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Sleep Initiation and Maintenance Disorders HELP
Based on 7,291 articles published since 2010
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These are the 7291 published articles about Sleep Initiation and Maintenance Disorders that originated from Worldwide during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders. 2019

Silvestri, R / Aricò, I / Bonanni, E / Bonsignore, M / Caretto, M / Caruso, D / Di Perri, M C / Galletta, S / Lecca, R M / Lombardi, C / Maestri, M / Miccoli, M / Palagini, L / Provini, F / Puligheddu, M / Savarese, M / Spaggiari, M C / Simoncini, T. ·Center of Sleep Medicine, UOSD of Neurophysiopathology and Disorders of Movement, AOU G Martino, Department of Clinical and Experimental Medicine, University of Messina, Italy. Electronic address: rsilvestri@unime.it. · Center of Sleep Medicine, UOSD of Neurophysiopathology and Disorders of Movement, AOU G Martino, Department of Clinical and Experimental Medicine, University of Messina, Italy. · Division of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Italy. · Division of Pneumology, University Hospital AOUP "Paolo Giaccone" PROMISE Department, University of Palermo, Italy. · Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Italy. · Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Italy. · Sleep Disorder Centre, Department of Medical Sciences and Public Health, University of Cagliari, Italy. · Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. · Department of Clinical and Experimental Medicine, University of Pisa, Italy. · IRCCS, Institute of Neurological Sciences, Bologna, Italy; Department of BioMedical and NeuroMotor Sciences, University of Bologna, Italy. · "FM Puca" Neurology Unit, University Hospital Consortium Corporation Polyclinic of Bari, Italy. · Neurological Day Care Unit - Local Health Authority (AUSL 4), Parma, Italy. ·Maturitas · Pubmed #31547910.

ABSTRACT: Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. Long-term benefits for postmenopausal insomnia may also be achieved with non-drug strategies such as cognitive behavioral therapy (CBT) and aerobic exercise. Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) both reduce blood pressure and cortisol levels in postmenopausal women suffering from OSA. However, the data regarding MHT on postmenopausal restless legs syndrome are conflicting.

2 Guideline Deprescribing benzodiazepine receptor agonists: Evidence-based clinical practice guideline. 2018

Pottie, Kevin / Thompson, Wade / Davies, Simon / Grenier, Jean / Sadowski, Cheryl A / Welch, Vivian / Holbrook, Anne / Boyd, Cynthia / Swenson, Robert / Ma, Andy / Farrell, Barbara. ·Associate Professor in the Department of Family Medicine and the Department of Epidemiology and Community Medicine at the Bruyère Research Institute at the University of Ottawa in Ontario. kpottie@uottawa.ca. · Master's student in the School of Epidemiology and Public Health at the University of Ottawa at the time of guideline development. · Associate Professor in the Department of Psychiatry at the University of Toronto in Ontario and Clinician Scientist and staff psychiatrist in the Geriatric Psychiatry Division at the Centre for Addiction and Mental Health in Toronto. · Clinician Investigator in the Department of Family Medicine at the University of Ottawa and Clinical Scientist at the C.T. Lamont Centre for Primary Health Care Research of the Bruyère Research Institute. · Professor in the Faculty of Pharmacy and Pharmaceutical Sciences at the University of Alberta in Edmonton. · Director of the Methods Centre at the Bruyère Research Institute and Assistant Professor in the School of Epidemiology and Public Health at the University of Ottawa at the time of guideline development. · Director of the Division of Clinical Pharmacology and Professor in the Department of Medicine at McMaster University in Hamilton, Ont, and Senior Scientist at the Centre for Evaluation of Medicines of St Joseph's Healthcare Hamilton. · Professor in the Department of Medicine in the Division of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine in Baltimore, MD. · Psychiatrist at the Ottawa Hospital and Full Professor in the Department of Psychiatry at the University of Ottawa. · Pharmacy resident at the Ottawa Hospital. · Assistant Professor in the Department of Family Medicine at the University of Ottawa, Adjunct Assistant Professor in the School of Pharmacy at the University of Waterloo in Ontario, and Scientist at the Bruyère Research Institute. ·Can Fam Physician · Pubmed #29760253.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop benzodiazepine receptor agonists (BZRAs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. METHODS: The overall team comprised 8 clinicians (1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists, and 1 geriatrician) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence was generated by conducting a systematic review of BZRA deprescribing trials for insomnia, as well as performing a review of reviews of the harms of continued BZRA use and narrative syntheses of patient preferences and resource implications. This evidence and GRADE quality of evidence ratings were used to generate recommendations. The team refined guideline content and recommendations through consensus and synthesized clinical considerations to address front-line clinician questions. The draft guideline was reviewed by clinicians and stakeholders. RECOMMENDATIONS: We recommend that deprescribing (tapering slowly) of BZRAs be offered to elderly adults (≥ 65 years) who take BZRAs, regardless of duration of use, and suggest that deprescribing (tapering slowly) be offered to adults aged 18 to 64 who have used BZRAs for more than 4 weeks. These recommendations apply to patients who use BZRAs to treat insomnia on its own (primary insomnia) or comorbid insomnia where potential underlying comorbidities are effectively managed. This guideline does not apply to those with other sleep disorders or untreated anxiety, depression, or other physical or mental health conditions that might be causing or aggravating insomnia. CONCLUSION: Benzodiazepine receptor agonists are associated with harms, and therapeutic effects might be short term. Tapering BZRAs improves cessation rates compared with usual care without serious harms. Patients might be more amenable to deprescribing conversations if they understand the rationale (potential for harm), are involved in developing the tapering plan, and are offered behavioural advice. This guideline provides recommendations for making decisions about when and how to reduce and stop BZRAs. Recommendations are meant to assist with, not dictate, decision making in conjunction with patients.

