European guideline for the diagnosis and treatment of insomnia. (2024)

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Riemann DDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Baglioni CDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Bassetti C University Hospital for Neurology, Inselspital Bern, Bern, Switzerland.
Bjorvatn B Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Dolenc Groselj LInstitute of Clinical Neurophysiology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Ellis JGNorthumbria Sleep Research Laboratory, Northumbria University, Newcastle, UK.
Espie CASleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, Oxford, UK.
Garcia-Borreguero DSleep Research Institute Madrid, Madrid, Spain.
Gjerstad MStavanger University Hospital, Stavanger, Norway.
Gonçalves MCentro de Medicina de Sono, Hospital Cuf, Porto, Portugal.
Hertenstein EDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Jansson-Fröjmark MDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Jennum PJDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Leger DCentre du Sommeil et de la Vigilance et EA 7330 VIFASOM, Université Paris Descartes, Clinic Hotel-Dieu, Sorbonne Paris Cité, APHP, HUPC, Hotel Dieu de Paris, Paris, France.
Nissen CDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Parrino LDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Paunio TNational Institute for Health and Welfare Helsinki, Helsinki, Finland.
Pevernagie DSleep Medicine Centre, Kempenhaeghe Foundation, Heeze, The Netherlands.
Verbraecken JMultidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Edegem-Wilrijk, Belgium.
Weeß HGSleep Center Pfalzklinikum, Klingenmünster, Germany.
Wichniak ASleep Medicine Center and Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.
Zavalko IBurnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency, Moscow, Russia.
Arnardottir ESSleep Measurements, National University Hospital of Iceland, Reykjavik, Iceland.
Deleanu OCInstitute for Pneumology, Medical Faculty, University of Bucharest, Bucharest, Romania.
Strazisar BCentre for Sleep Disorders in Children and Adolescents, General Hospital Celje, Ljubljana, Slovenia.
Zoetmulder MDepartment of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Spiegelhalder KDepartment of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

CBT-I

evidence-based medicine

hypnotics

Adult

Antidepressive Agents

Antipsychotic Agents

Benzodiazepines

Cognitive Behavioral Therapy

Comorbidity

Complementary Therapies

Europe

Female

Histamine Antagonists

Humans

Male

Melatonin

Phototherapy

Polysomnography

Sleep

Sleep Initiation and Maintenance Disorders

English 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 (≤4weeks; 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).

Language

English

Open access status

bronze

Identifiers

DOI 10.1111/jsr.12594
PMID 28875581

Persistent URL

https://susi.usi.ch/global/documents/9323

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