2023+欧洲失眠指南:失眠的诊断和治疗(英文更新版).pdf
《2023+欧洲失眠指南:失眠的诊断和治疗(英文更新版).pdf》由会员分享,可在线阅读,更多相关《2023+欧洲失眠指南:失眠的诊断和治疗(英文更新版).pdf(36页珍藏版)》请在咨信网上搜索。
1、R E V I E W A R T I C L EThe European Insomnia Guideline:An update on the diagnosisand treatment of insomnia 2023Dieter Riemann1,2|Colin A.Espie3|Ellemarije Altena4|Erna Sif Arnardottir5,6|Chiara Baglioni7|Claudio L.A.Bassetti8|Celyne Bastien9|Natalija Berzina10|Bjrn Bjorvatn11|Dimitris Dikeos12|Lej
2、a Dolenc Groselj13|Jason G.Ellis14|Diego Garcia-Borreguero15|Pierre A.Geoffroy16|Michaela Gjerstad17|Marta Gonalves18|Elisabeth Hertenstein19|Kerstin Hoedlmoser20|Tuuliki Hion21|Brigitte Holzinger22|Karolina Janku23|Markus Jansson-Frjmark24,25|Heli Jrnefelt26|Susanna Jernelv24,25|Poul Jrgen Jennum27
3、|Samson Khachatryan28|Lukas Krone3,8,19|Simon D.Kyle3|Jaap Lancee29|Damien Leger30|Adrian Lupusor31|Daniel Ruivo Marques32,33|Christoph Nissen34|Laura Palagini35|Tiina Paunio36|Lampros Perogamvros34|Dirk Pevernagie37|Manuel Schabus20|Tamar Shochat38|Andras Szentkiralyi39|Eus Van Someren40,41|Annemie
4、ke van Straten42|Adam Wichniak43|Johan Verbraecken44|Kai Spiegelhalder1CorrespondenceDieter Riemann,Department of ClinicalPsychology and Psychophysiology,Centre forMental Disorders,Medical Centre Universityof Freiburg,Faculty of Medicine,University ofFreiburg,Germany;Hauptstr.5,D-79104Freiburg,Germa
5、ny.Email:dieter.riemannuniklinik-freiburg.deSummaryProgress in the field of insomnia since 2017 necessitated this update of theEuropean Insomnia Guideline.Recommendations for the diagnostic procedure forinsomnia and its comorbidities are:clinical interview(encompassing sleep and medi-cal history);th
6、e use of sleep questionnaires and diaries(and physical examination andadditional measures where indicated)(A).Actigraphy is not recommended for theroutine evaluation of insomnia(C),but may be useful for differential-diagnostic pur-poses(A).Polysomnography should be used to evaluate other sleep disor
7、ders if sus-pected(i.e.periodic limb movement disorder,sleep-related breathing disorders,etc.),treatment-resistant insomnia(A)and for other indications(B).Cognitive-behaviouraltherapy for insomnia is recommended as the first-line treatment for chronic insomniain adults of any age(including patients
8、with comorbidities),either applied in-personor digitally(A).When cognitive-behavioural therapy for insomnia is not sufficientlyFor affiliations refer to page 26Received:16 August 2023Accepted:21 August 2023DOI:10.1111/jsr.14035This is an open access article under the terms of the Creative Commons At
9、tribution License,which permits use,distribution and reproduction in any medium,provided the original work is properly cited.2023 The Authors.Journal of Sleep Research published by John Wiley&Sons Ltd on behalf of European Sleep Research Society.J Sleep Res.2023;32: of 36https:/doi.org/10.1111/jsr.1
10、4035effective,a pharmacological intervention can be offered(A).Benzodiazepines(A),benzodiazepine receptor agonists(A),daridorexant(A)and low-dose sedating antide-pressants(B)can be used for the short-term treatment of insomnia(4 weeks).Longer-term treatment with these substances may be initiated in
11、some cases,consid-ering advantages and disadvantages(B).Orexin receptor antagonists can be used forperiods of up to 3 months or longer in some cases(A).Prolonged-release melatonincan be used for up to 3 months in patients 55 years(B).Antihistaminergic drugs,antipsychotics,fast-release melatonin,rame
12、lteon and phytotherapeutics are notrecommended for insomnia treatment(A).Light therapy and exercise interventionsmay be useful as adjunct therapies to cognitive-behavioural therapy for insomnia(B).KE YWOR DSdiagnosis,evidence-based medicine,guideline,insomnia,treatment1|SUMMARY FOR PATIENTS1.1|What
13、is insomnia?Insomnia is a sleep disorder where people struggle to get off to sleepor to stay asleep.Some individuals have both issues,and others mayalso have early-morning awakenings,where they are unable to getback to sleep after awakening earlier than desired.Importantly,thesenight-time sleep diff
14、iculties are coupled with significant daytime prob-lems that affect the persons ability to function at their best.Daytimefatigue,low mood or irritability,and problems with attention or con-centration are usually experienced.To be diagnosed with an“insom-nia disorder”,these difficulties have to occur