3 Guideline Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline. 2018

Bjerre, Lise M / Farrell, Barbara / Hogel, Matthew / Graham, Lyla / Lemay, Geneviève / McCarthy, Lisa / Raman-Wilms, Lalitha / Rojas-Fernandez, Carlos / Sinha, Samir / Thompson, Wade / Welch, Vivian / Wiens, Andrew. ·Assistant Professor in the Department of Family Medicine and in the School of Epidemiology and Public Health at the University of Ottawa in Ontario, Scientist in the C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute, and Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES). lbjerre@bruyere.org. · Assistant Professor in the Department of Family Medicine at the University of Ottawa, Adjunct Assistant Professor in the School of Pharmacy at the University of Waterloo in Ontario, and Scientist at the Bruyère Research Institute at the University of Ottawa. · Research Associate at the Bruyère Research Institute at the time of guideline development. · Medical Director of St Patrick's Home of Ottawa and Assistant Professor in the Department of Family Medicine at the University of Ottawa. · Assistant Professor of Medicine at the University of Ottawa, Chief of Geriatric Services at Hôpital Montfort, and a staff geriatrician with the Ottawa Hospital Division of Geriatrics. · Scientist at the Women's College Research Institute of Women's College Hospital in Toronto, Ont, and Assistant Professor with the Leslie Dan Faculty of Pharmacy and the Department of Family and Community Medicine at the University of Toronto. · Associate Professor and Associate Dean of Professional Programs in the Leslie Dan Faculty of Pharmacy at the University of Toronto at the time of guideline development. · Schlegel Research Chair in Geriatric Pharmacotherapy at the Schlegel-UW Research Institute on Ageing and the School of Pharmacy at the University of Waterloo at the time of guideline development. · Director of Geriatrics at Mount Sinai Hospital and the University Health Network hospitals in Toronto, Assistant Professor in the Department of Medicine, the Department of Family and Community Medicine, and the Institute for Health Policy, Management and Evaluation at the University of Toronto, and Assistant Professor in the Division of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine in Baltimore, MD. · Master's student in the School of Epidemiology and Public Health at the University of Ottawa at the time of guideline development. · Director of the Methods Centre at the Bruyère Research Institute and Assistant Professor in the School of Epidemiology and Public Health at the University of Ottawa at the time of guideline development. · Associate Professor and Head of the Division of Geriatric Psychiatry in the Department of Psychiatry at the University of Ottawa. ·Can Fam Physician · Pubmed #29358245.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop antipsychotics; to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. METHODS: The overall team comprised 9 clinicians (1 family physician, 1 family physician specializing in long-term care, 1 geriatric psychiatrist, 2 geriatricians, 4 pharmacists) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence was generated from a Cochrane systematic review of antipsychotic deprescribing trials for the behavioural and psychological symptoms of dementia, and a systematic review was conducted to assess the evidence behind the benefits of using antipsychotics for insomnia. A review of reviews of the harms of continued antipsychotic use was performed, as well as narrative syntheses of patient preferences and resource implications. This evidence and GRADE quality-of-evidence ratings were used to generate recommendations. The team refined guideline content and recommendation wording through consensus and synthesized clinical considerations to address common front-line clinician questions. The draft guideline was distributed to clinicians and stakeholders for review and revisions were made at each stage. RECOMMENDATIONS: We recommend deprescribing antipsychotics for adults with behavioural and psychological symptoms of dementia treated for at least 3 months (symptoms stabilized or no response to an adequate trial) and for adults with primary insomnia treated for any duration or secondary insomnia in which underlying comorbidities are managed. A decision-support algorithm was developed to accompany the guideline. CONCLUSION: Antipsychotics are associated with harms and can be safely tapered. Patients and caregivers might be more amenable to deprescribing if they understand the rationale (potential for harm), are involved in developing the tapering plan, and are offered behavioural advice or management. This guideline provides recommendations for making decisions about when and how to reduce the dose of or stop antipsychotics. Recommendations are meant to assist with, not dictate, decision making in conjunction with patients and families.

