Melo Florence de Lucca, Mendoza Juan Fulgencio Welko, Latorraca Carolina de Oliveira Cruz, Pacheco Rafael Leite, Martimbianco Ana Luiza Cabrera, Pachito Daniela Vianna, Riera Rachel
Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
MSc. Psychologist; Postgraduate Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP); and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
Sao Paulo Med J. 2018 Nov-Dec;136(6):579-585. doi: 10.1590/1516-3180.2018.0380311018.
Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States. This study summarizes all Cochrane systematic reviews (SRs) that evaluated interventions to treat insomnia.
Review of SRs, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP).
A sensitive search was carried out in the Cochrane Database of Systematic Reviews to identify Cochrane SRs that assessed the effects of any type of intervention for people with insomnia. The results, main characteristics of the SRs and the certainty of the evidence obtained from them were synthesized and discussed.
Seven SRs were included. They addressed the benefits and harm of acupuncture (n = 1), behavioral interventions (n = 1), music (n = 1), pharmacotherapy (n = 2), phototherapy (n = 1) and physical exercise (n = 1). The certainty of the evidence ranged from moderate to very low.
Acupuncture, music, physical exercise, paroxetine, doxepin, trimipramine and trazodone seem to present some benefit for patients with insomnia. However, the uncertainty around these results means that no robust and definitive recommendations for clinical practice can be made until the benefits and harms from each intervention for patients with insomnia have been confirmed through further studies.
失眠是一种常见的主诉，在美国每年有超过五百万人因失眠就医。本研究总结了所有评估治疗失眠干预措施的Cochrane系统评价（SRs）。
在圣保罗联邦大学保罗医科大学循证医学学科进行的SRs综述。
在Cochrane系统评价数据库中进行了全面检索，以识别评估任何类型干预措施对失眠患者效果的Cochrane SRs。对结果、SRs的主要特征以及从中获得的证据的确定性进行了综合和讨论。
纳入了七项SRs。它们涉及针灸（n = 1）、行为干预（n = 1）、音乐（n = 1）、药物治疗（n = 2）、光疗（n = 1）和体育锻炼（n = 1）的益处和危害。证据的确定性从中度到极低不等。
针灸、音乐、体育锻炼、帕罗西汀、多塞平、曲米帕明和曲唑酮似乎对失眠患者有一定益处。然而，这些结果的不确定性意味着，在通过进一步研究证实每种干预措施对失眠患者的益处和危害之前，无法为临床实践提出有力和明确的建议。
