11/19/2023 0 Comments Temazepam vs trazodone for insomniaDowngrading the quality of evidence for these treatments is predictable in GRADE, due to the funding source for most pharmacological clinical trials and the attendant risk of publication bias the relatively small number of eligible trials for each individual agent and the observed heterogeneity in the data. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data. ![]() A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. Recommendations: The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. The AASM Board of Directors approved the final recommendations. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. Methods: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. Introduction: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated.
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