4 Guideline European guideline for the diagnosis and treatment of insomnia. 2017

Riemann, Dieter / Baglioni, Chiara / Bassetti, Claudio / Bjorvatn, Bjørn / Dolenc Groselj, Leja / Ellis, Jason G / Espie, Colin A / Garcia-Borreguero, Diego / Gjerstad, Michaela / Gonçalves, Marta / Hertenstein, Elisabeth / Jansson-Fröjmark, Markus / Jennum, Poul J / Leger, Damien / Nissen, Christoph / Parrino, Liborio / Paunio, Tiina / Pevernagie, Dirk / Verbraecken, Johan / Weeß, Hans-Günter / Wichniak, Adam / Zavalko, Irina / Arnardottir, Erna S / Deleanu, Oana-Claudia / Strazisar, Barbara / Zoetmulder, Marielle / Spiegelhalder, Kai. ·Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. · University Hospital for Neurology, Inselspital Bern, Bern, Switzerland. · Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. · Institute of Clinical Neurophysiology, University Medical Center Ljubljana, Ljubljana, Slovenia. · Northumbria Sleep Research Laboratory, Northumbria University, Newcastle, UK. · Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, Oxford, UK. · Sleep Research Institute Madrid, Madrid, Spain. · Stavanger University Hospital, Stavanger, Norway. · Centro de Medicina de Sono, Hospital Cuf, Porto, Portugal. · Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. · Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. · Centre du Sommeil et de la Vigilance et EA 7330 VIFASOM, Université Paris Descartes, Clinic Hotel-Dieu, Sorbonne Paris Cité, APHP, HUPC, Hotel Dieu de Paris, Paris, France. · University Hospital of Psychiatry, Bern, Switzerland. · Department of Medicine and Surgery, University of Parma, Parma, Italy. · National Institute for Health and Welfare Helsinki, Helsinki, Finland. · Sleep Medicine Centre, Kempenhaeghe Foundation, Heeze, The Netherlands. · Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Edegem-Wilrijk, Belgium. · Sleep Center Pfalzklinikum, Klingenmünster, Germany. · Sleep Medicine Center and Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland. · Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency, Moscow, Russia. · Sleep Measurements, National University Hospital of Iceland, Reykjavik, Iceland. · Institute for Pneumology, Medical Faculty, University of Bucharest, Bucharest, Romania. · Centre for Sleep Disorders in Children and Adolescents, General Hospital Celje, Ljubljana, Slovenia. · Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. ·J Sleep Res · Pubmed #28875581.

ABSTRACT: This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The target audience for this guideline includes all clinicians involved in the management of insomnia, and the target patient population includes adults with chronic insomnia disorder. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the evidence and guide recommendations. The diagnostic procedure for insomnia, and its co-morbidities, should include a clinical interview consisting of a sleep history (sleep habits, sleep environment, work schedules, circadian factors), the use of sleep questionnaires and sleep diaries, questions about somatic and mental health, a physical examination and additional measures if indicated (i.e. blood tests, electrocardiogram, electroencephalogram; strong recommendation, moderate- to high-quality evidence). Polysomnography can be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders), in treatment-resistant insomnia, for professional at-risk populations and when substantial sleep state misperception is suspected (strong recommendation, high-quality evidence). Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence). A pharmacological intervention can be offered if cognitive behavioural therapy for insomnia is not sufficiently effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective in the short-term treatment of insomnia (≤4 weeks; weak recommendation, moderate-quality evidence). Antihistamines, antipsychotics, melatonin and phytotherapeutics are not recommended for insomnia treatment (strong to weak recommendations, low- to very-low-quality evidence). Light therapy and exercise need to be further evaluated to judge their usefulness in the treatment of insomnia (weak recommendation, low-quality evidence). Complementary and alternative treatments (e.g. homeopathy, acupuncture) are not recommended for insomnia treatment (weak recommendation, very-low-quality evidence).

