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

Luciano Ferreira Drager; Márcia Assis; Andrea Frota Rego Bacelar; Dalva Lucia Rollemberg Poyares; Silvia Gonçalves Conway; Gabriel Natan Pires; Alexandre Pinto de Azevedo; Alicia Carissimi; Allan Luiz Eckeli; Álvaro Pentagna; Carlos Maurício Oliveira Almeida; Clélia Maria Ribeiro Franco; Emmanuelle Silva Tavares Sobreira; Fernando Gustavo Stelzer; Giuliana Macedo Mendes; Gisele Richter Minhoto; Ila Marques Porto Linares; Ksdy Maiara Moura Sousa; Livia Leite Góes Gitaí; Lucia Sukys-Claudino; Manoel Alves Sobreira-Neto; Marcio Andrei Zanini; Regina Margis; Sandra Cristina Gonçalves Martinez

doi:10.1055/s-0043-1776281

Sleep Science, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(S 02): 507-549
DOI: 10.1055/s-0043-1776281

Review Article

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

Autoren

Luciano Ferreira Drager

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

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

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

³Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.
Andrea Frota Rego Bacelar

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

⁴Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.
Dalva Lucia Rollemberg Poyares

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

⁶Instituto do Sono, São Paulo, SP, Brazil.
Silvia Gonçalves Conway

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

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

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

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

⁶Instituto do Sono, São Paulo, SP, Brazil.
Alexandre Pinto de Azevedo

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

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

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

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

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

¹⁴Departamento de Neurologia, Universidade Estadual do Amazonas, UEA, Brazil.
Clélia Maria Ribeiro Franco

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

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

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

¹⁷Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.
Fernando Gustavo Stelzer

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

¹⁸Instituto de Especialidades e Sono, Goiânia, GO, Brazil.
Gisele Richter Minhoto

¹⁹Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil.
Ila Marques Porto Linares

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

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

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

²¹SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.
Livia Leite Góes Gitaí

²²Faculdade de Medicina, Universidade Federal de Alagoas, AL, Brazil.
Lucia Sukys-Claudino

²³Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
Manoel Alves Sobreira-Neto

¹⁶Universidade Federal do Ceará, Fortaleza, CE, Brazil.
Marcio Andrei Zanini

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

²⁵Private clinic, Porto Alegre, RS, Brazil.
Sandra Cristina Gonçalves Martinez

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

Abstract

Chronic 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.

Keywords

adults - diagnosis - insomnia - treatment

Volltext

Referenzen

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