Recent Advances in Diagnosis and Treatment of Insomnia Disorder

Seog Ju Kim

doi:10.4306/jknpa.2020.59.1.2

Journal List > J Korean Neuropsychiatr Assoc > v.59(1) > 1143424

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim: Recent Advances in Diagnosis and Treatment of Insomnia Disorder

Special Article

J Korean Neuropsychiatr Assoc 2020;59(1):2-12.

Published online: 17 January 2020

DOI: https://doi.org/10.4306/jknpa.2020.59.1.2

Recent Advances in Diagnosis and Treatment of Insomnia Disorder

Seog Ju Kim, MD, PhD

Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea

Address for correspondence Seog Ju Kim, MD, PhD Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel +82-2-3410-3583 Fax +82-2-3410-0050 E-mail ksj7126@skku.edu

Revised 21 January 202029 January 2020 Accepted 29 January 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The diagnostic concepts of insomnia are controversial. New diagnostic criteria of insomnia disorder have been published in the International Classification of Sleep Disorders (ICSD-3) and the Diagnostic and Statistical Manual of Mental Disorder (DSM-5). Both the ICSD-3 and DSM-5 did not accept the concept of secondary and primary insomnia. According to the ICSD-3 and DSM-5, insomnia disorder can be diagnosed, even with a comorbid mental or sleep disorder. The medical, psychiatric, and sleep history are essential for the diagnosis of insomnia disorder. Polysomnography can be helpful for differential diagnoses or the clinical subtyping of insomnia disorder. Recently, the European and American Sleep Society published clinical guidelines for the treatment of insomnia. Both guidelines strongly recommended non-pharmacological treatment (e.g., cognitive behavioral disorder for insomnia) as a treatment of choice for insomnia. Pharmacological treatments for insomnia are weakly recommended only for a short time. New non-pharmacological and pharmacological treatments for insomnia disorder are being developed and studied. J Korean Neuropsychiatr Assoc 2020;59(1):2-12

Keywords: Insomnia, Diagnosis, Treatment

REFERENCES

1). American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed.Darien, IL: American Academy of Sleep Medicine;2014.

2). American Psychiatry Association. Diagnostic and statistical manual of mental disorders, 5th edition: DSM-5. Arlington, VA: American Psychaitry Association;2013.

3). Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017; 13:307–349.

4). Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017; 26:675–700.

5). American Academy of Sleep Medicine. International classification of sleep disorders, revised: diagnostic and coding manual. Chicago, IL: American Academy of Sleep Medicine;2001.

6). Castelnovo A, Ferri R, Punjabi NM, Castronovo V, Garbazza C, Zucconi M, et al. The paradox of paradoxical insomnia: a theoretical review towards a unifying evidence-based definition. Sleep Med Rev. 2019; 44:70–82.

7). Krystal AD, Edinger JD, Wohlgemuth WK, Marsh GR. NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes. Sleep. 2002; 25:630–640.

8). Rezaie L, Fobian AD, McCall WV, Khazaie H. Paradoxical insomnia and subjective-objective sleep discrepancy: a review. Sleep Med Rev. 2018; 40:196–202.

9). Vgontzas AN, Fernandez-Mendoza J, Liao D, Bixler EO. Insomnia with objective short sleep duration: the most biologically severe phenotype of the disorder. Sleep Med Rev. 2013; 17:241–254.

10). Fernandez-Mendoza J. The insomnia with short sleep duration phenotype: an update on it's importance for health and prevention. Curr Opin Psychiatry. 2017; 30:56–63.

11). Benjamins JS, Migliorati F, Dekker K, Wassing R, Moens S, Blank-en TF, et al. Insomnia heterogeneity: characteristics to consider for data-driven multivariate subtyping. Sleep Med Rev. 2017; 36:71–81.

12). Galbiati A, Sforza M, Fasiello E, Castronovo V, Ferini-Strambi L. Impact of phenotypic heterogeneity of insomnia on the patients' response to Cognitive-Behavioral Therapy for Insomnia: current perspectives. Nat Sci Sleep. 2019; 11:367–376.

13). Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008; 4:487–504.

14). Benca RM, Buysse DJ. Reconsidering insomnia as a disorder rather than just a symptom in psychiatric practice. J Clin Psychiatry. 2018; 79:me17008ah1c.

