Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 24;12(9):3089.
doi: 10.3390/jcm12093089.

Do Insomnia Treatments Improve Daytime Function?

Nathaniel F Watson  1 , Suzanne M Bertisch  2 , Charles M Morin  3 , Rafael Pelayo  4 , John W Winkelman  5   6 , Phyllis C Zee  7 , Andrew D Krystal  8   9
Affiliations

Do Insomnia Treatments Improve Daytime Function?

Nathaniel F Watson et al. J Clin Med. .

Abstract

A scientific advisory panel of seven U.S. and Canadian sleep experts performed a clinical appraisal by comparing general medical opinion, assessed via a survey of practicing clinicians, regarding insomnia treatment, with the available scientific evidence. This clinical appraisal focuses on the specific statement, "Treatments for insomnia have uniformly been shown to significantly improve the associated daytime impairment seen with insomnia." The advisory panel reviewed and discussed the available body of evidence within the published medical literature to determine what discrepancies may exist between the currently published evidence base and general medical opinion. The advisory panels' evaluation of this statement was also compared with the results of a national survey of primary care physicians, psychiatrists, nurse practitioners, physician assistants, and sleep specialists in the United States. Contrary to general medical opinion, the expert advisory panel concluded that the medical literature did not support the statement. This gap highlights the need to educate the general medical community regarding insomnia treatment efficacy in pursuit of improved treatment outcomes.

Keywords: clinical appraisal; daytime function; insomnia; medications.

PubMed Disclaimer

Conflict of interest statement

The authors are solely responsible for the content of this publication and wish to declare the following beyond Idorsia. Dr. Watson has served as an advisory consultant for Eisai, Jazz Pharmaceuticals, Harmony Biosciences, Takeda, Johnson and Johnson, Itamar, GlaxoSmithKline, Pfizer and Bayer. Dr. Bertisch has served as consultant for ResMed, Eisai, Merck, and Optum Health. Dr. Morin has received research grant from Eisai, and Lallemand Health and has served on advisory consultant boards for Eisai, Pear Therapeutics, and Sunovion. He owns equity in BeHealth Solutions and receives royalties from Mapi Research Trust. Dr. Pelayo serves as an advisor to Adaptive Sound Technology, Eisai, SleepQuest, and SleepScore Labs. Dr. Pelayo sits on the Scientific Board of Restore Sleep. Dr. Winkelman has served as a consultant to Idorsia, Noctrix, received research support from Merck and receives royalties from UpToDate. Dr. Zee has received research grant funding from Vanda Pharmaceuticals (through Northwestern University); served on scientific advisory boards for Eisai, and Jazz; and served as a consultant to Eisai, Jazz, CVS Caremark, Sleep Number, Harmony biosciences and Septerma. She owns equity in Teva Pharmaceuticals. Additionally, her spouse has stock ownership in Pfizer. Dr. Krystal holds the following research Grants: Janssen Pharmaceuticals, Axsome Pharmaceutics, Neurocrine Biosciences, Reveal Biosensors, The Ray and Dagmar Dolby Family Fund, and the National Institutes of Health. Dr. Krystal has also served as a consultant for the following companies: Adare, Axsome Therapeutics, Big Health, Eisai, Evecxia, Ferring Pharmaceuticals, Galderma, Harmony Biosciences, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Millenium Pharmaceuticals, Merck, Neurocrine Biosciences, Neurawell, Pernix, Otsuka Pharmaceuticals, Sage, Takeda, Angelini. The opinions or views expressed in this publication are those of the authors and do not necessarily reflect the opinions and recommendations of the publisher or supporters. This publication is intended for scientific exchange purposes and results from an evidence-based collaborative process in which all authors may not agree on all points. Pharmaceutical products and/or use of products that have not been approved by the US Food and Drug Administration or other regulatory authorities may be discussed. Dosages, indication, and methods of use for compounds that are referred to by the authors may reflect their clinical experience or may be derived from the professional literature or other sources. For approved product information, consult the manufacturer’s prescribing information or the applicable regulatory authority.

Figures

Figure 1
Figure 1
Summary of the survey and clinical appraisal panel methodology. Eighteen articles were selected for presentation. HCP = health care provider.
Figure 2
Figure 2
Level of acceptance/rejection for field survey respondents and the expert panel pre- and post-presentation of evidence. The 508 survey respondents voted on their level of acceptance or rejection of the statement based on a six-point Likert scale (blue). Prior to seeing field survey results, and discussing the literature, the seven members of the appraisal panel voted on their level of acceptance/rejection (gray). The literature and data supporting and refuting the statement were then reviewed, discussed and the same seven-member panel voted once more (orange) on their levels of acceptance/rejection using the same six-point Likert scale.
Figure 3
Figure 3
Mean voting level for the statement. Blue bar, field survey respondents (n = 508). Grey bar, appraisal panel (n = 7) before meeting. Orange bar, appraisal panel members (n = 7) after meeting and presentation of the literature. The grading on the x-axis corresponds to the levels of support/rejection of the statement.
See this image and copyright information in PMC

References

    1. Lopresti A.L., Hood S.D., Drummond P.D. A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise. J. Affect. Disord. 2013;148:12–27. doi: 10.1016/j.jad.2013.01.014. - DOI - PubMed
    1. Ding C., Fan J., Yuan F., Feng G., Gong W., Song C., Ma Y., Chen Z., Liu A. Association between Physical Activity, Sedentary Behaviors, Sleep, Diet, and Adiposity among Children and Adolescents in China. Obes. Facts. 2022;15:26–35. doi: 10.1159/000519268. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention Sleep and Sleep Disorders: Data and Statistics. [(accessed on 1 September 2022)]; Available online: https://www.cdc.gov/sleep/data_statistics.html.
    1. Siebern A.T., Manber R. Inadequate Sleep Hygiene. In: Kushida C.A., editor. Reference Module in Neuroscience and Biobehavioral Psychology, Encyclopedia of Sleep. Academic Press; Cambridge, MA, USA: 2013. pp. 220–223. - DOI
    1. Bhaskar S., Hemavathy D., Prasad S. Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. J. Fam. Med. Prim. Care. 2016;5:780–784. doi: 10.4103/2249-4863.201153. - DOI - PMC - PubMed