What do Cochrane systematic reviews say about interventions for insomnia?

• Published in: São Paulo medical journal 2018-11, Vol.136 (6), p.579-585
• Main Authors: Melo, Florence de Lucca, Mendoza, Juan Fulgencio Welko, Latorraca, Carolina de Oliveira Cruz, Pacheco, Rafael Leite, Martimbianco, Ana Luiza Cabrera, Pachito, Daniela Vianna, Riera, Rachel
• Format: Article
• Language: English
• Subjects: Acupuncture Therapy - standards; Antidepressive Agents - therapeutic use; Evidence-Based Medicine; Exercise; Humans; MEDICINE, GENERAL & INTERNAL; Music Therapy - standards; Narrative Review; Randomized Controlled Trials as Topic; Review [publication type]. Evidence-based medicine. Evidence-based practice. Sleep Initiation and Maintenance Disorders. Comparative Effectiveness Research; Sleep - physiology; Sleep Initiation and Maintenance Disorders - drug therapy; Sleep Initiation and Maintenance Disorders - therapy; Systematic Reviews as Topic
• ISSN: 1516-3180; 1806-9460; 1806-9460
• DOI: 10.1590/1516-3180.2018.0380311018

Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States. This study summarizes all Cochrane systematic reviews (SRs) that evaluated interventions to treat insomnia. Review of SRs, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). A sensitive search was carried out in the Cochrane Database of Systematic Reviews to identify Cochrane SRs that assessed the effects of any type of intervention for people with insomnia. The results, main characteristics of the SRs and the certainty of the evidence obtained from them were synthesized and discussed. Seven SRs were included. They addressed the benefits and harm of acupuncture (n = 1), behavioral interventions (n = 1), music (n = 1), pharmacotherapy (n = 2), phototherapy (n = 1) and physical exercise (n = 1). The certainty of the evidence ranged from moderate to very low. Acupuncture, music, physical exercise, paroxetine, doxepin, trimipramine and trazodone seem to present some benefit for patients with insomnia. However, the uncertainty around these results means that no robust and definitive recommendations for clinical practice can be made until the benefits and harms from each intervention for patients with insomnia have been confirmed through further studies.