PDF(Pubmed)
Abstract：
UNASSIGNED: There is a lack of evidence regarding answers for clinical questions about treating insomnia disorder. This study aimed to answer the following clinical questions: (1) how to use each hypnotic and non-pharmacological treatment differently depending on clinical situations and (2) how to reduce or stop benzodiazepine hypnotics using alternative pharmacological and non-pharmacological treatments.
UNASSIGNED: Experts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1 = \"disagree\" to 9 = \"agree\"). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations.
UNASSIGNED: The primary pharmacological treatment, lemborexant (7.3 ± 2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3 ± 1.8) and suvorexant (6.8 ± 1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4 ± 1.1) and maintenance insomnia (8.1 ± 1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6 ± 2.3) and maintenance insomnia (5.7 ± 2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5 ± 1.8) and suvorexant (6.9 ± 1.9) were categorized as first-line recommendations.
UNASSIGNED: Expert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.
UNASSIGNED: Experts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1 = \"disagree\" to 9 = \"agree\"). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations.
UNASSIGNED: The primary pharmacological treatment, lemborexant (7.3 ± 2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3 ± 1.8) and suvorexant (6.8 ± 1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4 ± 1.1) and maintenance insomnia (8.1 ± 1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6 ± 2.3) and maintenance insomnia (5.7 ± 2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5 ± 1.8) and suvorexant (6.9 ± 1.9) were categorized as first-line recommendations.
UNASSIGNED: Expert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.
摘要：
■缺乏关于治疗失眠障碍的临床问题的答案的证据。本研究旨在回答以下临床问题：（1）如何根据临床情况不同地使用每种催眠和非药物治疗；（2）如何使用替代的药物和非药物治疗来减少或停止苯二氮卓催眠药。
■专家们被要求根据10个关于失眠障碍的临床问题，使用9分李克特量表（1=“不同意”至9=“同意”）评估治疗选择。收集了196位专家的答复，答案被归类为第一-，第二-，和第三线建议。
■主要的药物治疗，lemborexant(7.3±2.0),被归类为睡眠启动失眠的一线建议，将lemborexant（7.3±1.8）和suvorexant（6.8±1.8）归类为睡眠维持性失眠的一线建议。关于初级治疗的非药物治疗，睡眠卫生教育被列为睡眠开始（8.4±1.1）和维持失眠（8.1±1.5）的一线建议，而失眠的多成分认知行为疗法被归类为睡眠开始（5.6±2.3）和维持失眠（5.7±2.4）的二线治疗。当通过改用其他药物减少或停用苯二氮卓催眠药时，lemborexant（7.5±1.8）和suvorexant（6.9±1.9）被归类为一线建议。
■专家共识表明，在大多数临床情况下，推荐食欲素受体拮抗剂和睡眠卫生教育作为治疗失眠障碍的一线治疗方法。
■专家们被要求根据10个关于失眠障碍的临床问题，使用9分李克特量表（1=“不同意”至9=“同意”）评估治疗选择。收集了196位专家的答复，答案被归类为第一-，第二-，和第三线建议。
■主要的药物治疗，lemborexant(7.3±2.0),被归类为睡眠启动失眠的一线建议，将lemborexant（7.3±1.8）和suvorexant（6.8±1.8）归类为睡眠维持性失眠的一线建议。关于初级治疗的非药物治疗，睡眠卫生教育被列为睡眠开始（8.4±1.1）和维持失眠（8.1±1.5）的一线建议，而失眠的多成分认知行为疗法被归类为睡眠开始（5.6±2.3）和维持失眠（5.7±2.4）的二线治疗。当通过改用其他药物减少或停用苯二氮卓催眠药时，lemborexant（7.5±1.8）和suvorexant（6.9±1.9）被归类为一线建议。
■专家共识表明，在大多数临床情况下，推荐食欲素受体拮抗剂和睡眠卫生教育作为治疗失眠障碍的一线治疗方法。
