AI Article Synopsis
- This study investigates effective treatments for insomnia disorder, focusing on how to use different treatments based on clinical situations and how to safely reduce or stop benzodiazepine medications.
- Experts rated treatment options for insomnia using a nine-point scale, gathering insights from 196 professionals, which were then categorized into first-, second-, and third-line recommendations.
- Key findings suggest that lemborexant and suvorexant are preferred first-line pharmacological treatments for both sleep initiation and maintenance, while sleep hygiene education is the top non-pharmacological recommendation.
Article Abstract
Purpose: There is a lack of evidence regarding answers for clinical questions about treating insomnia disorder. This study aimed to answer the following clinical questions: (1) how to use each hypnotic and non-pharmacological treatment differently depending on clinical situations and (2) how to reduce or stop benzodiazepine hypnotics using alternative pharmacological and non-pharmacological treatments.
Methods: Experts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1 = "disagree" to 9 = "agree"). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations.
Results: The primary pharmacological treatment, lemborexant (7.3 ± 2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3 ± 1.8) and suvorexant (6.8 ± 1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4 ± 1.1) and maintenance insomnia (8.1 ± 1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6 ± 2.3) and maintenance insomnia (5.7 ± 2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5 ± 1.8) and suvorexant (6.9 ± 1.9) were categorized as first-line recommendations.
Conclusion: Expert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203548 | PMC |
| http://dx.doi.org/10.3389/fpsyt.2023.1168100 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prevalence and impact of exploding head syndrome in a Japanese working population.
Sleep
January 2025
Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan.
Study Objectives: Exploding head syndrome (EHS) is a parasomnia characterized by the perception of loud noises, or explosions inside the head during the sleep-to-wake transition. The prevalence of EHS remains unclear. This survey aimed to elucidate the prevalence of and factors associated with EHS in this cohort.
View Article and Find Full Text PDFSeltorexant for major depressive disorder.
Expert Opin Emerg Drugs
January 2025
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Introduction: Preclinical and clinical pharmacologic evidence indicate that orexin systems are relevant to sleep-wake cycle regulation and dimensions of reward and cognition, providing the basis to hypothesizing that they may be effective as therapeutics in mental disorders. Due to the limited efficacy and tolerability profiles of existing treatments for Major Depressive Disorder (MDD), investigational compounds in novel treatment classes are needed; seltorexant, an orexin receptor antagonist, is a potential new treatment currently under investigation.
Areas Covered: Mechanisms implicated in MDD, including reward and sleep are first overviewed.
Audio-Based Care for Managing Mental Health and Substance Use Disorders in Adults: A Systematic Review.
Med Care
February 2025
RTI International, Research Triangle Park, NC.
Background: Telehealth services can increase access to care by reducing barriers. Telephone-administered care, in particular, requires few resources and may be preferred by communities in areas that are systemically underserved. Understanding the effectiveness of audio-based care is important to combat the current mental health crisis and inform discussions related to reimbursement privileges.
View Article and Find Full Text PDFManaging sleep issues in Parkinson's disease: an up-to-date review.
Expert Rev Neurother
January 2025
Department of Neurology, Dokkyo Medical University, Mibu, Japan.
Introduction: In Parkinson's disease (PD), sleep-wake problems are disease-related symptoms that occur throughout the day and have a negative impact on patients' quality of life to an extent that is equal to or greater than that of typical motor symptoms.
Areas Covered: Insomnia due to fragmented sleep and excessive daytime sleepiness (EDS) worsen as PD progresses. Nighttime wearing-off and early morning-off should be considered first when fragmented sleep is reported in PD patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!