31.Management Of Insomnia

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31.Management Of Insomnia

 

 

CATEGORY: Psychiatry & Psychology 300 Courses

COURSE NUMBER: 31

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Syllabus

Executive Summary ………………………………………………………………………………………………….ES-1
Introduction……………………………………………………………………………………………………………………1
Background………………………………………………………………………………………………………………..1
Scope and Key Questions…………………………………………………………………………………………….5
Key Questions……………………………………………………………………………………………………….6
PICOTS………………………………………………………………………………………………………………..6
Methods………………………………………………………………………………………………………………………..9
Analytic Framework ……………………………………………………………………………………………………9
Criteria for Inclusion/Exclusion of Studies in the Review ………………………………………………..9
Searching for the Evidence: Literature Search Strategies for Identification
of Relevant Studies To Answer the Key Questions…………………………………………………..10
Data Abstraction and Data Management ………………………………………………………………………11
Assessment of Methodological Risk of Bias of Individual Studies…………………………………..11
Data Synthesis…………………………………………………………………………………………………………..12
Grading the Strength of Evidence for Individual Comparisons and Outcomes…………………..13
Assessing Applicability ……………………………………………………………………………………………..14
Results………………………………………………………………………………………………………………………….15
Literature Search and Screening ………………………………………………………………………………….15
Key Points…………………………………………………………………………………………………………..15
Efficacy and Comparative Effectiveness of Psychological Interventions………………………….16
Key Points…………………………………………………………………………………………………………..16
Efficacy of Cognitive Behavioral Therapy in the General Adult Population………………..17
Efficacy of Cognitive Behavioral Therapy in Older Adults……………………………………….28
Efficacy of Cognitive Behavioral Therapy in Adults With Pain …………………………………34
Efficacy of Cognitive Behavioral Therapy in Other Special Populations…………………….37
Efficacy of Multicomponent Behavioral Interventions in the General Adult
Population ……………………………………………………………………………………………………..38
Efficacy of Multicomponent Behavioral Interventions or Brief Behavioral
Therapy in Older Adults ………………………………………………………………………………….38
Efficacy of Sleep Restriction in the General Adult Population …………………………………..41
Efficacy of Sleep Restriction in Older Adults ………………………………………………………….41
Efficacy of Stimulus Control in the General Adult Population …………………………………..45
Efficacy of Stimulus Control in Older Adults ………………………………………………………….48
Efficacy of Relaxation Therapy in the General Adult Population……………………………….51
Comparative Effectiveness of Psychological Treatments…………………………………………..53
Efficacy of Pharmacologic Treatment ………………………………………………………………………….54
Key Points…………………………………………………………………………………………………………..54
Efficacy of Nonbenzodiazepine Hypnotics in the General Adult Population ……………….55
Efficacy of Nonbenzodiazepine Hypnotics in Older Adults……………………………………….70
Efficacy of Nonbenzodiazepine Hypnotics in Patients With Chronic Low Back Pain …..75
Efficacy of Melatonin and Ramelteon in the General Adult Population………………………78
Efficacy of Melatonin and Ramelteon in Older Adults……………………………………………..82
Efficacy of Benzodiazepine Hypnotics in the General Adult Population……………………..84
Efficacy of Benzodiazepine Hypnotics in Older Adults…………………………………………….87
Efficacy of Antidepressants in the General Adult Population…………………………………….89
Efficacy of Antidepressants in Older Adults……………………………………………………………91
Efficacy of Suvorexant in the General Population and Older Adults…………………………..95
Comparative Effectiveness of Pharmacologic Interventions for Insomnia Disorder ……..99
Long-Term Adverse Effects: Analysis of Observational Studies………………………………105
Efficacy and Comparative Effectiveness of Complementary and Alternative
Medicine Treatments ………………………………………………………………………………………….109
Key Points…………………………………………………………………………………………………………109
Efficacy of Acupuncture ……………………………………………………………………………………..109
Efficacy of Homeopathy……………………………………………………………………………………..113
Efficacy of Valerian……………………………………………………………………………………………113
Efficacy and Comparative Effectiveness of Bright Light Therapy ……………………………114
Efficacy of Other CAM Treatments ……………………………………………………………………..114
Comparative Effectiveness of Interventions of Different Types…………………………………….115
Comparative Effectiveness of Pharmacologic Versus Psychological
Interventions and Combination Treatments………………………………………………………115
Comparative Effectiveness of Combined Pharmacologic and Psychological
Interventions Versus Psychological Interventions……………………………………………..121
Comparative Effectiveness and Combination Treatments: Unique Comparisons………..126
Discussion……………………………………………………………………………………………………………………127
Applicability …………………………………………………………………………………………………………..129
Limitations……………………………………………………………………………………………………………..129
Future Research Needs …………………………………………………………………………………………….130
Conclusions…………………………………………………………………………………………………………….130
References…………………………………………………………………………………………………………………..132
Abbreviations……………………………………………………………………………………………………………..142

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