5 Guideline [Melatonin - known problems and perspectives of clinical usage]. 2017

Zakharov, A V / Khivintseva, E V / Pytin, V F / Sergeeva, M S / Antipov, O I. ·Samara State Medical University, Samara, Russia. · Povolzhsky state university of telecommunications and informatics, Samara, Russia. ·Zh Nevrol Psikhiatr Im S S Korsakova · Pubmed #28777368.

ABSTRACT: The article discusses well-known and ongoing studies of mechanisms of action of melatonin. The main clinical effects of melatonin are discussed. The emphasis on the chronobiological effect of melatonin, its adaptogenic and anti-carcinogenic properties has been done in the article. The most frequent manifestations of epiphyseal melatonin deficiency are various functional disorders in the form of insomnia, anxiety or depressive disorders. Recommendations on the effective use of melatonin in its deficiency due to pathology are given.

6 Guideline Guidelines for sleep studies in adults - a position statement of the Australasian Sleep Association. 2017

Douglas, James A / Chai-Coetzer, Ching Li / McEvoy, David / Naughton, Matthew T / Neill, Alister M / Rochford, Peter / Wheatley, John / Worsnop, Christopher. ·The Prince Charles Hospital, Brisbane, Queensland, Australia. Electronic address: n.shillabeer@elsevier.com. · Adelaide Institute for Sleep Health, Flinders Centre of Research Excellence, Flinders University, Adelaide, South Australia, Australia; Sleep Health Service, Repatriation General Hospital, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia. · Mater Medical Centre, Brisbane, Queensland, Australia. · The Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia. · WellSleep Sleep Investigation Centre, University of Otago, New Zealand. · Institute of Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia. · Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia; University of Sydney at Westmead Hospital, Sydney, NSW, Australia. ·Sleep Med · Pubmed #28648224.

ABSTRACT: -- No abstract --

7 Guideline Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. 2017

Sateia, Michael J / Buysse, Daniel J / Krystal, Andrew D / Neubauer, David N / Heald, Jonathan L. ·Geisel School of Medicine at Dartmouth, Hanover, NH. · University of Pittsburgh School of Medicine, Pittsburgh, PA. · University of California, San Francisco, San Francisco, CA. · Johns Hopkins University School of Medicine, Baltimore, MD. · American Academy of Sleep Medicine, Darien, IL. ·J Clin Sleep Med · Pubmed #27998379.

ABSTRACT: INTRODUCTION: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. METHODS: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The AASM Board of Directors approved the final recommendations. RECOMMENDATIONS: The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data. Downgrading the quality of evidence for these treatments is predictable in GRADE, due to the funding source for most pharmacological clinical trials and the attendant risk of publication bias; the relatively small number of eligible trials for each individual agent; and the observed heterogeneity in the data. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. We suggest that clinicians use suvorexant as a treatment for sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use eszopiclone as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use zaleplon as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use zolpidem as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use triazolam as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use temazepam as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use ramelteon as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use doxepin as a treatment for sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use trazodone as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use tiagabine as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use diphenhydramine as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use melatonin as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use tryptophan as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use valerian as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK).

8 Guideline Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. 2016

Qaseem, Amir / Kansagara, Devan / Forciea, Mary Ann / Cooke, Molly / Denberg, Thomas D / Anonymous4420866. · ·Ann Intern Med · Pubmed #27136449.