15). Currie SR, Clark S, Rimac S, Malhotra S. Comprehensive assessment of insomnia in recovering alcoholics using daily sleep diaries and ambulatory monitoring. Alcohol Clin Exp Res. 2003; 27:1262–1269.

16). Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An american academy of sleep medicine report. Sleep. 2006; 29:1415–1419.

17). Cheung JMY, Ji XW, Morin CM. Cognitive behavioral therapies for insomnia and hypnotic medications: considerations and controversies. Sleep Med Clin. 2019; 14:253–265.

18). Edinger JD, Wohlgemuth WK, Radtke RA, Marsh GR, Quillian RE. Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA. 2001; 285:1856–1864.

19). Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA. 1999; 281:991–999.

20). Bjorvatn B, Waage S, Pallesen S. The association between insomnia and bedroom habits and bedroom characteristics: an exploratory cross-sectional study of a representative sample of adults. Sleep Health. 2018; 4:188–193.

21). van der Zweerde T, Bisdounis L, Kyle SD, Lancee J, van Straten A. Cognitive behavioral therapy for insomnia: a metaanalysis of longterm effects in controlled studies. Sleep Med Rev. 2019; 48:101208.

22). Thakral M, Von Korff M, McCurry SM, Morin CM, Vitiello MV. Changes in dysfunctional beliefs about sleep after cognitive behavioral therapy for insomnia: a systematic literature review and metaanalysis. Sleep Med Rev. 2019; 49:101230.

23). Boland E, Goldschmied J, Kayser MS, Gehrman PR. Precision medicine for insomnia. Sleep Med Clin. 2019; 14:291–299.

24). Drerup ML, Ahmed-Jauregui S. Online delivery of cognitive behavioral therapy-insomnia: considerations and controversies. Sleep Med Clin. 2019; 14:283–290.

25). Buenaver LF, Townsend D, Ong JC. Delivering cognitive behavioral therapy for insomnia in the real world: considerations and controversies. Sleep Med Clin. 2019; 14:275–281.

26). Arnedt JT, Cuddihy L, Swanson LM, Pickett S, Aikens J, Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. Sleep. 2013; 36:353–362.

27). Ritterband LM, Thorndike FP, Ingersoll KS, Lord HR, Gonder-Frederick L, Frederick C, et al. Effect of a web-based cognitive behavior therapy for insomnia intervention with 1-year followup: a randomized clinical trial. JAMA Psychiatry. 2017; 74:68–75.

28). Luik AI, van der Zweerde T, van Straten A, Lancee J. Digital delivery of cognitive behavioral therapy for insomnia. Curr Psychiatry Rep. 2019; 21:50.

29). Seyffert M, Lagisetty P, Landgraf J, Chopra V, Pfeiffer PN, Conte ML, et al. Internet-delivered cognitive behavioral therapy to treat insomnia: a systematic review and metaanalysis. PLoS One. 2016; 11:e0149139.

30). Salvemini A, D'Onofrio G, Ciccone F, Greco A, Tullio A, Addante F, et al. Insomnia and information and communication technologies (ICT) in elderly people: a systematic review. Med Sci (Basel). 2019; 7:70.

31). Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011; 171:887–895.

32). Gunn HE, Tutek J, Buysse DJ. Brief behavioral treatment of insomnia. Sleep Med Clin. 2019; 14:235–243.

33). Troxel WM, Conrad TS, Germain A, Buysse DJ. Predictors of treatment response to brief behavioral treatment of insomnia (BBTI) in older adults. J Clin Sleep Med. 2013; 9:1281–1289.

34). Ellis JG. Cognitive behavioral therapy for insomnia and acute insomnia: considerations and controversies. Sleep Med Clin. 2019; 14:267–274.

35). Lack L, Scott H, Lovato N. Intensive sleep retraining treatment of insomnia. Sleep Med Clin. 2019; 14:245–252.

36). Rash JA, Kavanagh VAJ, Garland SN. A metaanalysis of mindfulness-based therapies for insomnia and sleep disturbance: moving towards processes of change. Sleep Med Clin. 2019; 14:209–233.

