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

Journal of Sleep Research, Год журнала: 2023, Номер 32(6)

Опубликована: Ноя. 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

Язык: Английский

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Gender medicine and sleep disorders: from basic science to clinical research

Frontiers in Neurology, Год журнала: 2024, Номер 15

Опубликована: Июль 10, 2024

Several pivotal differences in sleep and disorders are recognized between women men. This is not only due to changes hormonal balance during women's reproductive life, such as pregnancy menopause. Women more likely report insomnia non-specific symptoms of apneas, fatigue or mood disturbance, compared Thus, it important for clinicians researchers take sex gender into account when addressing order acknowledge the biology unique women. We present a narrative review that delves primary disorders, starting from basic science, explore impact on current status research health.

Язык: Английский

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Breaking Ground: From CPAP Treatment to the First Medicine for OSA Patients with Obesity

Current Pulmonology Reports, Год журнала: 2025, Номер 14(1)

Опубликована: Янв. 11, 2025

Abstract Purpose of Review Pharmacologic alternatives in management obstructive sleep apnea (OSA) have been pursued for decades. Considering rapid development and promising findings recent years, we provide an overview novel agents treatment targets, ongoing trials, as well future perspectives. Recent Findings Several drugs demonstrate efficacy, though none is sufficient to cure the disease a monotherapy. Instead, main potential lies applying drug therapy specific subgroups or addition established treatments (e.g., positive airway pressure, oral appliance therapy). Glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists may be particularly beneficial obese OSA patients. As major breakthrough, terzipatide, GIP analog GLP-1 agonist, has become first FDA-approved EMA-sanctioned pharmacologic option individuals. Beyond this, alerting could help manage residual daytime sleepiness improve functioning. However, long-term studies on safety, adherence, effectiveness are scarce highlight certain limitations challenges. Summary Incorporating pharmaceuticals along conventional synergy benefit patients, but side-effects risk reduction related adverse outcomes over time yet assessed. Furthermore, guidelines/frameworks mapping out applicable targets needed.

Язык: Английский

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Efficacy of orofacial myofunctional therapy combined with myofascial release in patients with mild obstructive sleep apnea: a randomized controlled trial

Journal of Oral Rehabilitation, Год журнала: 2023, Номер 50(7), С. 555 - 565

Опубликована: Апрель 3, 2023

Obstructive sleep apnoea (OSA) is characterized by repetitive narrowing and collapse of pharyngeal airway during sleep, leading to or hypopnoea. In this context, myofunctional therapy myofascial release might be effective, despite the literature on combination these approaches still scarce.This randomized controlled trial aimed assess efficacy oro-facial combined with in terms functioning patients mild OSA.Patients aged from 40 80 years diagnosis OSA were randomly allocated into intervention group (oro-facial plus release) control (only therapy). At baseline (T0), after 4 weeks (T1), 8 (T2), following outcomes assessed: apnoea/hypopnoea index (AHI), average oxygen saturation (SpO2 ), time spent < 90% (T90), snoring index, Pittsburgh Sleep Quality Index (PSQI).Out 60 enrolled, 28 (aged 61.46 ± 8.74 years) complete treatment 24 60.42 6.61 group. There no significant differences AHI between groups. A difference was reported for ΔT0-T1 SpO2 (p = .01), T90 .030), ΔT0-T2 .026 <.001 respectively), .003 respectively).Taken together, a showed potential quality OSA. Future studies are necessary better investigate role interventions patients.

Язык: Английский

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Obstructive Sleep Apnea Comorbid with Insomnia Symptoms and Objective Short Sleep Duration is Associated with Clinical and Preclinical Cardiometabolic Risk Factors: Clinical Implications

Sleep Medicine, Год журнала: 2024, Номер 124, С. 115 - 119

Опубликована: Сен. 12, 2024

Язык: Английский

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Cognitive Behavioral Therapy Alone or in Combination with Eszopiclone in Comorbid Insomnia and Obstructive Sleep Apnea in Veterans with Posttraumatic Stress Disorder: A Randomized Trial