ABSTRACT: DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of chronic insomnia disorder in adults. METHODS: This guideline is based on a systematic review of randomized, controlled trials published in English from 2004 through September 2015. Evaluated outcomes included global outcomes assessed by questionnaires, patient-reported sleep outcomes, and harms. The target audience for this guideline includes all clinicians, and the target patient population includes adults with chronic insomnia disorder. This guideline grades the evidence and recommendations by using the ACP grading system, which is based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. RECOMMENDATION 1: ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder. (Grade: strong recommendation, moderate-quality evidence). RECOMMENDATION 2: ACP recommends that clinicians use a shared decision-making approach, including a discussion of the benefits, harms, and costs of short-term use of medications, to decide whether to add pharmacological therapy in adults with chronic insomnia disorder in whom cognitive behavioral therapy for insomnia (CBT-I) alone was unsuccessful. (Grade: weak recommendation, low-quality evidence).

9 Guideline Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians. 2015

Asnis, Gregory M / Thomas, Manju / Henderson, Margaret A. ·Albert Einstein College of Medicine/Montefiore Medical Center, Department of Psychiatry & Behavioral Science, Bronx, NY 10467, USA. asnisarts@aol.com. · The Anxiety and Depression Clinic, Bronx, NY 10570, USA. asnisarts@aol.com. · The Anxiety and Depression Clinic, Bronx, NY 10570, USA. manju.thomas3@gmail.com. · The Anxiety and Depression Clinic, Bronx, NY 10570, USA. mahg96@aol.com. ·Int J Mol Sci · Pubmed #26729104.

ABSTRACT: Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I) as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA) approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant) including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines) which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about "sleep-related complex behaviors", e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects.

10 Guideline An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities. 2015

Mukherjee, Sutapa / Patel, Sanjay R / Kales, Stefanos N / Ayas, Najib T / Strohl, Kingman P / Gozal, David / Malhotra, Atul / Anonymous2140833. · ·Am J Respir Crit Care Med · Pubmed #26075423.

ABSTRACT: RATIONALE: Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health. OBJECTIVES: The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep. METHODS: ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience. MAIN RESULTS: We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health. CONCLUSIONS: Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health.

11 Guideline [Clinical practice guideline. Diagnosis and treatment of insomnia in the elderly]. 2014

Medina-Chávez, Juan Humberto / Fuentes-Alexandro, Salvador Amadeo / Gil-Palafox, Irwin Bernardo / Adame-Galván, Lorena / Solís-Lam, Fernando / Sánchez-Herrera, Lucía Yveth / Sánchez-Narváez, Francisco / Anonymous300788. ·División de Excelencia Clínica, Coordinación de Unidades Médicas de Alta Especialidad, Instituto Mexicano del Seguro Social, Distrito Federal, México. humberto.medina@imss.gob.mx. ·Rev Med Inst Mex Seguro Soc · Pubmed #24625494.

ABSTRACT: Insomnia is the difficulty to initiate or to maintain sleep. It also has to do with waking up too early at least for a month. A patient with insomnia has daytime consequences such as fatigue, sleepiness, changes in mood, lose of concentration, as well as changes in his social performance and his family relationships, among others. The relationship between this disorder and physical and mental health is important due to the impact that it has on the quality of life and life expectancy of those who suffer from it. Unfortunately, insomnia usually goes unnoticed or untreated, which contributes to the onset or worsening of psychiatric and medical conditions. This exacerbates the problem of insomnia in the elderly people. In relation to the treatment it is recommended: 1) the search and management of secondary causes of insomnia, 2) a non-drug therapy that includes sleep hygiene measures, 3) pharmacotherapy. It is not recommended to start a treatment with a hypnotic drug without rule out medications or diseases that cause or exacerbate insomnia. It is not recommended the use of narcoleptics, melatonin, antihistamines or long half-life benzodiazepines. The consequences include limitations on activities of daily living, loss of functionality, impaired quality of life, increased morbidity and mortality, as well as the worsening of preexisting chronic conditions.

12 Guideline A Pan-Canadian practice guideline: prevention, screening, assessment, and treatment of sleep disturbances in adults with cancer. 2013

Howell, Doris / Oliver, Thomas K / Keller-Olaman, Sue / Davidson, Judith / Garland, Sheila / Samuels, Charles / Savard, Josée / Harris, Cheryl / Aubin, Michèle / Olson, Karin / Sussman, Jonathan / Macfarlane, James / Taylor, Claudette / Anonymous3440759. ·University Health Network (Princess Margaret Hospital), 610 University Avenue PMH, Room 15-617, Toronto, ON, Canada, doris.howell@uhn.on.ca. ·Support Care Cancer · Pubmed #23708820.

