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

Riemann, Dieter; Espie, Colin A; Altena, Ellemarije; Arnardottir, Erna Sif; Baglioni, Chiara; Bassetti, Claudio L A; Bastien, Celyne; Berzina, Natalija; Bjorvatn, Bjørn; Dikeos, Dimitris; Dolenc Groselj, Leja; Ellis, Jason G; Garcia-Borreguero, Diego; Geoffroy, Pierre A; Gjerstad, Michaela; Gonçalves, Marta; Hertenstein, Elisabeth; Hoedlmoser, Kerstin; Hion, Tuuliki; Holzinger, Brigitte; ... (2023). The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. Journal of sleep research, 32(6), e14035. Wiley 10.1111/jsr.14035

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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 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).

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Bassetti, Claudio L.A., Hertenstein, Elisabeth, Krone, Lukas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1365-2869

Publisher:

Wiley

Language:

English

Submitter:

Pubmed Import

Date Deposited:

29 Nov 2023 13:56

Last Modified:

03 Dec 2023 02:31

Publisher DOI:

10.1111/jsr.14035

PubMed ID:

38016484

Uncontrolled Keywords:

diagnosis evidence-based medicine guideline insomnia treatment

BORIS DOI:

10.48350/189528

URI:

https://boris.unibe.ch/id/eprint/189528

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