd version, Diseases, 11th revision. as a chronic condition frequent (up 10% adult population, with preponderance females), signifies an important independent risk factor for physical and, especially, mental health. diagnosis primarily rests on self‐report. Objective measures like actigraphy or polysomnography not (yet) part routine canon, but play role research. Disease concepts insomnia range from cognitive‐behavioural models (epi‐) genetics psychoneurobiological approaches. The latter derived knowledge about basic sleep–wake regulation encompass theories rapid eye movement instability/restless sleep. Cognitive‐behavioural led conceptualization therapy insomnia, which now considered first‐line treatment worldwide. Future research strategies will include combination experimental paradigms neuroimaging may benefit more attention dysfunctional overnight alleviation distress insomnia. With respect therapy, merits widespread implementation, digital assist delivery along guidelines. However, given still considerable proportion patients responding insufficiently fundamental studies highly necessary better understand brain behavioural mechanisms underlying Mediators moderators response/non‐response associated development tailored novel interventions also require investigation. Recent suggest prove add significantly preventive strategy combat global burden disorders.
Language: Английский
Citations
196
Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)
Published: Feb. 2, 2023
Given the limited availability and accessibility of onsite cognitive behavioral therapy for insomnia (CBT-I), other CBT-I settings, such as internet-delivered (iCBT-I), have been proposed. The primary aim study was to compare efficacy available settings on severity. A systematic review frequentist network meta-analysis performed. PsycINFO, PsycARTICLES, MEDLINE, PubMed, CINAHL were searched randomized controlled trials (RCTs) investigating any in adults with disorder. literature search (3851 references) resulted 52 RCTs. For outcome severity, all examined except smartphone-delivered yielded significant effects when compared WL. Large standardized mean differences found individual (- 1.27;95%CI - 1.70, 0.84), group-delivered 1.00;95%CI 1.42. 0.59), telehealth 1.28;95%CI 2.06, 0.50), guided bibliotherapy 0.99;95%CI 1.67, 0.32). Both iCBT-I 0.71;95%CI 1.18, 0.24) unguided 0.78;95%CI 0.38) medium effect sizes. results underline that health care systems should intensify their efforts provide synchronously-delivered (individual onsite, group-delivered, telehealth), particularly CBT-I, given its solid evidence base. Medium large sizes indicate self-help may be a viable alternative is not available.
Language: Английский
Citations
66
Sleep Medicine Reviews, Journal Year: 2022, Volume and Issue: 65, P. 101673 - 101673
Published: Aug. 27, 2022
Language: Английский
Citations
54
Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)
Published: Aug. 16, 2023
Summary Despite cognitive behaviour therapy for insomnia (CBT‐I) being the first‐line intervention disorder, it is often not readily available to patients in need. The stepped care model (SCM) represents an approach facilitating efficient and wide‐ranging provision of evidence‐based those with insomnia. SCM reflects a pyramid therapeutics based on CBT‐I gradually increasing clinical intensity addressing complexity. By applying through hoped that treatment gap can be bridged such only more reached, but resource effectively distributed, receiving tailored as needed. Nevertheless, this should done at risk lower quality offered, high‐standard training clinicians scrutiny non‐clinician led interventions remains important. As national health laws within European countries have substantial differences, application relates may challenged by contrasting interpretations. In order appropriately implemented: (a) treatments promoted model; (b) involved suitably qualified offer CBT general, appropriate further CBT‐I; (c) professionals included SCM, related it, preventive educational programmes, diagnostic procedures, pharmacological treatments, also good knowledge promote correct allocation interventional step.
Language: Английский
Citations
23
Sleep Medicine Reviews, Journal Year: 2024, Volume and Issue: 75, P. 101931 - 101931
Published: April 16, 2024
Insomnia and nightmares are both prevalent debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia in individuals without a concomitant psychopathology. dreams also addressed. PsycINFO Medline were searched for papers published English or French from 1970 March 2023. Sixty-seven articles included review. Most results support positive variables nightmare with insomnia, nightmares, general population, students, children older adults, military personnel veterans. These apparent context of COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective alleviating symptoms. Regarding dreams, compared controls, characterized by more negative contents affects. show that connected may mutually aggravating. A model is proposed explain how increase likelihood experiencing can turn lead loss nonrestorative sleep.
