The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023
Summary Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diar...
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| Veröffentlicht in: | Journal of sleep research Jg. 32; H. 6; S. e14035 - n/a |
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
England
Wiley
01.12.2023
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| Schlagworte: | |
| ISSN: | 0962-1105, 1365-2869, 1365-2869 |
| Online-Zugang: | Volltext |
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| Abstract | Summary
Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential‐diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders, etc.), treatment‐resistant insomnia (A) and for other indications (B). Cognitive‐behavioural therapy for insomnia is recommended as the first‐line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in‐person or digitally (A). When cognitive‐behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low‐dose sedating antidepressants (B) can be used for the short‐term treatment of insomnia (≤ 4 weeks). Longer‐term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged‐release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast‐release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive‐behavioural therapy for insomnia (B). |
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| AbstractList | Summary
Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential‐diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders, etc.), treatment‐resistant insomnia (A) and for other indications (B). Cognitive‐behavioural therapy for insomnia is recommended as the first‐line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in‐person or digitally (A). When cognitive‐behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low‐dose sedating antidepressants (B) can be used for the short‐term treatment of insomnia (≤ 4 weeks). Longer‐term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged‐release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast‐release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive‐behavioural therapy for insomnia (B). Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B). Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B). Summary Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential‐diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep‐related breathing disorders, etc.), treatment‐resistant insomnia (A) and for other indications (B). Cognitive‐behavioural therapy for insomnia is recommended as the first‐line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in‐person or digitally (A). When cognitive‐behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low‐dose sedating antidepressants (B) can be used for the short‐term treatment of insomnia (≤ 4 weeks). Longer‐term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged‐release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast‐release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive‐behavioural therapy for insomnia (B). |
| Author | Gjerstad, Michaela Berzina, Natalija Wichniak, Adam Dolenc Groselj, Leja Jennum, Poul Jørgen Verbraecken, Johan Baglioni, Chiara Szentkiralyi, Andras Jansson‐Fröjmark, Markus Bassetti, Claudio L. A. Garcia‐Borreguero, Diego Holzinger, Brigitte Krone, Lukas Dikeos, Dimitris Järnefelt, Heli Altena, Ellemarije Riemann, Dieter Hertenstein, Elisabeth Palagini, Laura Hoedlmoser, Kerstin Arnardottir, Erna Sif Espie, Colin A. Marques, Daniel Ruivo Khachatryan, Samson Spiegelhalder, Kai Van Someren, Eus Straten, Annemieke Shochat, Tamar Paunio, Tiina Geoffroy, Pierre A. Lupusor, Adrian Pevernagie, Dirk Ellis, Jason G. Kyle, Simon D. Leger, Damien Lancee, Jaap Schabus, Manuel Hion, Tuuliki Janku, Karolina Perogamvros, Lampros Bastien, Celyne Gonçalves, Marta Jernelöv, Susanna Nissen, Christoph Bjorvatn, Bjørn |
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A. organization: University of Bern – sequence: 7 givenname: Celyne surname: Bastien fullname: Bastien, Celyne organization: Université Laval – sequence: 8 givenname: Natalija surname: Berzina fullname: Berzina, Natalija organization: Psychiatric Practice – sequence: 9 givenname: Bjørn surname: Bjorvatn fullname: Bjorvatn, Bjørn organization: University of Bergen – sequence: 10 givenname: Dimitris surname: Dikeos fullname: Dikeos, Dimitris organization: National and Kapodistrian University of Athens – sequence: 11 givenname: Leja orcidid: 0000-0002-8350-951X surname: Dolenc Groselj fullname: Dolenc Groselj, Leja organization: University Medical Center Ljubljana – sequence: 12 givenname: Jason G. orcidid: 0000-0002-8496-520X surname: Ellis fullname: Ellis, Jason G. organization: Northumbria University – sequence: 13 givenname: Diego surname: Garcia‐Borreguero fullname: Garcia‐Borreguero, Diego organization: Sleep Research Institute – sequence: 14 givenname: Pierre A. orcidid: 0000-0001-9121-209X surname: Geoffroy fullname: Geoffroy, Pierre A. organization: Paris Cite University – sequence: 15 givenname: Michaela surname: Gjerstad fullname: Gjerstad, Michaela organization: Stavanger University Hospital – sequence: 16 givenname: Marta surname: Gonçalves fullname: Gonçalves, Marta organization: Hospital Cuf – sequence: 17 givenname: Elisabeth surname: Hertenstein fullname: Hertenstein, Elisabeth organization: University of Bern – sequence: 18 givenname: Kerstin surname: Hoedlmoser fullname: Hoedlmoser, Kerstin organization: University of Salzburg – sequence: 19 givenname: Tuuliki surname: Hion fullname: Hion, Tuuliki