The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023

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

---

Systematic review and meta-analysis on fully automated digital cognitive behavioral therapy for insomnia

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

---

Efficacy of eHealth vs. in-person cognitive behavioral therapy for insomnia: A Systematic Review and Meta-Analysis of equivalence (Preprint)

JMIR Mental Health, Journal Year: 2024, Volume and Issue: 11, P. e58217 - e58217

Published: June 15, 2024

Insomnia is a prevalent condition with significant health, societal, and economic impacts. Cognitive behavioral therapy for insomnia (CBTI) recommended as the first-line treatment. With limited accessibility to in-person-delivered CBTI (ipCBTI), electronically delivered eHealth (eCBTI), ranging from telephone- videoconference-delivered interventions fully automated web-based programs mobile apps, has emerged an alternative. However, relative efficacy of eCBTI compared ipCBTI not been conclusively determined.

Language: Английский

---

Understanding Digital Therapeutics in Disease Self-management: A Systematic Literature Review

Technology in Society, Journal Year: 2025, Volume and Issue: unknown, P. 102831 - 102831

Published: Jan. 1, 2025

Language: Английский

---

2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults – Brazilian Sleep Association

Sleep Science, Journal Year: 2023, Volume and Issue: 16(S 02), P. 507 - 549

Published: Oct. 1, 2023

Abstract Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition society and a frequent complaint at the offices of different areas health practice (particularly Medicine Psychology). This scenario has been accompanied by significant evolution treatment, well challenges approaching patients appropriately way. guideline, coordinated Brazilian Sleep Association counting on active participation various specialists area, encompasses update diagnosis treatment adults. To end, it followed structured methodology. Topics interest related to were written based theoretical framework, evidence literature, professional experience. As for topics insomnia, series questions developed PICO acronym (P – Patient, problem, or population; I Intervention; C Comparison, control, comparator; O Outcome). The work groups defined eligible options within each these parameters. Regarding pharmacological interventions, only ones currently available Brazil possibly becoming upcoming years considered eligible. Systematic reviews conducted help prepare texts define level intervention. final result objective practical providing recommendations with best scientific support professionals involved management insomnia.

Language: Английский

---

Efficacy and safety of digital therapeutic application of Sleep Index‐Based Treatment for Insomnia (dSIBT‐I): a pilot study

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 33(1)

Published: Sept. 13, 2023

The aim of this study was to evaluate the safety and efficacy digital therapeutic application Sleep Index-Based Treatment for Insomnia (dSIBT-I) compare them with those Cognitive Behavioural Therapy (dCBT-I). This randomised prospective pilot conducted at Asan Medical Center. A total 50 patients insomnia were recruited between December 2022 January 2023 randomly allocated dSIBT-I or dCBT-I group. carried out one month. primary outcome significant reduction in Severity Index score Week 4 compared baseline, while secondary proportion participants whose scores reduced <15 4. We performed linear mixed model generalised estimating equation analyses. Both groups showed improvements There no difference two terms (group × time effect, F = 1.07, p 0.382) effects, 1.80, 0.615). However, 2, group better results than both (p 0.044) (82.6% vs. 48.0%, 0.017). No treatment-emergent adverse events reported either is a safe effective therapy insomnia, rapid treatment effects.

Language: Английский

---

Effectiveness of digital cognitive-behavioral therapy for insomnia alone or combined with sleep medication: A real-world evidence study

Sleep Epidemiology, Journal Year: 2023, Volume and Issue: 3, P. 100061 - 100061

Published: July 19, 2023

Insomnia is a highly prevalent sleep disorder, but its first line of treatment (Cognitive Behavioral Therapy for - CBTi) not widely available and affordable. Digital therapy has been an alternative to these limitations combination with pharmacological may improve patients' clinical outcomes adherence. This was real-world evidence study aimed evaluate the efficacy CBTi smartphone app combined or medication, based on sample users (SleepUp®) registered between June 2020 2022. Individuals were categorized into two groups ("dCBTi alone" "dCBTi combined") according their self-reported use medication day treatment. Assessments made self-report logs (sleep quality efficiency) insomnia severity (Insomnia Severity Index). Comparisons considering entry (baseline) mean last three days in which filled out (final). The final samples comprised 143 individuals: 73 (51%) reported using at baseline, while 70 (49%) did not. In both groups, there improvement quality, (p<0.001), efficiency (p<0.001). magnitude effects greater dCTBi group. result indicates that dCBTi can be useful as adjuvant insomnia.

