TY - JOUR

T1 - The European Insomnia Guideline

T2 - An update on the diagnosis and treatment of insomnia 2023

AU - Riemann, Dieter

AU - Espie, Colin A.

AU - Altena, Ellemarije

AU - Arnardottir, Erna Sif

AU - Baglioni, Chiara

AU - Bassetti, Claudio L.A.

AU - Bastien, Celyne

AU - Berzina, Natalija

AU - Bjorvatn, Bjørn

AU - Dikeos, Dimitris

AU - Dolenc Groselj, Leja

AU - Ellis, Jason G.

AU - Garcia-Borreguero, Diego

AU - Geoffroy, Pierre A.

AU - Gjerstad, Michaela

AU - Gonçalves, Marta

AU - Hertenstein, Elisabeth

AU - Hoedlmoser, Kerstin

AU - Hion, Tuuliki

AU - Holzinger, Brigitte

AU - Janku, Karolina

AU - Jansson-Fröjmark, Markus

AU - Järnefelt, Heli

AU - Jernelöv, Susanna

AU - Jennum, Poul Jørgen

AU - Khachatryan, Samson

AU - Krone, Lukas

AU - Kyle, Simon D.

AU - Lancee, Jaap

AU - Leger, Damien

AU - Lupusor, Adrian

AU - Marques, Daniel Ruivo

AU - Nissen, Christoph

AU - Palagini, Laura

AU - Paunio, Tiina

AU - Perogamvros, Lampros

AU - Pevernagie, Dirk

AU - Schabus, Manuel

AU - Shochat, Tamar

AU - Szentkiralyi, Andras

AU - Van Someren, Eus

AU - van Straten, Annemieke

AU - Wichniak, Adam

AU - Verbraecken, Johan

AU - Spiegelhalder, Kai

N1 - Publisher Copyright: © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

PY - 2023

Y1 - 2023

N2 - Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).

AB - Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).

KW - diagnosis

KW - evidence-based medicine

KW - guideline

KW - insomnia

KW - treatment

U2 - 10.1111/jsr.14035

DO - 10.1111/jsr.14035

M3 - Review

C2 - 38016484

AN - SCOPUS:85173815561

VL - 32

JO - Journal of Sleep Research (Print)

JF - Journal of Sleep Research (Print)

SN - 0962-1105

IS - 6

M1 - e14035

ER -