Therefore, instead of selecting a single guideline, the Working Committee decided to develop the Korean clinical guideline based on the three guidelines that reflects the various opinions of different countries.Įpworth Sleepiness Scale (ESS) is used to assess self-rated average sleepiness over usual way of life in recent times (0-24 normal <10). Recommendations for CBT-I, a non-pharmacological treatment for insomnia, were given by the ACP Treatment Guideline (2016) for the overall diagnosis and treatment of insomnia by the ESRS Treatment Guidelines (2017) and for each drug based on a detailed level of evidences by the AASM Treatment Guideline (2017). It was found that each of the three guidelines had their own characteristics that complemented each other. The AGREE II tool is composed of 23 detailed evaluation items in 6 evaluation areas, and each item is rated on a 7-point Likert scale. The three selected guidelines were evaluated by four independent raters on several aspects using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool, including quality, rigor of development, content, and applicability. The AASM, ESRS, and the American College of Physicians (ACP) guidelines were considered to be most relevant. The search results were reviewed at a meeting of the working committee and advisory committee together (June 15, 2018), Guidelines were evaluated to ensure that they were appropriate for Korean sleep medicine experts, up-to-date, and issued by reputable institutions. Vincent’s Hospital, The Catholic University of Korea, Suwon, Republic of KoreaĥDepartment of Psychiatry, Chungbuk National University Hospital, Cheongju, Republic of KoreaĦDepartment of Psychiatry, Ulsan University Hospital, Ulsan, Republic of KoreaħDepartment of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of KoreaĨDepartment of Psychiatry, Damyang Chamsarang Hospital, Damyang, Republic of KoreaĩDepartment of Psychiatry, Doeun Hospital, Jincheon, Republic of Koreaġ0Department of Psychiatry, Dream Sleep Clinic, Seoul, Republic of Koreaġ1Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Koreaġ2Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 2017 13(2):307–349.1Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of KoreaĢClearspring Psychiatric Clinic, Seoul, Republic of KoreaģDepartment of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaĤDepartment of Psychiatry, St.

Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, and Heald JL. “The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources,” the guidelines stated.

Ramelteon is recommended as treatment for sleep onset insomnia (weak recommendation).

Valerian is not recommended as treatment for sleep onset or sleep maintenance insomnia (weak recommendation).

Triazolam is recommended for the treatment of sleep onset insomnia (weak recommendation).

Melatonin is not recommended for sleep onset or sleep maintenance insomnia (weak recommendation).

Suvorexant is recommended for sleep maintenance insomnia (weak recommendation).

Study: Lower Dose of Insomnia Medication More Effective Insomnia May Increase the Risk of Asthma in Adults

Fourteen specific recommendations for individual options, including prescription and over-the-counter agents and dietary supplements commonly used to treat insomnia in adults were provided. Recommendations were based on a systematic review of randomized controlled trials, and graded according to the strength of the evidence. The guidelines are the first from the organization to focus on evidence regarding the effectiveness of individual drugs for treating sleep onset and sleep maintenance insomnia. The American Academy of Sleep Medicine has released new guidelines for the pharmacologic treatment of insomnia in adults.

Acute insomnia treatment guidelines