Abstract
Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States. This study summarizes all Cochrane systematic reviews (SRs) that evaluated interventions to treat insomnia. Review of SRs, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). A sensitive search was carried out in the Cochrane Database of Systematic Reviews to identify Cochrane SRs that assessed the effects of any type of intervention for people with insomnia. The results, main characteristics of the SRs and the certainty of the evidence obtained from them were synthesized and discussed. Seven SRs were included. They addressed the benefits and harm of acupuncture (n = 1), behavioral interventions (n = 1), music (n = 1), pharmacotherapy (n = 2), phototherapy (n = 1) and physical exercise (n = 1). The certainty of the evidence ranged from moderate to very low. Acupuncture, music, physical exercise, paroxetine, doxepin, trimipramine and trazodone seem to present some benefit for patients with insomnia. However, the uncertainty around these results means that no robust and definitive recommendations for clinical practice can be made until the benefits and harms from each intervention for patients with insomnia have been confirmed through further studies.
Highlights
Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States.[1]
Types of outcomes We considered any outcomes that had been evaluated by the authors of the systematic reviews (SRs) included
What do Cochrane systematic reviews say about interventions for insomnia? | NARRATIVE REVIEW
Summary
Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States.[1] It is considered to be a subjective condition that affects sleep maintenance, onset or early waking.[2] It is a public health issue because of its impact on people’s wellbeing.[3]. Patients with insomnia usually present difficulty in initiating or maintaining sleep and may wake up without the capacity to go back to sleep. This situation may induce development of symptoms during the day, such as sleepiness, mood disturbances and fatigue.[4,5]. The following individual factors are commonly associated with the risk of insomnia: female sex, older age (for any sex), previous episodes of insomnia and family history.[6,7]
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