From the Guidelines
The 2017 American Academy of Sleep Medicine (AASM) guidelines recommend that adults with chronic insomnia be treated with cognitive behavioral therapy for insomnia (CBT-I) as a primary intervention, and medications such as prescription and non-prescription medications be considered mainly in patients who are unable to access or respond to CBT-I 1.
Key Recommendations
- The guidelines provide a recommendation and evidence base for each individual drug, and the selection of a particular drug should rest on the evidence summarized, as well as additional patient-level factors, such as the optimal pharmacokinetic profile, assessments of benefits versus harms, and past treatment history 1.
- The guidelines are intended to serve as one component in an ongoing assessment of the individual patient with insomnia, and should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia 1.
Treatment Approach
- The guidelines suggest that pharmacotherapy, alone or in combination with CBT-I, must continue to be considered a part of the therapeutic armamentarium for patients with chronic insomnia 1.
- The guidelines do not recommend one drug over another, but rather provide a recommendation and evidence base for each individual drug, and the selection of a particular drug should be based on individual patient factors 1.
From the Research
2017 American Academy of Sleep Medicine (AASM) Guidelines
There are no direct references to the 2017 AASM guidelines in the provided studies. However, the following information can be gathered from the studies:
- The AASM has published guidelines for the treatment of obstructive sleep apnea (OSA) in adults using positive airway pressure (PAP) 2.
- The AASM has also published reviews on the use of auto-titrating continuous positive airway pressure for treatment of adult OSA 3.
- A multicenter evaluation of oral pressure therapy for the treatment of OSA was conducted in AASM-accredited sleep clinics 4.
- The World Sleep Society has endorsed the AASM's Clinical Practice Guideline on the Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure 5.
Key Points
- The AASM guidelines recommend the use of PAP therapy for the treatment of OSA in adults 2.
- The guidelines also discuss the use of different PAP modalities, such as continuous PAP, auto-adjusting PAP, and bilevel PAP 2.
- The AASM has published reviews on the use of auto-titrating continuous positive airway pressure for treatment of adult OSA 3.
- Oral appliances can be used to treat OSA when patients cannot tolerate CPAP 6.
Treatment Options
- PAP therapy is a recommended treatment for OSA in adults 2.
- Oral appliances can be used as an alternative treatment for OSA when patients cannot tolerate CPAP 6.
- Oral pressure therapy is another treatment option for OSA, which has shown clinically significant improvements in sleep quality and continuity 4.