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CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(S 02): 507-549
DOI: 10.1055/s-0043-1776281
Review Article

2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults – Brazilian Sleep Association

Luciano Ferreira Drager 
1   Associação Brasileira do Sono, São Paulo, SP, Brazil.
2   Unidades de HipertenSão, Instituto do Coração (InCor) e Disciplina de Nefrologia, Universidade de São Paulo, São Paulo, SP, Brazil.
,
Márcia Assis 
1   Associação Brasileira do Sono, São Paulo, SP, Brazil.
3   Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.
,
Andrea Frota Rego Bacelar 
1   Associação Brasileira do Sono, São Paulo, SP, Brazil.
4   Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.
,
Dalva Lucia Rollemberg Poyares 
5   Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
6   Instituto do Sono, São Paulo, SP, Brazil.
,
Silvia Gonçalves Conway 
7   Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
8   Departamento de Otoneurologia, Universidade de São Paulo, São Paulo, SP, Brazil.
9   AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
,
Gabriel Natan Pires 
5   Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
6   Instituto do Sono, São Paulo, SP, Brazil.
,
Alexandre Pinto de Azevedo 
7   Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
,
Alicia Carissimi 
10   Faculdade Dom Bosco, Porto Alegre, RS, Brazil.
11   Cronosul Clínica de Psicologia do Sono, Psicoterapia e Neuropsicologia, Porto Alegre, RS, Brazil.
,
Allan Luiz Eckeli 
12   Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
,
Álvaro Pentagna 
13   Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
,
Carlos Maurício Oliveira Almeida 
14   Departamento de Neurologia, Universidade Estadual do Amazonas, UEA, Brazil.
,
Clélia Maria Ribeiro Franco 
15   Hospital Universitário Oswaldo Cruz (HUOC), Universidade Federal de Pernambuco, Recife, PE, Brazil.
,
Emmanuelle Silva Tavares Sobreira 
9   AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
16   Universidade Federal do Ceará, Fortaleza, CE, Brazil.
17   Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.
,
Fernando Gustavo Stelzer 
12   Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
,
Giuliana Macedo Mendes 
18   Instituto de Especialidades e Sono, Goiânia, GO, Brazil.
,
Gisele Richter Minhoto 
19   Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil.
,
Ila Marques Porto Linares 
7   Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
20   Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
,
Ksdy Maiara Moura Sousa 
5   Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
21   SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.
,
Livia Leite Góes Gitaí 
22   Faculdade de Medicina, Universidade Federal de Alagoas, AL, Brazil.
,
Lucia Sukys-Claudino 
23   Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
,
Manoel Alves Sobreira-Neto 
16   Universidade Federal do Ceará, Fortaleza, CE, Brazil.
,
Marcio Andrei Zanini 
24   Instituto de Assistência Médica ao Servidor Público Estadual (IAMPSE), São Paulo, SP, Brazil.
,
Regina Margis 
25   Private clinic, Porto Alegre, RS, Brazil.
,
Sandra Cristina Gonçalves Martinez 
26   Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
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Abstract

Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P – Patient, problem, or population; I – Intervention; C – Comparison, control, or comparator; O – Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.

Keywords

adults - diagnosis - insomnia - treatment


Publication History

Article published online:
22 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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