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Latest & greatest articles for insomnia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on insomnia or other clinical topics then use Trip today.
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Ramelteon in the treatment of chronic insomnia: systematic review and meta-analysis As a melatonin receptor agonist, ramelteon has been approved in the United States as a treatment for insomnia. As a potential alternation, ramelteon should be further evaluated in different doses and populations. This systematic review with meta-analysis aims to determine the efficacy and safety of ramelteon in the treatment of chronic insomnia.We systematically searched and identified in Medline, Embase (...) , PsycINFO and Cochrane Library until September 2011. We only included randomised controlled trials focused on ramelteon, vs. placebo, or any other treatment for patients with chronic insomnia. Data were extracted and evaluated by two independent investigators. If neither clinical nor statistical heterogeneity was found, we pooled results using a fixed-effect model.Eight studies were selected to include from 175 identified references. There were significant improvements in all the outcomes (subjective
Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Chronic insomnia. Insomnia is a prevalent complaint in clinical practice that can present independently or comorbidly with another medical or psychiatric disorder. In either case, it might need treatment of its own. Of the different therapeutic options available, benzodiazepine-receptor agonists (BzRAs) and cognitive-behavioural therapy (CBT) are supported by the best empirical evidence. BzRAs are readily available and effective in the short-term management of insomnia, but evidence of long (...) -term efficacy is scarce and most hypnotic drugs are associated with potential adverse effects. CBT is an effective alternative for chronic insomnia. Although more time consuming than drug management, CBT produces sleep improvements that are sustained over time, and this therapy is accepted by patients. Although CBT is not readily available in most clinical settings, access and delivery can be made easier through use of innovative methods such as telephone consultations, group therapy, and self-help
Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review Mitchell MD, Gehrman P, Perlis M, Umscheid CA CRD summary The review concluded that cognitive behavioural therapy was an effective treatment for insomnia that can produce durable results in a relatively small number (...) of visits. Given the small evidence base, unclear reporting of some results and limited quality, the authors' conclusions cannot be considered reliable Authors' objectives To evaluate the effectiveness of cognitive behavioural therapy (CBT) compared to medication in patients with primary and comorbid insomnia. Searching MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and PsycINFO were searched to September 2011 without language or publication restrictions. Search terms were
Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. To investigate the effectiveness of non-benzodiazepine hypnotics (Z drugs) and associated placebo responses in adults and to evaluate potential moderators of effectiveness in a dataset used to approve these drugs.Systematic review and meta-analysis.US Food and Drug Administration (FDA).Randomised double blind parallel placebo controlled trials
The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial To determine whether nightly administration of melatonin, magnesium, and zinc improves primary insomnia in long-term care facility residents.Double-blind, placebo-controlled clinical trial.One long-term care facility in Pavia, Italy.Forty-three participants with primary insomnia (22 in the supplemented group, 21 in the placebo group (...) ) aged 78.3 ± 3.9.Participants took a food supplement (5 mg melatonin, 225 mg magnesium, and 11.25 mg zinc, mixed with 100 g of pear pulp) or placebo (100 g pear pulp) every day for 8 weeks, 1 hour before bedtime.The primary goal was to evaluate sleep quality using the Pittsburgh Sleep Quality Index. The Epworth Sleepiness Scale, the Leeds Sleep Evaluation Questionnaire (LSEQ), the Short Insomnia Questionnaire (SDQ), and a validated quality-of-life instrument (Medical Outcomes Study 36-item Short
Insomnia: treatment pathways, costs and quality of life Insomnia: treatment pathways, costs and quality of life Insomnia: treatment pathways, costs and quality of life Scott GW, Scott HM, O'Keeffe KM, Gander PH Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study (...) and the conclusions drawn. CRD summary This study examined the cost-effectiveness of several treatments for insomnia in adults aged 20 to 59 years. The authors concluded that successful treatment for insomnia was highly cost-effective, despite conservative assumptions. Most of the data were from interviews with experts and the treatment pathways were not fully described, but the authors’ conclusions appear to be valid and robust. Type of economic evaluation Cost-utility analysis Study objective This study
Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial Acupressure on the Shenmen point (indexed as HT7) can improve insomnia, but there has been no longitudinal study to evaluate its efficacy for residents of long-term care facilities. No evidence from the existing literature indicates how long its efficacy can be maintained after stopping acupressure.The aim of this study was to evaluate the effectiveness of acupressure (...) on the Shenmen point for residents of long-term care facilities with insomnia.Fifty residents with insomnia in long-term care facilities were enrolled in a randomized controlled trial, with 25 participants allocated to the experimental group and 25 participants to the control group. For a 5-week period, the experimental group received standard acupressure on the HT7 points of both wrists, whereas the control group received only light touch on the same places. Insomnia was measured with the Athens Insomnia