Language: Английский
Citations
9
npj Digital Medicine, Journal Year: 2025, Volume and Issue: 8(1)
Published: March 12, 2025
Insomnia impairs daily functioning and increases health risks. Cognitive behavioral therapy for insomnia (CBT-I) is effective but limited by cost therapist availability. Fully automated digital CBT-I (FA dCBT-I) provides an accessible alternative without involvement. This systematic review meta-analysis evaluated the effectiveness of FA dCBT-I across 29 randomized controlled trials (RCTs) involving 9475 participants. Compared to control groups, demonstrated moderate large effects on severity. Subgroup analyses indicated that had a significant impact when contrasted with most groups was less than therapist-assisted CBT-I. Meta-regression revealed group type moderated outcomes, whereas completion rate did not. implies treatment adherence, rather merely completing intervention, crucial its effectiveness. study supports potential as promising option managing underscores hybrid model combining support more beneficial.
Language: Английский
Citations
1
Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)
Published: Aug. 29, 2023
Summary Cognitive behavioural therapy (CBT) is the recommended first‐line treatment for insomnia. However, guideline care very seldom available and most patients receive no treatment, or less effective second‐line pharmacotherapy sleep hygiene, neither of which are evidence‐based chronic The primary challenge CBT has been supply. There not enough therapists to meet enormous demand. We must accelerate clinician training, but this approach can never be sufficient, even with abbreviated, efficient therapies. Fortunately, however, landscape also changed dramatically. Fully‐automated digital (dCBT) emerged as a safe, effective, scalable delivery format. dCBT software only, so it disseminated readily widely medication. Moreover, integrated into services. Just medications delivered through health professionals systems, approved programmes same. an ecosystem psychologically‐based should necessitate medical prescription model. Our proposed stepped framework, comprises both population clinical service initiatives, enabling universal access diverse ways in may (in‐person, face‐to‐face, using telehealth, group therapy, digitally) operate congruently efficiently optimise people at all levels complexity need. With safe clinically products now set become established treatments, clearly differentiated from wellness apps, there potential rapidly transform insomnia services and, first time, deliver international scale.
Language: Английский
Citations
17
Journal of Sleep Research, Journal Year: 2024, Volume and Issue: 33(6)
Published: March 14, 2024
Summary Insomnia is a primary symptom of shift work disorder, yet it remains undertreated. This randomised‐controlled pilot trial examined the efficacy digital, guided cognitive behavioural therapy for insomnia adapted to (SleepCare) in nurses with disorder. The hypothesis was that SleepCare reduces severity compared waitlist control condition. A total 46 unmedicated suffering from disorder (age: 39.7 ± 12.1 years; 80.4% female) were randomised group or group. outcome measure Severity Index. Other questionnaires on sleep, mental health and occupational functioning, sleep diary data actigraphy analysed as secondary outcomes. Assessments conducted before (T0), after intervention/waitlist period (T1), 6 months treatment completion (T2). showed significant reduction T0 T1 condition (β = −4.73, SE 1.12, p < 0.001). Significant improvements observed sleepiness, dysfunctional beliefs about pre‐sleep arousal, effort, self‐reported efficiency onset latency. No effect found data. Depressive anxiety symptoms, irritation ability improved significantly. Overall, satisfaction engagement intervention high. severity, functioning. first investigating digital population insomnia. Future research should further explore these effects larger sample sizes active conditions.
Language: Английский
Citations
8
Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: 93(2), P. 114 - 128
Published: Jan. 1, 2024
<b><i>Introduction:</i></b> Cognitive behavioral therapy for insomnia (CBT-I) is the current first-line treatment insomnia. However, rates of nonresponse and nonremission are high effects on quality life only small to moderate, indicating a need novel developments. We propose that Acceptance Commitment Therapy (ACT) addresses core pathophysiological pathways ACT therefore has potential improve efficacy when combined with bedtime restriction, most effective component CBT-I. The aim this study was compare restriction (ACT-I) CBT-I in improving severity sleep-related life. <b><i>Methods:</i></b> Sixty-three patients disorder (mean age 52 years, 65% female, 35% male) were randomly assigned receive either ACT-I or group format. primary outcomes (Insomnia Severity Index) (Glasgow Sleep Impact Index). Outcomes assessed before randomization (T0), directly after (T1), at 6-month follow-up (T2). <b><i>Results:</i></b> results indicated significant, large pre-to-post improvements both groups, secondary outcomes. Improvements maintained follow-up. there no significant by time interactions linear mixed models, an absence differential efficacy. On subjective satisfaction scale, significantly greater their improvement several aspects health including energy level work productivity. <b><i>Conclusions:</i></b> suggest feasible effective, but not more than Future studies needed assess whether noninferior shed light mechanisms change treatments.
Language: Английский
Citations
7