15、 at least several times aweek over a period of 3 months.Insomnia is a very common disorder(up to 10%of the adult population in Europe)and,in addition to agreat deal of personal suffering,it also results in increased costs tohealthcare services and to society at large(e.g.reduced productivityat work)
16、.1.2|How can insomnia be treated?Currently,there are two ways to treat insomnia.According to scien-tific evidence the first,and the most effective,approach is cognitive-behavioural therapy for insomnia(CBT-I).As the name suggests,CBT-I addresses the mental or cognitive aspects of insomnia(e.g.therac
17、ing mind),and the behavioural aspect reestablishes a healthy sleeppattern.CBT-I can be offered as single or group therapy(face-to-faceF2F)or as a digital therapy,where it is delivered as a web-basedintervention or on a treatment-based app.The second approach totreat insomnia is pharmacological(i.e.p
18、ill-based).There is a variety ofsleep medications available,but it is recommended that these are onlytaken for a short period(no longer than 4 weeks)to avoid the bodygetting used to them or becoming dependent upon them.In somecases,after weighing the advantages and disadvantages,some medi-cations ma
19、y be given for longer periods of time.1.3|Who developed this guideline?This European Insomnia Guideline 2023 was developed by a group ofresearchers and clinicians in the European Sleep Research Society(ESRS),and the European Insomnia Network(EIN).1.4|Which treatment is recommended by thisguideline?I
20、t is recommended that all patients with insomnia,whether they haveother medical conditions or mental health problems,or not,are offeredCBT-I as their initial treatment.CBT-I may be delivered by a clinician ortherapist(F2F),or(preferably guided)digitally using a scientifically dem-onstrated web or mo
21、bile treatment platform.If this approach is not suf-ficiently effective,it is recommended that patients and their treatingphysicians should come to a shared decision about whether or not med-ication might be initiated.At present,the evidence suggests that drugtreatments in general should be limited
22、to,at most,4 weeks in duration,and even then with care:tolerance develops within days to weeks.Doseincreases are not advised,and may accelerate the development ofdependence.In some cases,longer treatment periods may be indicated,carefully weighing the advantages and disadvantages.2|GUIDELINE REPORTT
23、his guideline is an update of the European Insomnia Guideline thatwas published in 2017(Riemann,Baum,et al.,2017),and developedby a task force of the ESRS and the EIN.The European InsomniaGuideline was based on the German Insomnia Guideline(Riemann,Baglioni,et al.,2017)and was endorsed by the World
24、Sleep Society(Morin et al.,2021).A revision of the German Insomnia Guideline isunderway(Spiegelhalder et al.,2023).This first update of theEuropean Insomnia Guideline is inspired by and draws upon this revi-sion of the German Insomnia Guideline.2 of 36RIEMANNET AL.This guideline focuses on the targe
25、t population of adult patientssuffering from chronic insomnia as defined by the International Classi-fication of Diseases(ICD-10/ICD-11).This includes all subtypes ofinsomnia,for example,non-organic insomnia/chronic insomnia andinsomnia comorbid with somatic(formerly named“organic”insomnia)or mental
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 欧洲 失眠 指南 诊断 以及 治疗 医治 新版
1、咨信平台为文档C2C交易模式,即用户上传的文档直接被用户下载,收益归上传人(含作者)所有;本站仅是提供信息存储空间和展示预览,仅对用户上传内容的表现方式做保护处理,对上载内容不做任何修改或编辑。所展示的作品文档包括内容和图片全部来源于网络用户和作者上传投稿,我们不确定上传用户享有完全著作权,根据《信息网络传播权保护条例》,如果侵犯了您的版权、权益或隐私,请联系我们,核实后会尽快下架及时删除,并可随时和客服了解处理情况,尊重保护知识产权我们共同努力。
2、文档的总页数、文档格式和文档大小以系统显示为准(内容中显示的页数不一定正确),网站客服只以系统显示的页数、文件格式、文档大小作为仲裁依据,平台无法对文档的真实性、完整性、权威性、准确性、专业性及其观点立场做任何保证或承诺,下载前须认真查看,确认无误后再购买,务必慎重购买;若有违法违纪将进行移交司法处理,若涉侵权平台将进行基本处罚并下架。
3、本站所有内容均由用户上传,付费前请自行鉴别,如您付费,意味着您已接受本站规则且自行承担风险,本站不进行额外附加服务,虚拟产品一经售出概不退款(未进行购买下载可退充值款),文档一经付费(服务费)、不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
4、如你看到网页展示的文档有www.zixin.com.cn水印,是因预览和防盗链等技术需要对页面进行转换压缩成图而已,我们并不对上传的文档进行任何编辑或修改,文档下载后都不会有水印标识(原文档上传前个别存留的除外),下载后原文更清晰;试题试卷类文档,如果标题没有明确说明有答案则都视为没有答案,请知晓;PPT和DOC文档可被视为“模板”,允许上传人保留章节、目录结构的情况下删减部份的内容;PDF文档不管是原文档转换或图片扫描而得,本站不作要求视为允许,下载前自行私信或留言给上传者【老金】。
5、本文档所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用;网站提供的党政主题相关内容(国旗、国徽、党徽--等)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。
6、文档遇到问题,请及时私信或留言给本站上传会员【老金】,需本站解决可联系【 微信客服】、【 QQ客服】,若有其他问题请点击或扫码反馈【 服务填表】;文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“【 版权申诉】”(推荐),意见反馈和侵权处理邮箱:1219186828@qq.com;也可以拔打客服电话:4008-655-100;投诉/维权电话:4009-655-100。