European guideline for the diagnosis and treatment of insomnia

Dieter Riemann; Chiara Baglioni; Claudio Bassetti; Bjørn Bjorvatn; Leja Dolenc Groselj; Jason G. Ellis; Colin A. Espie; Diego Garcia-Borreguero; Michaela Gjerstad; Marta Gonçalves; Elisabeth Hertenstein; Markus Jansson-Fröjmark; Poul J. Jennum; Damien Leger; Christoph Nissen; Liborio Parrino; Tiina Paunio; Dirk Pevernagie; Johan Verbraecken; Hans Günter Weeß; Adam Wichniak; Irina Zavalko; Erna S. Arnardottir; Oana Claudia Deleanu; Barbara Strazisar; Marielle Zoetmulder; Kai Spiegelhalder

doi:10.1111/jsr.12594

European guideline for the diagnosis and treatment of insomnia

Dieter Riemann^*, Chiara Baglioni, Claudio Bassetti, Bjørn Bjorvatn, Leja Dolenc Groselj, Jason G. Ellis, Colin A. Espie, Diego Garcia-Borreguero, Michaela Gjerstad, Marta Gonçalves, Elisabeth Hertenstein, Markus Jansson-Fröjmark, Poul J. Jennum, Damien Leger, Christoph Nissen, Liborio Parrino, Tiina Paunio, Dirk Pevernagie, Johan Verbraecken, Hans Günter WeeßAdam Wichniak, Irina Zavalko, Erna S. Arnardottir, Oana Claudia Deleanu, Barbara Strazisar, Marielle Zoetmulder, Kai Spiegelhalder

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

411 Citationer (Scopus)

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).

Originalsprog	Engelsk
Tidsskrift	Journal of Sleep Research
Vol/bind	26
Udgave nummer	6
Sider (fra-til)	675-700
Antal sider	26
ISSN	0962-1105
DOI	https://doi.org/10.1111/jsr.12594
Status	Udgivet - dec. 2017

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Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia-Borreguero, D., Gjerstad, M., Gonçalves, M., Hertenstein, E., Jansson-Fröjmark, M., Jennum, P. J., Leger, D., Nissen, C., Parrino, L., Paunio, T., Pevernagie, D., Verbraecken, J., ... Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700. https://doi.org/10.1111/jsr.12594

Riemann, D, Baglioni, C, Bassetti, C, Bjorvatn, B, Dolenc Groselj, L, Ellis, JG, Espie, CA, Garcia-Borreguero, D, Gjerstad, M, Gonçalves, M, Hertenstein, E, Jansson-Fröjmark, M, Jennum, PJ, Leger, D, Nissen, C, Parrino, L, Paunio, T, Pevernagie, D, Verbraecken, J, Weeß, HG, Wichniak, A, Zavalko, I, Arnardottir, ES, Deleanu, OC, Strazisar, B, Zoetmulder, M & Spiegelhalder, K 2017, 'European guideline for the diagnosis and treatment of insomnia', Journal of Sleep Research, bind 26, nr. 6, s. 675-700. https://doi.org/10.1111/jsr.12594

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title = "European guideline for the diagnosis and treatment of insomnia",

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).",

keywords = "CBT-I, evidence-based medicine, hypnotics",

author = "Dieter Riemann and Chiara Baglioni and Claudio Bassetti and Bj{\o}rn Bjorvatn and {Dolenc Groselj}, Leja and Ellis, {Jason G.} and Espie, {Colin A.} and Diego Garcia-Borreguero and Michaela Gjerstad and Marta Gon{\c c}alves and Elisabeth Hertenstein and Markus Jansson-Fr{\"o}jmark and Jennum, {Poul J.} and Damien Leger and Christoph Nissen and Liborio Parrino and Tiina Paunio and Dirk Pevernagie and Johan Verbraecken and Wee{\ss}, {Hans G{\"u}nter} and Adam Wichniak and Irina Zavalko and Arnardottir, {Erna S.} and Deleanu, {Oana Claudia} and Barbara Strazisar and Marielle Zoetmulder and Kai Spiegelhalder",

year = "2017",

month = dec,

doi = "10.1111/jsr.12594",

language = "English",

volume = "26",

pages = "675--700",

journal = "Journal of Sleep Research",

issn = "0962-1105",

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T1 - European guideline for the diagnosis and treatment of insomnia

AU - Riemann, Dieter

AU - Baglioni, Chiara

AU - Bassetti, Claudio

AU - Bjorvatn, Bjørn

AU - Dolenc Groselj, Leja

AU - Ellis, Jason G.

AU - Espie, Colin A.

AU - Garcia-Borreguero, Diego

AU - Gjerstad, Michaela

AU - Gonçalves, Marta

AU - Hertenstein, Elisabeth

AU - Jansson-Fröjmark, Markus

AU - Jennum, Poul J.

AU - Leger, Damien

AU - Nissen, Christoph

AU - Parrino, Liborio

AU - Paunio, Tiina

AU - Pevernagie, Dirk

AU - Verbraecken, Johan

AU - Weeß, Hans Günter

AU - Wichniak, Adam

AU - Zavalko, Irina

AU - Arnardottir, Erna S.

AU - Deleanu, Oana Claudia

AU - Strazisar, Barbara

AU - Zoetmulder, Marielle

AU - Spiegelhalder, Kai

PY - 2017/12

Y1 - 2017/12

N2 - 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).

AB - 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).

KW - CBT-I

KW - evidence-based medicine

KW - hypnotics

U2 - 10.1111/jsr.12594

DO - 10.1111/jsr.12594

M3 - Journal article

C2 - 28875581

AN - SCOPUS:85035020111

SN - 0962-1105

VL - 26

SP - 675

EP - 700

JO - Journal of Sleep Research

JF - Journal of Sleep Research

IS - 6

ER -

European guideline for the diagnosis and treatment of insomnia

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