ABSTRACT: PURPOSE: This study aims to provide recommendations on the optimal strategies and interventions for the prevention, screening, assessment, and management of cancer-related sleep disturbance (insomnia and insomnia syndrome) in adult cancer populations. METHODS: A systematic search of the published health literature was conducted to identify randomized controlled trials, clinical practice guidelines, systematic reviews, and other guidance documents. The Sleep Disturbance Expert Panel [comprised of nurses, psychologists, primary care physicians, oncologists, physicians specialized in sleep disturbances, researchers, and guideline methodologists] reviewed, discussed, and approved the final version of the guideline. Health care professionals across Canada were asked to provide feedback through an external review process. RESULTS: Three clinical practice guidelines and 12 randomized controlled trials were identified as the evidence base. Overall, despite the paucity of evidence, the evidence and expert consensus suggest that it is important to screen and assess adult cancer patients for sleep disturbances using standardized screening tools on a routine basis. While prevention of sleep disturbance is the desired objective, cognitive behavioral therapies are effective in improving sleep outcomes. As part of the external review with 16 health care providers, 81 % indicated that they agreed with the recommendations as written. CONCLUSIONS: Sleep difficulty is a prevalent problem in cancer populations that needs greater recognition by health professionals. Prevention, screening, assessment, and treatment strategies supported by the best available evidence are critical. Recommendations and care path algorithms for practice are offered.

13 Guideline A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. 2012

Malow, Beth A / Byars, Kelly / Johnson, Kyle / Weiss, Shelly / Bernal, Pilar / Goldman, Suzanne E / Panzer, Rebecca / Coury, Daniel L / Glaze, Dan G / Anonymous1500741. ·Departments of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. beth.malow@vanderbilt.edu ·Pediatrics · Pubmed #23118242.

ABSTRACT: OBJECTIVE: This report describes the development of a practice pathway for the identification, evaluation, and management of insomnia in children and adolescents who have autism spectrum disorders (ASDs). METHODS: The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for an overarching approach to insomnia by a general pediatrician, primary care provider, or autism medical specialist, including identification, evaluation, and management. A field test at 4 ATN sites was used to evaluate the pathway. In addition, a systematic literature review and grading of evidence provided data regarding treatments of insomnia in children who have neurodevelopmental disabilities. RESULTS: The literature review revealed that current treatments for insomnia in children who have ASD show promise for behavioral/educational interventions and melatonin trials. However, there is a paucity of evidence, supporting the need for additional research. Consensus among the ATN sleep medicine committee experts included: (1) all children who have ASD should be screened for insomnia; (2) screening should be done for potential contributing factors, including other medical problems; (3) the need for therapeutic intervention should be determined; (4) therapeutic interventions should begin with parent education in the use of behavioral approaches as a first-line approach; (5) pharmacologic therapy may be indicated in certain situations; and (6) there should be follow-up after any intervention to evaluate effectiveness and tolerance of the therapy. Field testing of the practice pathway by autism medical specialists allowed for refinement of the practice pathway. CONCLUSIONS: The insomnia practice pathway may help health care providers to identify and manage insomnia symptoms in children and adolescents who have ASD. It may also provide a framework to evaluate the impact of contributing factors on insomnia and to test the effectiveness of nonpharmacologic and pharmacologic treatment strategies for the nighttime symptoms and daytime functioning and quality of life in ASD.

14 Guideline New guidelines for diagnosis and treatment of insomnia. 2010

Pinto, Luciano Ribeiro / Alves, Rosana Cardoso / Caixeta, Eliazor / Fontenelle, John Araujo / Bacellar, Andrea / Poyares, Dalva / Aloe, Flavio / Rizzo, Geraldo / Minhoto, Gisele / Bittencourt, Lia Rita / Ataide, Luiz / Assis, Márcia / Pradella-Hallinan, Márcia / Pinto, Maria Christina Ribeiro / Rodrigues, Raimundo Nonato D / Hasan, Rosa / Fonseca, Ronaldo / Tavares, Stella. ·Brazilian Sleep Association, São Paulo, SP, Brazil. luciano@psicobio.epm.br ·Arq Neuropsiquiatr · Pubmed #20730332.