37). Melo DLM, Carvalho LBC, Prado LBF, Prado GF. Biofeedback therapies for chronic insomnia: a systematic review. Appl Psychophysiol Biofeedback. 2019; 44:259–269.

38). Schabus M, Griessenberger H, Gnjezda MT, Heib DPJ, Wislowska M, Hoedlmoser K. Better than sham? A double-blind placebo-controlled neurofeedback study in primary insomnia. Brain. 2017; 140:1041–1052.

39). Huang Z, Li Y, Bianchi MT, Zhan S, Jiang F, Li N, et al. Repetitive transcranial magnetic stimulation of the right parietal cortex for comorbid generalized anxiety disorder and insomnia: a randomized, double-blind, sham-controlled pilot study. Brain Stimul. 2018; 11:1103–1109.

40). Jiang CG, Zhang T, Yue FG, Yi ML, Gao D. Efficacy of repetitive transcranial magnetic stimulation in the treatment of patients with chronic primary insomnia. Cell Biochem Biophys. 2013; 67:169–173.

41). Wilt TJ, MacDonald R, Brasure M, Olson CM, Carlyle M, Fuchs E, et al. Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians. Ann Intern Med. 2016; 165:103–112.

42). Gerlach LB, Wiechers IR, Maust DT. Prescription benzodiazepine use among older adults: a critical review. Harv Rev Psychiatry. 2018; 26:264–273.

43). Wong CK, Marshall NS, Grunstein RR, Ho SS, Fois RA, Hibbs DE, et al. Spontaneous adverse event reports associated with zolpidem in the United States 2003-2012. J Clin Sleep Med. 2017; 13:223–234.

44). Lee J, Jung SJ, Choi JW, Shin A, Lee YJ. Use of sedative-hypnotics and the risk of Alzheimer's dementia: a retrospective cohort study. PLoS One. 2018; 13:e0204413.

45). Pillai V, Roth T, Roehrs T, Moss K, Peterson EL, Drake CL. Effectiveness of benzodiazepine receptor agonists in the treatment of insomnia: an examination of response and remission rates. Sleep. 2017; 40.

46). By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 Updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015; 63:2227–2246.

47). Hintze JP, Edinger JD. Hypnotic discontinuation in chronic insomnia. Sleep Med Clin. 2018; 13:263–270.

48). Beaulieu-Bonneau S, Ivers H, Guay B, Morin CM. Longterm maintenance of therapeutic gains associated with cognitive-behavioral therapy for insomnia delivered alone or combined with zolpidem. Sleep. 2017; 40:zsx002.

49). Winkler A, Rief W. Effect of placebo conditions on polysomnographic parameters in primary insomnia: a metaanalysis. Sleep. 2015; 38:925–931.

50). Takaesu Y, Utsumi T, Okajima I, Shimura A, Kotorii N, Kuriyama K, et al. Psychosocial intervention for discontinuing benzodiazepine hypnotics in patients with chronic insomnia: a systematic review and metaanalysis. Sleep Med Rev. 2019; 48:101214.

51). Auld F, Maschauer EL, Morrison I, Skene DJ, Riha RL. Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders. Sleep Med Rev. 2017; 34:10–22.

52). Wade A, Downie S. Prolonged-release melatonin for the treatment of insomnia in patients over 55 years. Expert Opin Investig Drugs. 2008; 17:1567–1572.

53). Riha RL. The use and misuse of exogenous melatonin in the treatment of sleep disorders. Curr Opin Pulm Med. 2018; 24:543–548.

54). Sys J, Van Cleynenbreugel S, Deschodt M, Van der Linden L, Tourn-oy J. Efficacy and safety of non-benzodiazepine and non-Z-drug hypnotic medication for insomnia in older people: a systematic literature review. Eur J Clin Pharmacol. 2019.

55). Frase L, Nissen C, Riemann D, Spiegelhalder K. Making sleep easier: pharmacological interventions for insomnia. Expert Opin Phar-macother. 2018; 19:1465–1473.

56). Everitt H, Baldwin DS, Stuart B, Lipinska G, Mayers A, Malizia AL, et al. Antidepressants for insomnia in adults. Cochrane Database Syst Rev. 2018; 5:CD010753.