Language: Английский

---

Outcomes of remotely delivered behavioral insomnia interventions for children and adolescents: systematic review of randomized controlled trials

Frontiers in Sleep, Journal Year: 2024, Volume and Issue: 2

Published: Jan. 11, 2024

Pediatric insomnia is common and can be effectively treated with behavioral therapies delivered face-to face. Such treatments could also improve children's mood, cognition, quality of life, caregivers' wellbeing. There a discrepancy between high needs limited access to pediatric treatments, which improved by provision technology enhanced interventions. No study reviewed outcomes randomized controlled trials (RCTs) remotely psychological for insomnia. The current aimed examine (i) the RCTs insomnia/insomnia symptoms (ii) whether gains made in treatment extend functional correlates. We conducted systematic review according Cochrane PRISMA guidelines. PsychINFO, PubMed/Medline CENTRAL databases were searched reporting on symptoms. Data was abstracted risk bias assessed November 2022 2023. Seven (nine manuscripts) involving 786 participants, mean age from 19.3 months 16.9 years, identified. Four different used. Risk ranged low highest randomization process. Across studies, significant improvements found some (but not all) sleep parameters, namely: efficacy questionnaires actigraphy, despite heterogeneity used, participants instruments employed assess outcomes. Improvements gained compared face-to-face 3 studies comparable or slightly lower. worsening observed either objective subjective measures sleep, except onset latency wake after that but worsened actigraphy one each. Children's mood across parent self-report measures. Other possible understudied. Our provides preliminary evidence following insomnia, mood. Further research needed develop individualized will cater developmental types only group individual

Language: Английский

---

Non-pharmacological therapeutic approaches for the treatment of insomnia: An integrative review

Seven Editora eBooks, Journal Year: 2024, Volume and Issue: unknown

Published: May 24, 2024

The advances made in medicine, through studies and research, can offer more effective treatments for various types of illness, both with the use drugs non-pharmacological treatments. With regard to insomnia, a disease characterized by difficulty sleeping loss circadian cycle quality, long time it was treated, most cases, only that remedied this condition, but did not act on core real cause, alleviating symptoms. In addition, many treatment insomnia are addictive, leading patients them constantly. integrative review aimed identify pointing out methods used patients, analyzing process, efficacy, clinical applicability safety. Trustworthy credible websites such as PubMed, LILACS VHL were collect data research sources, using descriptors "Sleep Onset Maintenance Disorder Non-Pharmacological". way, relevant data, experiences evidence obtained analysis among found. conclusion, therapeutic approaches represent vital component offering substantial benefits without risks associated prolonged medication. Their incorporation part an integrated personalized plan significantly improve quality life individuals affected insomnia.

Language: Английский

---

Clinical Efficacy and Safety of 16 Chinese Patent Medicines in Combination with Benzodiazepines/Non-Benzodiazepines for the Treatment of Chronic Insomnia in Adults: A Multiple-Treatment Meta-Analysis

Pharmacological Research - Modern Chinese Medicine, Journal Year: 2024, Volume and Issue: 11, P. 100449 - 100449

Published: May 25, 2024

Chronic insomnia in adults affects the health and quality of life patients. Chinese patent medicines (CPMs) combined with benzodiazepines/non-benzodiazepines (BZDs/N-BZDs) are used frequently routine clinical practice. However, evidence on efficacy safety these interventions is lacking. A multiple treatment meta-analysis (MTMA) was conducted to evaluate comparative 16 CPMs BZDs/N-BZDs for chronic adults. We systematically reviewed 171 randomized controlled trials (RCTs) involving 16,874 participants (8,506 intervention groups 8,368 control groups) from inception several databases 2023. This review encompassed electronic databases, regulatory-agency websites, international registers published adult patients who received CPM + therapies. random-effects MTMA undertaken using Stata/MP17, RevMan (5.3), R. Outcome measures were Pittsburgh Sleep Quality Index (PSQI), overall rate, as well incidence dry mouth, dizziness, somnolence. Our showed that BZD/N-BZD therapy a co-intervention Tianmengjiaonang (TMJN) likely be optimal option improving PSQI (surface under cumulative sorting curve (SUCRA) = 95.00%), whereas shensongyangxinjiaonang (SSYXJN) had highest probability effectiveness (SUCRA 88.20%). Jiaotaiwan (JTW), Bailemian (BLMJN), Wulinjiaonang (WLJN) reducing somnolence 90.00%), mouth 72.90%), dizziness 84.40%). All combination more efficacious safer than alone insomnia. SSYXJN TMJN because they improve sleep reduce risk adverse effects. effects may vary person person. Hence, patients, carers, clinicians should carefully consider efficacy, safety, risk–benefit profile all active based real-world data.

Language: Английский

---