Manifestations and Management of Chronic Insomnia in Adults. Evidence Report/Technology Assessment No. 125

摘要

Researchers at the University of Alberta conducted a systematic review of (1) the prevalence, natural history, incidence, risk factors, and consequences of chronic insomnia in adults and (2) the efficacy and safety of treatments used in the management of chronic insomnia in adults. They found evidence that (1) chronic insomnia is associated with older age, female gender, present or past psychiatric illness and psychological problems, medical conditions and poor general health, increased healthcare utilization, lower quality of life and social relationships, socioeconomic status (marital separation, unemployment, poorer working conditions and lower social status), and decrements in memory, mood, and cognitive function$ (2) benzodiazepines and non-benzodiazepines as well as antidepressants are effective in the management of chronic insomnia, but that they pose a risk of harm$ and (3) melatonin, relaxation therapy, and cognitive/behavioral therapy are effective in the management of chronic insomnia in subsets of the chronic insomnia population, and there is no evidence that melatonin poses a risk of harm. However, more research is required in this area, given that the results are based on a small number of studies.