The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines
Open Access
- 3 March 2020
- journal article
- research article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 172 (5), 325-+
- https://doi.org/10.7326/M19-3575
Abstract
Description: In September 2019, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) approved a new joint clinical practice guideline for assessing and managing patients with chronic insomnia disorder and obstructive sleep apnea (OSA). This guideline is intended to give health care teams a framework by which to screen, evaluate, treat, and manage the individual needs and preferences of VA and DoD patients with either of these conditions. Methods: In October 2017, the VA/DoD Evidence-Based Practice Work Group initiated a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions, systematically searched and evaluated the literature, created three 1-page algorithms, and advanced 41 recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Recommendations: This synopsis summarizes the key recommendations of the guideline in 3 areas: diagnosis and assessment of OSA and chronic insomnia disorder, treatment and management of OSA, and treatment and management of chronic insomnia disorder. Three clinical practice algorithms are also included.This publication has 59 references indexed in Scilit:
- GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendationsJournal of Clinical Epidemiology, 2013
- Meta-Analysis: Melatonin for the Treatment of Primary Sleep DisordersPLOS ONE, 2013
- Sleep Disorders and Associated Medical Comorbidities in Active Duty Military PersonnelSleep, 2013
- Self‐Help Treatment for Insomnia Symptoms Associated with Chronic Conditions in Older Adults: A Randomized Controlled TrialJournal of the American Geriatrics Society, 2012
- A Randomized, Placebo-Controlled Trial of Online Cognitive Behavioral Therapy for Chronic Insomnia Disorder Delivered via an Automated Media-Rich Web ApplicationSleep, 2012
- Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic reviewBMC Family Practice, 2012
- A Placebo- and Active-Controlled Assessment of 6- and 50-mg Oral Doxepin on Cardiac Repolarization in Healthy Volunteers: A Thorough QT EvaluationClinical Therapeutics, 2011
- STOP QuestionnaireAnesthesiology, 2008
- Obstructive sleep apnea and ischemic heart disease in southwestern US veterans: implications for clinical practiceSleep and Breathing, 2005
- Grading quality of evidence and strength of recommendationsBMJ, 2004