ABSTRACT: The Brazilian Sleep Association brought together specialists in sleep medicine, in order to develop new guidelines on the diagnosis and treatment of insomnias. The following subjects were discussed: concepts, clinical and psychosocial evaluations, recommendations for polysomnography, pharmacological treatment, behavioral and cognitive therapy, comorbidities and insomnia in children. Four levels of evidence were envisaged: standard, recommended, optional and not recommended. For diagnosing of insomnia, psychosocial and polysomnographic investigation were recommended. For non-pharmacological treatment, cognitive behavioral treatment was considered to be standard, while for pharmacological treatment, zolpidem was indicated as the standard drug because of its hypnotic profile, while zopiclone, trazodone and doxepin were recommended.

15 Editorial Sleep, resilience and suicide. 2019

Sher, Leo. ·James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Leo.Sher@mssm.edu. ·Sleep Med · Pubmed #31859035.

ABSTRACT: -- No abstract --

16 Editorial Reducing Suicidality Through Insomnia Treatment: Critical Next Steps in Suicide Prevention. 2019

Hamilton, Jessica L / Buysse, Daniel J. ·Department of Psychiatry (Hamilton, Buysse) and Clinical and Translational Science Institute (Buysse), University of Pittsburgh School of Medicine, Pittsburgh. ·Am J Psychiatry · Pubmed #31672043.

ABSTRACT: -- No abstract --

17 Editorial The enigma of objective and subjective measurement of response to cognitive behavioral therapy for insomnia: Call to action. 2019

Dietch, Jessica R / Taylor, Daniel J. ·Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA. · Department of Psychology, University of Arizona, 1503 E University Blvd. Building 68, Tucson, AZ, 85721, USA. Electronic address: danieljtaylor@email.arizona.edu. ·Sleep Med Rev · Pubmed #31522979.

ABSTRACT: -- No abstract --

18 Editorial Editorial: Neuroimaging Findings in Sleep Disorders and Circadian Disruption. 2019

Dai, Xi-Jian / Rao, Hengyi / Spiegelhalder, Kai. ·Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. · Division of Sleep, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. · Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany. ·Front Neurol · Pubmed #30984096.

ABSTRACT: -- No abstract --

19 Editorial Using Insomnia as a Model for Optimizing Internet-Delivered Psychotherapy. 2019

Rumble, Meredith E / Plante, David T. ·Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison. ·Am J Psychiatry · Pubmed #30929498.

ABSTRACT: -- No abstract --

20 Editorial [Editorial]. 2019

von Salisch, Maria / Resch, Franz. ·Universitätsklinikum Heidelberg Universitätsklinikum Heidelberg. ·Prax Kinderpsychol Kinderpsychiatr · Pubmed #30757972.

ABSTRACT: -- No abstract --

21 Editorial Categorization deficit of facially expressed anger in insomnia (Commentary on Zhang et al. Individuals with insomnia misrecognize angry faces as fearful faces while missing the eyes: an eye-tracking study). 2019

Akram, Umair. ·Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, UK. · Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK. ·Sleep · Pubmed #30753718.

ABSTRACT: -- No abstract --

22 Editorial The power of pooled analyses to inform about the effects of CBTI on outcomes beyond sleep. 2019

Manber, Rachel. ·Department of Psychiatry and Behavioral Sciences, Stanford University, USA. ·Sleep Med Rev · Pubmed #30691658.

ABSTRACT: -- No abstract --

23 Editorial Editorial: Obstructive Sleep Apnea and the Brain. 2018

Gouveris, Haralampos / Eckert, Danny J. ·Department of Otorhinolaryngology, Medical Centre of the Johannes Gutenberg University, Mainz, Germany. · Neuroscience Research Australia (NeuRA) and the University of New South Wales, Sydney, NSW, Australia. ·Front Surg · Pubmed #30631767.

ABSTRACT: -- No abstract --

24 Editorial Power versus phenotyping precision of genome-wide association studies on sleep traits. 2018

Oexle, Konrad. ·Institute of Neurogenomics, Neurogenetic Systems Analysis Unit, Helmholtz Zentrum München, Neuherberg, Germany. ·Sleep · Pubmed #30423180.

ABSTRACT: -- No abstract --

25 Editorial The Insomniac's Kidney-A Novel Perspective on Renal Dysfunction. 2018

Covassin, Naima / Somers, Virend K. ·Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. · Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. Electronic address: somers.virend@mayo.edu. ·Mayo Clin Proc · Pubmed #30392538.

ABSTRACT: -- No abstract --

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