Treatment strategy for insomnia disorder: Japanese expert consensus

被引：13

作者：

Takaesu, Yoshikazu ^{[1
,2
]}

Sakurai, Hitoshi ^{[2
]}

Aoki, Yumi ^{[2
,3
]}

Takeshima, Masahiro ^{[4
]}

Ie, Kenya ^{[5
,6
]}

Matsui, Kentaro ^{[7
,8
]}

Utsumi, Tomohiro ^{[8
,9
]}

Shimura, Akiyoshi ^{[10
]}

Okajima, Isa ^{[11
]}

Kotorii, Nozomu ^{[12
,13
]}

Yamashita, Hidehisa ^{[14
]}

Suzuki, Masahiro ^{[15
]}

Kuriyama, Kenichi ^{[8
,16
]}

Shimizu, Eiji ^{[17
,18
]}

Mishima, Kazuo ^{[4
]}

Watanabe, Koichiro ^{[2
]}

Inada, Ken ^{[19
]}

机构：

[1] Univ Ryukyus, Grad Sch Med, Dept Neuropsychiat, Nishihara, Okinawa, Japan

[2] Kyorin Univ, Fac Med, Dept Neuropsychiat, Tokyo, Japan

[3] St Lukes Int Univ, Psychiat & Mental Hlth Nursing, Tokyo, Japan

[4] Akita Univ, Dept Neuropsychiat, Grad Sch Med, Akita, Japan

[5] St Marianna Univ, Dept Internal Med, Div Gen Internal Med, Sch Med, Kawasaki, Japan

[6] Kawasaki Municipal Tama Hosp, Dept Internal Med, Div Gen Internal Med, Kawasaki, Japan

[7] Natl Ctr Neurol & Psychiat, Natl Ctr Hosp, Dept Clin Lab, Tokyo, Japan

[8] Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Dept Sleep Wake Disorders, Tokyo, Japan

[9] Jikei Univ, Dept Psychiat, Sch Med, Tokyo, Japan

[10] Tokyo Med Univ, Dept Psychiat, Tokyo, Japan

[11] Tokyo Kasei Univ, Fac Humanities, Dept Psychol Counseling, Tokyo, Japan

[12] Kotorii Isahaya Hosp, Nagasaki, Japan

[13] Kurume Univ, Sch Med, Dept Psychiat, Fukuoka, Japan

[14] Minna No Sleep & Stress Care Clin, Hiroshima, Japan

[15] Nihon Univ, Dept Psychiat, Sch Med, Tokyo, Japan

[16] Natl Ctr Neurol & Psychiat, Natl Ctr Hosp, Dept Psychiat, Tokyo, Japan

[17] Chiba Univ, Res Ctr Child Mental Dev, Chiba, Japan

[18] Chiba Univ, Grad Sch Med, Dept Cognit Behav Physiol, Chiba, Japan

[19] Kitasato Univ, Sch Med, Dept Psychiat, Tokyo, Japan

来源：

FRONTIERS IN PSYCHIATRY | 2023年 / 14卷

关键词：

insomnia; hypnotics; cognitive behavioral therapy; sleep hygiene education (SHE); orexin receptor antagonists; benzodiazepine; CLINICAL-PRACTICE GUIDELINE; AMERICAN ACADEMY; ADULTS; BENZODIAZEPINE; SUVOREXANT; SAFETY;

D O I：

10.3389/fpsyt.2023.1168100

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

PurposeThere 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. MethodsExperts 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. ResultsThe 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. ConclusionExpert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder.

引用

页数：9

共 21 条

[21] Long-term effectiveness and safety of lemborexant in adults with insomnia disorder: results from a phase 3 randomized clinical trial
Yardley, Jane
Karppa, Mikko
Inoue, Yuichi
Pinner, Kate
Perdomo, Carlos
Ishikawa, Kohei
Filippov, Gleb
Kubota, Naoki
Moline, Margaret
[J]. SLEEP MEDICINE, 2021, 80 : 333 - 342

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