Psychiatric Quarterly, Год журнала: 2025, Номер unknown

Опубликована: Апрель 9, 2025

Abstract We sought to assess the augmentation of brief behavioral therapy for insomnia (BBTI) with eszopiclone (ESZ) over BBTI alone treatment chronic on sleep quality, indices, and continuous positive airway pressure (CPAP) adherence in PTSD veterans COMISA. The pilot trial involved 53 patients (46 males 7 females, mean age 48.2±8.3 years) COMISA randomized combination plus 2 weeks (2 mg/d) or follow-up visits conducted at 6 24 weeks. main outcome measure was quality assessed by Pittsburgh Sleep Quality Index (PSQI). A significant decrease PSQI scores observed between baseline ESZ (-5.24 [95% CI, -6.55 -3.94]; p < 0.001) BBTI-only (-5.45 [95%CI, -6.75 -4.14]; 0.001). No group allocation effects x time interactions were detected. Similar improvements recorded ISI (BBTI (-8.32 -10.51 -6.14]; (-8.64 -10.88 -6.41]; 0.001)) no interaction effect groups time. Combination produced a higher remission rate weeks, both interventions achieving comparable rates Results mixed models CPAP use revealed effects. In COMISA, resulted improvement life that achieved therapy. Although addition conferred an early benefit relative BBTI, modalities similar outcomes long-term follow-up. Clinical Trial Registration This study registered ClinicalTrials.gov (Identifier NCT03937713).

Язык: Английский

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EEG spectral analysis of nighttime sleep and daytime MSLTs and neurocognitive evaluations in subjects with co-morbid insomnia and OSA

Respiratory Research, Год журнала: 2025, Номер 26(1)

Опубликована: Апрель 13, 2025

Chronic insomnia and obstructive sleep apnea commonly co-occur. Few studies have explored the neurophysiological neurocognitive characteristics of COMISA, which could help guide improving treatment diagnostic tools determining novel therapeutic targets. This study aims to explore COMISA using electroencephalographic (EEG) spectral analysis subjective objective measurements. Participants were from our community recruited OSA-insomnia-COMISA cohort with 206 included for current including 74 chronic insomniacs (CIs), 55 OSA patients 77 patients. Standard polysomnography (PSG) multiple latency tests (MSLTs) recorded used obtain relative EEG power in each stage during PSG session MSLTs. A series conducted evaluate executive function, attention, retrospective prospective memory meta-cognition. In MSLTs, showed combined both CIs OSA. Specifically, exhibited similar CIs, decreased delta increased alpha beta NREM stages, REM Similar profile OSA, Compared patients, worse subjectively measured attention meta-cognition related negative beliefs about uncontrollability danger worry (NEG), positively associated ISI scores. The overnight daytime MSLT appear be manifestation elements However, features NEG primarily affected by insomnia.

Язык: Английский

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Cognitive/Behavioral Approaches for Treating Sleep Disorders

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 261 - 268

Опубликована: Апрель 1, 2025

Abstract This chapter targets behaviors, feelings, and thinking modes which can affect insomnia, comorbid insomnia obstructive sleep apnea (COMISA), circadian rhythm disorders (CRSD), nightmares. As a mean to improve or decrease wake at onset during the night in individuals presenting with cognitive-behavioral treatment for (CBT-I) includes therapies dealing behaviors thoughts interfering associated feelings keeping person awake night. CBT-I is first-line recommended insomnia. It has also been delivered COMISA CRSD randomized control trials (RCT), contrary parasomnias restless leg syndrome (RLS) are most often studied single case designs. reviews different offers alternatives when available aforementioned disorders.

Язык: Английский

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Response to letter to the Editor: ‘roles of vitamins and nutrition in obstructive sleep apnea’

Expert Review of Respiratory Medicine, Год журнала: 2025, Номер unknown, С. 1 - 1

Опубликована: Май 5, 2025

Язык: Английский

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The Future of Insomnia Research—There's Still Work to Be Done

Journal of Sleep Research, Год журнала: 2025, Номер unknown

Опубликована: Май 9, 2025

ABSTRACT Insomnia Disorder (ID) is a highly debilitating disorder affecting up to 10% of the general population. In recent years, number studies in this area has increased rapidly, resulting wealth accumulated knowledge. ID generally regarded as hyperarousal cognitive, emotional, cortical and physiological domains. Nevertheless, there still significant lack knowledge about pathophysiology ID. For example, existence insomnia subtypes discussed, albeit no uniform definition yet been found. Significant progress made understanding neurobiology insomnia, which points dysfunction emotion regulation. However, neuroimaging frequently have small sample sizes allow only for limited causal conclusions. The assessment sleep significantly influenced by increasing availability methods ambulatory measurement. While these enable be measured more cost‐effectively than polysomnography, many devices sufficient empirical evidence validity. terms treatment, cognitive behavioural therapy (CBT‐I) shown effective. underlying mechanisms CBT‐I remain partially unclear, optimal sequence applying individual components, well effectiveness cases comorbidity, open questions. Furthermore, widely applied pharmacological treatment approaches are used off‐label with base. This narrative review aims summarise current state research on attempts outline selection important future challenges research.

Язык: Английский

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