This is the current release of the guideline.

Chronic insomnia is a major public health problem affecting millions of individuals, along with their families and communities. Little is known about the mechanisms, causes, clinical course, comorbidities, and consequences of chronic insomnia. Evidence supports the efficacy of cognitive-behavioral therapy and benzodiazepine receptor agonists in the treatment of this disorder, at least in the short term. Very little evidence supports the efficacy of other treatments, despite their widespread use. Moreover, even for those treatments that have been systematically evaluated, the panel is concerned about the mismatch between the potential lifelong nature of this illness and the longest clinical trials, which have lasted 1 year or less. A substantial public and private research effort is warranted, including developing research tools and conducting longitudinal studies of randomized clinical trials. Finally, there is a major need for educational programs directed at physicians, health care providers, and the public.

Diagnosis

Diagnosis is based primarily on patient-derived and family or caregiver complaints, as determined by the clinical interview. However, there has been little research to show how accurately persons reporting sleep problems can judge their own sleep latency or periods of wakefulness during the night. Medical history and physical examination are useful in establishing the presence of comorbid syndromes.

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Not applicable: The guideline was not adapted from another source.

2005 Jun

National Institutes of Health (NIH) State-of-the-Science Panel - Independent Expert Panel

United States Government

National Institutes of Health (NIH) State-of-the-Science Panel

Panel Members: Alan I. Leshner, PhD, Conference and Panel Chairperson, Chief Executive Officer, American Association for the Advancement of Science, Executive Publisher, Science, Washington, DC; Helen A. Baghdoyan, PhD, Professor, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan; Susan J. Bennett, DNS, RN, Professor, Indiana University, School of Nursing, Indianapolis, Indiana; Sean M. Caples, DO, Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota; Robert J. DeRubeis, PhD, Professor and Chair, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania; Robert J. Glynn, PhD, ScD, Associate Professor of Medicine (Biostatistics), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Robert M. Kaplan, PhD, Professor and Chair, Department of Health Services, University of California, Los Angeles, School of Public Health, Los Angeles, California; James N. Kvale, MD, Professor, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Charles Poole, ScD, MPH, Associate Professor, Department of Epidemiology, University of North Carolina. School of Public Health, Chapel Hill, North Carolina; Lee N. Robins, PhD, Emeritus Professor of Social Science in Psychiatry, Department of Psychiatry, Emeritus University Professor of Social Science, Washington University School of Medicine, St. Louis, Missouri; Catherine M. Waters, PhD, RN, Associate Professor, Department of Community Health Systems, University of California, San Francisco School of Nursing, San Francisco, California; Charles F. Zorumski, MD, Samuel B. Guze Professor of Psychiatry, Head, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri

All of the panelists who participated in this conference and contributed to the writing of this statement were identified as having no financial or scientific conflict of interest, and all signed forms attesting to this fact. Unlike the expert speakers who present scientific data at the conference, the individuals invited to participate on National Institutes of Health (NIH) Consensus and State-of-the-Science panels are reviewed prior to selection to assure that they are not proponents of an advocacy position with regard to the topic and are not identified with research that could be used to answer the conference questions.

This is the current release of the guideline.

None available

This NGC summary was completed by ECRI Institute on June 24, 2008.

No copyright restrictions apply.