Insomnio crónico

Why / when / how

Intervening on sleep reduces the severity of chronic insomnia, with a broad effect sustained over time and a balance between benefit and harm that is more favorable than that of hypnotics. The certainty of the evidence for the critical outcomes is moderate. That is why the recommendation is strong in favor, because the benefits clearly outweigh the risks.

Cautions

Before intervening on sleep, assess the patient's habits, context, and treatments, and rule out sleep disorders that require specific study and management, such as obstructive apnea and restless legs syndrome. Use medications for sleeping with caution and in a limited way, prioritizing behavioral measures. Advise seeking professional evaluation in the presence of warning signs such as dangerous daytime sleepiness, snoring with breathing pauses, and persistent insomnia that does not improve, and refer to the specialist when appropriate. Reassess the response periodically.

Quantitative evidence