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Review
. 2023 Nov 22;16(Suppl 2):507-549.
doi: 10.1055/s-0043-1776281. eCollection 2023 Oct.

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

Luciano Ferreira Drager  1   2 , Márcia Assis  1   3 , Andrea Frota Rego Bacelar  1   4 , Dalva Lucia Rollemberg Poyares  5   6 , Silvia Gonçalves Conway  7   8   9 , Gabriel Natan Pires  5   6 , Alexandre Pinto de Azevedo  7 , Alicia Carissimi  10   11 , Allan Luiz Eckeli  12 , Álvaro Pentagna  13 , Carlos Maurício Oliveira Almeida  14 , Clélia Maria Ribeiro Franco  15 , Emmanuelle Silva Tavares Sobreira  9   16   17 , Fernando Gustavo Stelzer  12 , Giuliana Macedo Mendes  18 , Gisele Richter Minhoto  19 , Ila Marques Porto Linares  7   20 , Ksdy Maiara Moura Sousa  5   21 , Livia Leite Góes Gitaí  22 , Lucia Sukys-Claudino  23 , Manoel Alves Sobreira-Neto  16 , Marcio Andrei Zanini  24 , Regina Margis  25 , Sandra Cristina Gonçalves Martinez  26
Affiliations
Review

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

Luciano Ferreira Drager et al. Sleep Sci. .

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.

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Conflict of interest statement

Conflict of interest Luciano F. Drager Lectures: Biolab, EMS, Eurofarma, ResMed, and Takeda. Educational material: EMS and Eurofarma. Scientific consultancy: ResMed. Participation in scientific study: ResMed (real-world studies). Marcia Assis Educational material: EMS, Eurofarma, Mantecorp, Takeda, and Apsen. Andrea Bacelar Lectures: Eurofarma, Sanofi-Medley, EMS, Apsen, Aché, Resmed, Sandoz, Biolab, Torrent, Momenta. Dalva Poyares Lectures: Takeda, Teva, Libbs, Eurofarma, and Resmed. Scientific consultancy: Biolab. Participation in scientific study: Aché (lead researcher). Silvia Conway No conflict of interest. Gabriel Natan Pires Partner at SleepUp. Alexandre Azevedo Lectures: Eurofarma. Educational material: Eurofarma, Momenta, Abbot. Alicia Carissimi No conflict of interest. Allan Eckeli Lectures: Apsen and Eurofarma. Álvaro Pentagna No conflict of interest. Carlos Maurício Almeida Lectures: Libbs, EMS, and Tegra Pharma. Clélia Franco Lectures: Teva. Emmanuelle Silva Tavares Sobreira No conflict of interest. Fernando Stelzer No conflict of interest. Giuliana Macedo No conflict of interest. Gisele Minhoto Lectures: Eurofarma, Takeda, Genon, Hypera, Mantecorp. Educational material: Apsen, Biolab, Eurofarma, Takeda. Sponsorship to participate in conferences: Lundbeck. Ila Linhares No conflict of interest. Ksdy Sousa No conflict of interest. Livia Gitai No conflict of interest. Lucia Sukys-Claudino No conflict of interest. Manoel Sobreira No conflict of interest. Marcio Zanini Lectures: Lundbeck. Educational material: Lundbeck and Supera Advisory board: SleepUp. Regina Margis Lectures: Apsen, Sanofi, and Eurofarma. Sandra Martinez No conflict of interest.

Figures

Fig. 1
Fig. 1
Physiopathological model of insomnia (adapted from Bollu and Kaur and Riemann and colleagues 5 ).
Fig. 2
Fig. 2
Flowchart of study inclusion.
Fig. 3
Fig. 3
Differential diagnosis of insomnia (adapted from Ferré-Maso and colleagues 39 ).
See this image and copyright information in PMC

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