Adult Primary Insomnia - Diagnosis to Management 1 InsomniaInsomnia Diagnosis to Management Guideline for Adult Primary Introduction • The management of primary insomnia is based on the foundation of behavioural and cognitive non-pharmacologic strategies. Pharmacologic interventions are adjunctive to the nonpharmacologic strategies. Adjunctive pharmacotherapy is used on a short-term (less than 7-14 days on a nightly basis) or intermittent (2-3 nights per week) for the sole purpose (...) of preventing an exacerbation of the primary insomnia • The patient must be an active participant in treatment process. Primary insomnia is a chronic illness that requires regular follow-up and monitoring to evaluate the patient’s response to treatment and motivation to resolve the problem • The goal of management is to provide the patient with the tools necessary to manage the chronic nature of the illness and minimize dependence on sedative medications. Non-pharmacologic Non-pharmacologic therapies
Adult Insomnia - Assessment to Diagnosis 1 Guideline for Adult Introduction Acute Insomnia: 1. Duration of 4 weeks or less. 2,3,4,5 Chronic Insomnia: 2. Duration of 4 weeks or more. 2,3,4,5 Primary Sleep Disorder: 3. A primary or intrinsic sleep disorder is one that arises out of the physiological processes of sleep. Examples of primary sleep disorders are obstructive sleep apnea, restless legs syndrome, periodic limb movement disorder or parasomnias. 2 Secondary Insomnia 4. : Secondary (...) insomnia refers to difficulty initiating and/ or maintaining sleep that occurs as a result of or co-morbidly in conjunction with a medical, psychiatric or psychological process. Examples of secondary insomnia include: pain associated with rheumatoid arthritis that disrupts initiation and/or maintenance of sleep, insomnia co-morbidly associated with a major depressive episode, or insomnia associated with an acute emotional stressor. 6,7 Primary Insomnia 5. (also known as psychophysiologic insomnia (PPI
Cognitive behavioural therapy for insomnia in adults: a review of the clinical effectiveness Cognitive behavioural therapy for insomnia in adults: a review of the clinical effectiveness Cognitive behavioural therapy for insomnia in adults: a review of the clinical effectiveness Canadian Agency for Drugs and Technologies in Health Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has (...) been made for the HTA database. Citation Canadian Agency for Drugs and Technologies in Health. Cognitive behavioural therapy for insomnia in adults: a review of the clinical effectiveness. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). 2010 Authors' conclusions In the available literature, CBT seems to be effective in mediating the symptoms of primary insomnia as indicated by sleep outcome measures. The results demonstrate that CBT is as effective and in some studies even
Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Efficacy of an Internet-based behavioral intervention for adults with insomniaInsomnia is a major health problem with significant psychological, health, and economic consequences. However, availability of one of the most effective insomnia treatments, cognitive behavioral therapy, is significantly limited. The Internet may be a key conduit for delivering this intervention.To evaluate the efficacy of a structured behavioral Internet intervention for adults with insomnia.Forty-five adults were (...) restructuring, and relapse prevention.The Insomnia Severity Index and daily sleep diary data were used to determine changes in insomnia severity and the main sleep variables, including wake after sleep onset and sleep efficiency.Intention-to-treat analyses showed that scores on the Insomnia Severity Index significantly improved from 15.73 (95% confidence interval [CI], 14.07 to 17.39) to 6.59 (95% CI, 4.73 to 8.45) for the Internet group but did not change for the control group (16.27 [95% CI, 14.61
Controlled clinical trial of zolpidem for the treatment of insomnia associated with attention-deficit/ hyperactivity disorder in children 6 to 17 years of age The goal was to evaluate the hypnotic efficacy of zolpidem at 0.25 mg/kg per day (maximum of 10 mg/day), compared with placebo, in children 6 through 17 years of age who were experiencing insomnia associated with attention-deficit/hyperactivity disorder.An 8-week, North American, multicenter, double-blind, placebo-controlled, parallel (...) to persistent sleep on polysomnographic recordings after 4 weeks of treatment in children and adolescents 6 through 17 years of age who had attention-deficit/hyperactivity disorder-associated insomnia.
Scheduled Bright Light for Treatment of Insomnia in Older Adults To determine whether bright light can improve sleep in older individuals with insomnia.Single-blind, placebo-controlled, 12-week, parallel-group randomized design comparing four treatment groups representing a factorial combination of two lighting conditions and two times of light administration.At-home light treatment; eight office therapy sessions.Thirty-six women and fifteen men (aged 63.6+/-7.1) meeting primary insomnia (...) (melatonin midpoint) and sleep (darkness) predicted the magnitude of phase delays, but not phase advances, engendered by bright light.Except for one subjective measure, scheduled morning or evening bright light effects were not different from those of scheduled dim light. Thus, support was not found for bright light treatment of older individuals with primary insomnia.
Cost-effectiveness of eszopiclone for the treatment of adults with primary chronic insomnia Cost-effectiveness of eszopiclone for the treatment of adults with primary chronic insomnia Cost-effectiveness of eszopiclone for the treatment of adults with primary chronic insomnia Snedecor SJ, Botteman MF, Bojke C, Schaefer K, Barry N, Pickard AS Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study evaluated the cost-effectiveness of eszopiclone, compared with no treatment, for adults with chronic primary insomnia. The authors concluded that eszopiclone was cost-effective, especially when including productivity losses. The methods were satisfactory, but the six-month time horizon might not have fully captured the relevant differences
Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Traditional needle acupuncture treatment for insomnia: a systematic review of randomized controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Self-help therapy for insomnia: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.