Arghya Pal, Tanmay Joshi, Aniruddha Basu, Ravi Gupta
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引用次数: 0
Abstract
Purpose: Insomnia is a highly prevalent disorder that is seen across all age groups causing significant morbidity to the patients. Its prevalence has further risen during COVID-19 pandemic. It is widely acknowledged that untreated insomnia can lead to significant health risks and socio-occupational dysfunction.
Methods: A narrative review was conducted following focused search of databases.
Results: Available guidelines mention two different approaches for the management of insomnia-pharmacological and non-pharmacological. Non-pharmacological therapies like multicomponent cognitive behavior therapy for insomnia (CBT-I) have been advocated for the management of acute as well as chronic insomnia in the literature as it has been found efficacious and useful. Multiple variants of CBT-I, e.g., digitally delivered CBT-I, brief CBT-I have been tested during pandemic owing to closure of clinics. However, there are certain issues to be considered while choosing CBT-I as therapy. For example, like other forms of psychotherapies, is there a need for assessing the candidature of patient before administering CBT-I; is CBT-I free of adverse effects as commonly thought; is CBT-I more efficacious than hypnotics; and at last, how to manage cases that are not candidate for CBT-I.
Conclusion: This narrative review addresses the scientific robustness of evidence for issues related to adherence, efficacy and adverse effects of non-pharmacological therapies. Available literature suggests that data related to adherence and efficacy of CBT-I suffer from methodological shortcomings and careful selection of patient is important for the successful therapy. At the same time, attempts have been made to shed light to the areas where CBT-I can be helpful in the management of insomnia.
期刊介绍：
Sleep, a pervasive, prominent and universal behavior, which occupies a third of human life. However, why we sleep remains unclear and it is one of the enigmas of modern neuroscience. Sleep loss and sleep deprivation has deleterious consequences. Many research laboratories across the globe evaluate sleep at the intersection between the cellular and the systems level. Such approaches are needed to understand the purpose of sleep. Within the sleep field, several of the predictions and hypotheses are often explored using simple to complex animal models, high-density EEG, and other synthetic approaches such as a large-scale computational simulation of multiple brain regions. Understanding how brain activity across behavioral states provide a conscious experience, which has pivotal implications for several clinical fields such as translational neuroscience, neuropsychiatry and neuropsychology. This is a rapidly growing area with a wide research base, yet currently has no dedicated journal. To fill the void, this is where the proposed journal ''Vigilance'' comes into picture. Vigilance will provide such unique platform to collect and disseminate state-of-the art scientific understanding on research in the increasingly overlapping fields of basic, translational and clinical sleep medicine. Vigilance will be a a Springer owned journal in collaboration and editorial support from the Indian Society for Sleep Research (ISSR), which aims to publish exemplary peer-reviewed manuscripts directing neurobiological investigation related to normal and altered vigilance states. Vigilance will be a broad-spectrum international scholarly journal, which aims to publish rigorously peer-reviewed, high quality research manuscripts within the biomedical as well as clinical research under one roof so that the translational research in sleep medicine can be nurtured and promoted. Therefore the wide scope of the journal will aid in contributing a great measure for the excellence in the scientific r esearch. Support in the research community for Vigilance has been widespread, and the journal has already secured several leaders in the field as members of its editorial board. This multidisciplinary journal will render a global podium for biomedical and clinical researchers to share their scientific excellence. Vigilance aims to attract research articles, case reports, clinical investigations, review articles and short communications from basic, translational, and clinical aspects of sleep research. Vigilance will cover a wide range of topics in this discipline and creates a platform for the authors to contribute towards the advancement in basic, translational, and clinical medicine. Areas covered include, but not limited to measurement of sleep across phylogeny, ontogeny, sleep functions, sleep organization at molecular, cellular, systems, and behavior levels, mechanisms of behavioral states regulation, molecular/genetic approach to studying sleep, neural substrates of altered states of consciousness, large-scale computer simulations to 3D modeling. At the clinical frontiers, areas such as chronobiology, primary sleep disorders and co-morbid sleep disorders will be covered. Journal will also cover translational and interdisciplinary clinical research related to all areas of sleep medicine in terms of diagnosis, treatment, and management of sleep disorders.
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