TY - JOUR
T1 - Chronic Insomnia Disorder across Europe
T2 - Expert Opinion on Challenges and Opportunities to Improve Care
AU - Ellis, Jason
AU - Ferini-Strambi, Luigi
AU - García-Borreguero, Diego
AU - Heidbreder, Anna
AU - O’Regan, David
AU - Parrino, Liborio
AU - Selsick, Hugh
AU - Penzel, Thomas
N1 - Funding information: The medical writing support and the APC were funded by Idorsia Pharmaceuticals Ltd.
PY - 2023/2/28
Y1 - 2023/2/28
N2 - 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.
AB - 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.
KW - chronic insomnia
KW - cognitive behavioural therapy
KW - Europe
KW - general practitioners
KW - healthcare policy
KW - healthcare providers
KW - hypnotics
KW - sleep
KW - pharmacotherapy
UR - http://www.scopus.com/inward/record.url?scp=85149791173&partnerID=8YFLogxK
U2 - 10.3390/healthcare11050716
DO - 10.3390/healthcare11050716
M3 - Review article
SN - 2227-9032
VL - 11
JO - Healthcare (Switzerland)
JF - Healthcare (Switzerland)
IS - 5
M1 - 716
ER -