Do Insomnia Treatments Improve Daytime Function?

Nathaniel F Watson; Suzanne M Bertisch; Charles M Morin; Rafael Pelayo; John W Winkelman; Phyllis C Zee; Andrew D Krystal

doi:10.3390/jcm12093089

Do Insomnia Treatments Improve Daytime Function?

J Clin Med. 2023 Apr 24;12(9):3089. doi: 10.3390/jcm12093089.

Authors

Nathaniel F Watson¹, Suzanne M Bertisch², Charles M Morin³, Rafael Pelayo⁴, John W Winkelman^{5

6}, Phyllis C Zee⁷, Andrew D Krystal^{8

9}

Affiliations

¹ Department of Neurology, University of Washington School of Medicine, Seattle, WA 98104, USA.
² Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02130, USA.
³ Department of Psychology, Cervo/Brain Research Centre, Laval University, Québec City, QC G1J 2G3, Canada.
⁴ Department of Psychiatry and Behavioral Sciences, Stanford University Sleep Medicine Center, Redwood City, CA 94063, USA.
⁵ Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
⁶ Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
⁷ Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University, Evanston, IL 60209, USA.
⁸ Department of Psychiatry, UCSF Weill Institute for Neurosciences, San Francisco, CA 94103, USA.
⁹ Department of Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA 94103, USA.

Abstract

A scientific advisory panel of seven U.S. and Canadian sleep experts performed a clinical appraisal by comparing general medical opinion, assessed via a survey of practicing clinicians, regarding insomnia treatment, with the available scientific evidence. This clinical appraisal focuses on the specific statement, "Treatments for insomnia have uniformly been shown to significantly improve the associated daytime impairment seen with insomnia." The advisory panel reviewed and discussed the available body of evidence within the published medical literature to determine what discrepancies may exist between the currently published evidence base and general medical opinion. The advisory panels' evaluation of this statement was also compared with the results of a national survey of primary care physicians, psychiatrists, nurse practitioners, physician assistants, and sleep specialists in the United States. Contrary to general medical opinion, the expert advisory panel concluded that the medical literature did not support the statement. This gap highlights the need to educate the general medical community regarding insomnia treatment efficacy in pursuit of improved treatment outcomes.

Keywords: clinical appraisal; daytime function; insomnia; medications.

Grants and funding

Publication of this open-access online article is the result of a survey assessment conducted by the publisher. The Insomnia Clinical Appraisal December 2021 project was initiated and funded by Idorsia Pharmaceuticals Ltd. (Idorsia). Management of the meeting and survey, and medical writing and editorial support, was funded by Idorsia and was provided by LAS Communications, Inc. Idorsia identified the chairperson and faculty members and was consulted in the development and review of the practice statements. All seven authors were members of the Alliance for Sleep funded by Idorsia. Idorsia conducted a medical review of the final draft publication. Authors received financial reimbursement by Idorsia for time spent on the literature review and analysis but received no compensation toward the development and writing of this manuscript.