Evidence Review on Pharmacologic Treatment of Chronic Insomnia

Insomnia is a risk factor for mental disorders, metabolic syndrome, hypertension, coronary heart disease, and increased mortality. It is the most common sleep disorder. In 2020, the age-adjusted prevalence of U.S. adults reporting short sleep duration was estimated at 34.8%. Chronic insomnia has an estimated prevalence of 5% to 15%. Social and biological risk factors for insomnia include advanced age, female sex, shift work, low socioeconomic status, marital status (divorced or separated), African American race, a family or personal history of insomnia, and genetic factors. The American College of Physicians (ACP) has commissioned a systematic review to determine the effectiveness and comparative effectiveness and harms of different pharmacologic treatments for chronic insomnia in adults. The review will assess the health outcomes and risk of harms for various treatments and consider the impact of potential effect modifiers (age, sex, race/ethnicity, and coexisting medical or health conditions) on the effectiveness and safety of these therapies..