- Insomnia is one of the most common sleep disorders in the world.
- The American Academy of Sleep Medicine issues new guidelines that provide clinical recommendations for specific insomnia drugs to treat chronic insomnia disorder.
- Clinicians must consider the recommendations and take proper judgements while deciding drugs for insomnia patients.
The American Academy of Sleep Medicine is the first to issue new clinical guidelines to provide comprehensive, evidence-based analysis of drugs which are used in the treatment of chronic insomnia disorder.
The guidelines were published in the Journal of Clinical Sleep Medicine, which provides recommendations that help clinicians to choose pharmacological agents for the treatment of insomnia in adults.
‘The American Academy of Sleep Medicine issues new recommendations that help clinicians to choose specific drugs for the treatment of chronic insomnia.’
The guidelines which were based on a systematic literature review, meta-analyses, assessment of evidence using GRADE methodology was developed by an expert task force and was approved by the board of directors from American Academy of Sleep Medicine.
President Ronald D. Chervin, MD, MS, said, "The publication of this clinical practice guideline is an important step forward for the field of sleep medicine."
"It further equips clinicians to provide high quality, patient-centered care for millions of people who suffer from chronic insomnia."
According to the Centers for the Disease Control and Prevention, an estimated 4.1% of the U.S. adults were found to take a prescription sleep aid in the past month based on the survey data which was collected from 2005-2010.
The clinical guidelines included 14 specific recommendations for specific insomnia drugs which also included
- Prescription medications - zolpidem and eszopiclone
- Over-the-counter medications - diphenhydramine
- Dietary supplements - melatonin and valerian
The recommendations were found to suggest whether clinicians may or may not use the drug for sleep onset insomnia versus no treatment.
These guidelines may not however recommend one drug over another even though few comparative studies were carried out on the efficacy.
The authors also found that the data available to support the recommendations are often less than certain and therefore the strength of the recommendations may be weak. This may reflect a lower degree of certainty which may affect on the appropriateness of patient care strategy.
Clinicians must take proper judgements while providing care for patients with insomnia. The decisions are not only based on the recommendations but also on the experience and circumstances of the patients.
The medications for chronic insomnia disorder are mainly considered in patients who are unable to take part in cognitive behavioral therapy for insomnia (CBT-I). The patients who have symptoms even after therapy are those who require temporary adjunct to CBT-I.
The clinical guidelines previously published by the American Academy of Sleep Medicine showed CBT-I to be an effective treatment for insomnia initially. This was repeated in the American Academy of Sleep Medicine in a 2014 Choosing Wisley statement.
Insomnia is caused by certain medical conditions, unhealthy sleep habits, specific substances or biological factors or psychiatric conditions like depression.
Insomnia is a symptom of an underlying sleep disorder like restless sleep disorder, sleep apnea.
Two types of Insomnia
- This type of insomnia occur for up to three months. And may affect 15-20% of people.
- This type of insomnia occur three times per week and may last for more than 3 months. 10% of the people are found to have chronic insomnia.
- Michael J. Sateia et al, Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline, Journal of Clinical Sleep Medicine (2017) DOI: 10.5664/jcsm.6470
- Insomnia - Overview and Facts - (http://www.sleepeducation.org/essentials-in-sleep/insomnia)