2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults – Brazilian Sleep Association

Author:

Drager Luciano Ferreira12ORCID,Assis Márcia13ORCID,Bacelar Andrea Frota Rego14ORCID,Poyares Dalva Lucia Rollemberg56ORCID,Conway Silvia Gonçalves789ORCID,Pires Gabriel Natan56ORCID,de Azevedo Alexandre Pinto7ORCID,Carissimi Alicia1011ORCID,Eckeli Allan Luiz12ORCID,Pentagna Álvaro13ORCID,Almeida Carlos Maurício Oliveira14ORCID,Franco Clélia Maria Ribeiro15ORCID,Sobreira Emmanuelle Silva Tavares91617ORCID,Stelzer Fernando Gustavo12ORCID,Mendes Giuliana Macedo18ORCID,Minhoto Gisele Richter19ORCID,Linares Ila Marques Porto720ORCID,Sousa Ksdy Maiara Moura521ORCID,Gitaí Livia Leite Góes22ORCID,Sukys-Claudino Lucia23ORCID,Sobreira-Neto Manoel Alves16ORCID,Zanini Marcio Andrei24ORCID,Margis Regina25ORCID,Martinez Sandra Cristina Gonçalves26ORCID

Affiliation:

1. Associação Brasileira do Sono, São Paulo, SP, Brazil.

2. Unidades de HipertenSão, Instituto do Coração (InCor) e Disciplina de Nefrologia, Universidade de São Paulo, São Paulo, SP, Brazil.

3. Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.

4. Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.

5. Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.

6. Instituto do Sono, São Paulo, SP, Brazil.

7. Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.

8. Departamento de Otoneurologia, Universidade de São Paulo, São Paulo, SP, Brazil.

9. AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.

10. Faculdade Dom Bosco, Porto Alegre, RS, Brazil.

11. Cronosul Clínica de Psicologia do Sono, Psicoterapia e Neuropsicologia, Porto Alegre, RS, Brazil.

12. Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

13. Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

14. Departamento de Neurologia, Universidade Estadual do Amazonas, UEA, Brazil.

15. Hospital Universitário Oswaldo Cruz (HUOC), Universidade Federal de Pernambuco, Recife, PE, Brazil.

16. Universidade Federal do Ceará, Fortaleza, CE, Brazil.

17. Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.

18. Instituto de Especialidades e Sono, Goiânia, GO, Brazil.

19. Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil.

20. Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

21. SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.

22. Faculdade de Medicina, Universidade Federal de Alagoas, AL, Brazil.

23. Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.

24. Instituto de Assistência Médica ao Servidor Público Estadual (IAMPSE), São Paulo, SP, Brazil.

25. Private clinic, Porto Alegre, RS, Brazil.

26. Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.

Abstract

AbstractChronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P – Patient, problem, or population; I – Intervention; C – Comparison, control, or comparator; O – Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.

Publisher

Georg Thieme Verlag KG

Subject

Behavioral Neuroscience,Medicine (miscellaneous),Neuroscience (miscellaneous)

Reference265 articles.

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