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Chronic Insomnia Disorder across Europe: Expert Opinion on Challenges and Opportunities to Improve Care.
Ellis, Jason; Ferini-Strambi, Luigi; García-Borreguero, Diego; Heidbreder, Anna; O'Regan, David; Parrino, Liborio; Selsick, Hugh; Penzel, Thomas.
Affiliation
  • Ellis J; Department of Psychology, Northumbria University, Newcastle NE1 8ST, UK.
  • Ferini-Strambi L; Department of General Psychology, Università Vita-Salute San Raffaele, 20132 Milan, Italy.
  • García-Borreguero D; Sleep Research Institute, 28036 Madrid, Spain.
  • Heidbreder A; Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Austria.
  • O'Regan D; Faculty of Life Sciences and Medicine, King's College, London WC2R 2LS, UK.
  • Parrino L; Disorder Centre, Guy's Hospital, London SE1 9RT, UK.
  • Selsick H; Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy.
  • Penzel T; Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals, London NW1 2PG, UK.
Healthcare (Basel) ; 11(5)2023 Feb 28.
Article in En | MEDLINE | ID: mdl-36900721
ABSTRACT
One in ten adults in Europe have chronic insomnia, which is characterised by frequent and persistent difficulties initiating and/or maintaining sleep and daily functioning impairments. Regional differences in practices and access to healthcare services lead to variable clinical care across Europe. Typically, a patient with chronic insomnia (a) will usually present to a primary care physician; (b) will not be offered cognitive behavioural therapy for insomnia-the recommended first-line treatment; (c) will instead receive sleep hygiene recommendations and eventually pharmacotherapy to manage their long-term condition; and (d) will use medications such as GABA receptor agonists for longer than the approved duration. Available evidence suggests that patients in Europe have multiple unmet needs, and actions for clearer diagnosis of chronic insomnia and effective management of this condition are long overdue. In this article, we provide an update on the clinical management of chronic insomnia in Europe. Old and new treatments are summarised with information on indications, contraindications, precautions, warnings, and side effects. Challenges of treating chronic insomnia in European healthcare systems, considering patients' perspectives and preferences are presented and discussed. Finally, suggestions are provided-with healthcare providers and healthcare policy makers in mind-for strategies to achieve the optimal clinical management.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Guideline Language: En Journal: Healthcare (Basel) Year: 2023 Document type: Article Affiliation country: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Guideline Language: En Journal: Healthcare (Basel) Year: 2023 Document type: Article Affiliation country: United kingdom