Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline
Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline
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DOI：
10.5664/jcsm.8986
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发表时间：
2021-02-01
影响因子：
4.3
通讯作者：
Martin, Jennifer L.
中科院分区：
文献类型：
--
作者：
Edinger, Jack D.;Arnedt, J. Todd;Martin, Jennifer L.
导言：本指南为成人慢性失眠障碍的行为和心理治疗建立了临床实践建议。方法：美国睡眠医学学会(AASM)委托一个由睡眠医学和睡眠心理学专家组成的特别工作组，根据对文献的系统审查和使用建议评估、发展和评估(GRADE)方法的证据评估来制定建议并分配优势。工作组评估了相关文献的摘要和证据的质量，临床相关益处和危害的平衡，患者的价值和偏好，以及支持建议的资源使用考虑。AASM董事会批准了最终的建议。建议：以下建议旨在指导临床医生选择特定的行为和心理疗法治疗成人慢性失眠障碍。每个建议陈述都有一个强度(“强”或“有条件”)。“强烈”推荐(即，“我们推荐……”)是临床医生在大多数情况下都应该遵循的。“有条件的”建议要求临床医生使用临床知识和经验，并充分考虑患者的价值观和偏好，以确定最佳的治疗方案。我们建议临床医生使用多成分认知行为疗法治疗失眠，以治疗成人慢性失眠障碍。我们建议临床医生在成人慢性失眠障碍的治疗中使用多组分的短期失眠疗法。(有条件的)3.我们建议临床医生将刺激控制作为治疗成人慢性失眠障碍的单一成分疗法。(有条件的)4.我们建议临床医生将睡眠限制疗法作为治疗成人慢性失眠障碍的单一成分疗法。(有条件的)5.我们建议临床医生将放松疗法作为治疗成人慢性失眠障碍的单一成分疗法。(有条件的)6.我们建议临床医生不要将睡眠卫生作为治疗成人慢性失眠障碍的单一成分疗法。(有条件的)
Introduction: This guideline establishes clinical practice recommendations for the use of behavioral and psychological treatments for chronic insomnia disorder in adults.Methods: The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine and sleep psychology to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The task force evaluated a summary of the relevant literature and the quality of evidence, the balance of clinically relevant benefits and harms, patient values and preferences, and resource use considerations that underpin the recommendations. The AASM Board of Directors approved the final recommendations.Recommendations: The following recommendations are intended as a guide for clinicians in choosing a specific behavioral and psychological therapy for the treatment of chronic insomnia disorder in adult patients. Each recommendation statement is assigned a strength ("strong" or "conditional"). A "strong" recommendation (ie, "We recommend...") is one that clinicians should follow under most circumstances. A "conditional" recommendation is one that requires that the clinician use clinical knowledge and experience, and to strongly consider the patient's values and preferences to determine the best course of action.1. We recommend that clinicians use multicomponent cognitive behavioral therapy for insomnia for the treatment of chronic insomnia disorder in adults. (STRONG)2. We suggest that clinicians use multicomponent brief therapies for insomnia for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)3. We suggest that clinicians use stimulus control as a single-component therapy for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)4. We suggest that clinicians use sleep restriction therapy as a single-component therapy for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)5. We suggest that clinicians use relaxation therapy as a single-component therapy for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)6. We suggest that clinicians not use sleep hygiene as a single-component therapy for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)