57). Karsten J, Hagenauw LA, Kamphuis J, Lancel M. Low doses of mirtazapine or quetiapine for transient insomnia: a randomised, double-blind, cross-over, placebo-controlled trial. J Psychopharmacol. 2017; 31:327–337.

58). Ruwe F, IJzerman-Boon P, Roth T, Zammit G, Ivgy-May N. A phase 2 randomized dose-finding study with esmirtazapine in patients with primary insomnia. J Clin Psychopharmacol. 2016; 36:457–464.

59). Srinivasan V, Brzezinski A, Pandi-Perumal SR, Spence DW, Cardinali DP, Brown GM. Melatonin agonists in primary insomnia and depression-associated insomnia: are they superior to sedative-hypnotics? Prog Neuropsychopharmacol Biol Psychiatry. 2011; 35:913–923.

60). Yi XY, Ni SF, Ghadami MR, Meng HQ, Chen MY, Kuang L, et al. Trazodone for the treatment of insomnia: a metaanalysis of randomized placebo-controlled trials. Sleep Med. 2018; 45:25–32.

61). Merenstein D, Diener-West M, Halbower AC, Krist A, Rubin HR. The trial of infant response to diphenhydramine: the TIRED study–a randomized, controlled, patient-oriented trial. Arch Pediatr Adolesc Med. 2006; 160:707–712.

62). Hoyer D, Allen A, Jacobson LH. Hypnotics with novel modes of action. Br J Clin Pharmacol. 2019.

63). Raglan GB, Swanson LM, Arnedt JT. Cognitive behavioral therapy for insomnia in patients with medical and psychiatric comorbidities. Sleep Med Clin. 2019; 14:167–175.

64). Gebara MA, Siripong N, DiNapoli EA, Maree RD, Germain A, Reynolds CF, et al. Effect of insomnia treatments on depression: a systematic review and metaanalysis. Depress Anxiety. 2018; 35:717–731.

65). Asarnow LD, Manber R. Cognitive behavioral therapy for insomnia in depression. Sleep Med Clin. 2019; 14:177–184.

66). Blom K, Jernelöv S, Rück C, Lindefors N, Kaldo V. Three-year followup comparing cognitive behavioral therapy for depression to cognitive behavioral therapy for insomnia, for patients with both diagnoses. Sleep. 2017; 40:zsx108.

67). Fava M, McCall WV, Krystal A, Wessel T, Rubens R, Caron J, et al. Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder. Biol Psychiatry. 2006; 59:1052–1060.

68). Colvonen PJ, Straus LD, Stepnowsky C, McCarthy MJ, Goldstein LA, Norman SB. Recent advancements in treating sleep disorders in co-occurring PTSD. Curr Psychiatry Rep. 2018; 20:48.

69). Akinnusi M, El Solh AA. Drug treatment strategies for insomnia in patients with posttraumatic stress disorder. Expert Opin Pharmaco-ther. 2019; 20:691–699.

70). Kaplan KA, Harvey AG. Behavioral treatment of insomnia in bipolar disorder. Am J Psychiatry. 2013; 170:716–720.

71). Glidewell RN, McPherson Botts E, Orr WC. Insomnia and anxiety: diagnostic and management implications of complex interactions. Sleep Med Clin. 2015; 10:93–99.

72). Uhde TW, Cortese BM, Vedeniapin A. Anxiety and sleep problems: emerging concepts and theoretical treatment implications. Curr Psychiatry Rep. 2009; 11:269–276.

73). Al-Jawder SE, Bahammam AS. Comorbid insomnia in sleep-related breathing disorders: an under-recognized association. Sleep Breath. 2012; 16:295–304.

74). Sweetman A, Lack L, Catcheside PG, Antic NA, Smith S, Chai-Coetzer CL, et al. Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sleep. 2019; 42:zsz178.

75). Gupta R, Zalai D, Spence DW, BaHammam AS, Ramasubramanian C, Monti JM, et al. When insomnia is not just insomnia: the deeper correlates of disturbed sleep with reference to DSM-5. Asian J Psychiatr. 2014; 12:23–30.

76). Miller MA, Mehta N, Clark-Bilodeau C, Bourjeily G. Sleep pharmacotherapy for common sleep disorders in pregnancy and lactation. Chest. 2020; 157:184–197.

TOOLS

Similar articles