New guideline supports behavioral, psychological treatments for insomnia


Date:
December 16, 2020
Source:
American Academy of Sleep Medicine
Summary:
A new clinical practice guideline establishing recommendations
for the use of behavioral and psychological treatments for chronic
insomnia disorder in adults has been published.



FULL STORY ==========================================================================
The American Academy of Sleep Medicine has published a new clinical
practice guideline establishing recommendations for the use of behavioral
and psychological treatments for chronic insomnia disorder in adults.


==========================================================================
The guideline includes one strong recommendation -- which is one that clinicians should follow under most circumstances -- for the use of
cognitive behavioral therapy for insomnia. CBT-I combines one or more
cognitive therapy strategies with education about sleep regulation plus behavioral strategies such as stimulus control instructions and sleep restriction therapy. Treatment typically involves four to eight sessions.

"This is the first systematic review to use the GRADE system to
evaluate behavioral insomnia therapies," said lead author Jack Edinger,
who has a doctorate in clinical psychology and is a professor in the
section of sleep medicine at National Jewish Health in Denver. "The multicomponent treatment, cognitive behavioral therapy for insomnia,
is the most supported therapy." Published online as an accepted paper
in the Journal of Clinical Sleep Medicine, the guideline updates the
AASM's 2006 practice parameters. It was developed by an expert task
force and approved by the AASM board of directors.

The process included a systematic literature review, meta-analyses,
and assessment of the evidence using the GRADE methodology. A draft of
the guideline was made available for public comment.

"There have been significant advancements in behavioral and psychological treatments for chronic insomnia, which affects millions of American
adults," said AASM President Dr. Kannan Ramar. "The AASM guideline
will help optimize patient-centered care by providing actionable recommendations for clinicians and patients." The guideline includes
several conditional recommendations -- which require the clinician to
use clinical knowledge and experience while considering the patient's
values and preferences -- suggesting that clinicians use multi- component
brief therapies and three single-component therapies: stimulus control,
sleep restriction therapy, and relaxation therapy. The guideline also
suggests that sleep hygiene should not be used as a single-component
treatment for chronic insomnia disorder in adults.

"Although sleep hygiene practices are often suggested and well-understood
by patients, sleep hygiene recommendation do not constitute an effective
stand- alone therapy," said Edinger.

Insomnia involves difficulty falling asleep or staying asleep, or
regularly waking up earlier than desired, despite allowing enough time
in bed for sleep.

Daytime symptoms include fatigue or sleepiness; feeling dissatisfied
with sleep; having trouble concentrating; feeling depressed, anxious,
or irritable; and having low motivation or energy. Chronic insomnia
disorder, which affects about 10 percent of the adult population, is distinguished by a sleep disturbance with associated daytime symptoms
occurring at least three times per week for at least three months.

The AASM's previously published clinical practice guideline for
the pharmacologic treatment of chronic insomnia also emphasizes that medications for chronic insomnia disorder should be considered mainly in patients who are unable to participate in CBT-I, patients who still have symptoms after this therapy, or those who require a temporary adjunct
to CBT-I.


========================================================================== Story Source: Materials provided by
American_Academy_of_Sleep_Medicine. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Jack D. Edinger, J. Todd Arnedt, Suzanne M. Bertisch, Colleen
E. Carney,
John J. Harrington, Kenneth L. Lichstein, Michael J. Sateia,
Wendy M.

Troxel, Eric S. Zhou, Uzma Kazmi, Jonathan L. Heald, Jennifer
L. Martin.

Behavioral and psychological treatments for chronic insomnia
disorder in adults: an American Academy of Sleep Medicine clinical
practice guideline. Journal of Clinical Sleep Medicine, 2020; DOI:
10.5664/ jcsm.8986 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/12/201216134635.htm

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