organization: East‐Viru Central Hospital – sequence: 20 givenname: Brigitte surname: Holzinger fullname: Holzinger, Brigitte organization: Institute for Consciousness and Dream Research – sequence: 21 givenname: Karolina orcidid: 0000-0002-6804-6967 surname: Janku fullname: Janku, Karolina organization: Center for Sleep and Chronobiology Research, National Institute of Mental Health – sequence: 22 givenname: Markus orcidid: 0000-0003-2059-1621 surname: Jansson‐Fröjmark fullname: Jansson‐Fröjmark, Markus organization: Karolinska Institutet, Stockholm, Sweden and Stockholm Health Care Services – sequence: 23 givenname: Heli surname: Järnefelt fullname: Järnefelt, Heli organization: Finnish Institute of Occupational Health – sequence: 24 givenname: Susanna orcidid: 0000-0002-0633-8104 surname: Jernelöv fullname: Jernelöv, Susanna organization: Karolinska Institutet, Stockholm, Sweden and Stockholm Health Care Services – sequence: 25 givenname: Poul Jørgen surname: Jennum fullname: Jennum, Poul Jørgen organization: University of Copenhagen – sequence: 26 givenname: Samson orcidid: 0000-0002-3098-2135 surname: Khachatryan fullname: Khachatryan, Samson organization: Armenian National Institute of Health – sequence: 27 givenname: Lukas orcidid: 0000-0002-5535-7221 surname: Krone fullname: Krone, Lukas organization: University of Bern – sequence: 28 givenname: Simon D. surname: Kyle fullname: Kyle, Simon D. organization: Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford – sequence: 29 givenname: Jaap orcidid: 0000-0002-7722-5780 surname: Lancee fullname: Lancee, Jaap organization: University of Amsterdam – sequence: 30 givenname: Damien orcidid: 0000-0003-1168-480X surname: Leger fullname: Leger, Damien organization: Université Paris Cité, APHP, Hôtel Dieu de Paris, Centre du Sommeil et de la Vigilance – sequence: 31 givenname: Adrian surname: Lupusor fullname: Lupusor, Adrian organization: Functional Neurology, Institute of Neurology and Neurosurgery – sequence: 32 givenname: Daniel Ruivo orcidid: 0000-0003-3729-0120 surname: Marques fullname: Marques, Daniel Ruivo organization: University of Coimbra – sequence: 33 givenname: Christoph orcidid: 0000-0001-9809-0275 surname: Nissen fullname: Nissen, Christoph organization: University Hospital Geneve – sequence: 34 givenname: Laura orcidid: 0000-0003-1676-629X surname: Palagini fullname: Palagini, Laura organization: University of Pisa – sequence: 35 givenname: Tiina surname: Paunio fullname: Paunio, Tiina organization: University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Public Health and Welfare, Finnish Institute for Health and Welfare – sequence: 36 givenname: Lampros surname: Perogamvros fullname: Perogamvros, Lampros organization: University Hospital Geneve – sequence: 37 givenname: Dirk orcidid: 0000-0002-7372-8583 surname: Pevernagie fullname: Pevernagie, Dirk organization: Ghent University – sequence: 38 givenname: Manuel surname: Schabus fullname: Schabus, Manuel organization: University of Salzburg – sequence: 39 givenname: Tamar orcidid: 0000-0002-4371-3567 surname: Shochat fullname: Shochat, Tamar organization: University of Haifa – sequence: 40 givenname: Andras surname: Szentkiralyi fullname: Szentkiralyi, Andras organization: University of Münster – sequence: 41 givenname: Eus orcidid: 0000-0002-9970-8791 surname: Van Someren fullname: Van Someren, Eus organization: Amsterdam UMC, Amsterdam Neuroscience, VU University – sequence: 42 givenname: Annemieke orcidid: 0000-0001-6875-2215 surname: Straten fullname: Straten, Annemieke organization: Vrije Universiteit Amsterdam – sequence: 43 givenname: Adam surname: Wichniak fullname: Wichniak, Adam organization: Sleep Medicine Center and Third Department of Psychiatry, Institute of Psychiatry and Neurology – sequence: 44 givenname: Johan surname: Verbraecken fullname: Verbraecken, Johan organization: Antwerp University Hospital and University of Antwerp – sequence: 45 givenname: Kai orcidid: 0000-0002-4133-3464 surname: Spiegelhalder fullname: Spiegelhalder, Kai organization: University of Freiburg |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38016484$$D View this record in MEDLINE/PubMed https://hal.science/hal-04730459$$DView record in HAL http://kipublications.ki.se/Default.aspx?queryparsed=id:154721940$$DView record from Swedish Publication Index (Karolinska Institutet) |
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| Copyright | 2023 The Authors. published by John Wiley & Sons Ltd on behalf of European Sleep Research Society. 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society. licence_http://creativecommons.org/publicdomain/zero |
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| Keywords | treatment diagnosis evidence-based medicine guideline insomnia |
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Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure... Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for... Summary Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure... |
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| SubjectTerms | Adult Antidepressive Agents - therapeutic use Benzodiazepines - therapeutic use Cognitive science diagnosis evidence‐based medicine guideline Humans insomnia Melatonin - pharmacology Melatonin - therapeutic use Sleep Sleep Initiation and Maintenance Disorders - drug therapy Sleep Initiation and Maintenance Disorders - therapy treatment |
| Title | The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023 |
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