12/23/2023 0 Comments Acute insomnia guidelinesIn contrast to benzodiazepines, Z-drugs are more selective in their action and have a lower tendency to develop dependence and withdrawal symptoms. Despite being indicated for this disorder, benzodiazepines have the potential to trigger dependence with consequent rebound and withdrawal symptoms upon sudden discontinuation. Some of the drugs used in the treatment of insomnia are benzodiazepines and Z-drugs. Comparatively, hypnotic drugs act faster than CBT-I and are thus preferred by patients. These methods include cognitive behavioural therapy for insomnia (CBT-I) and hypnotic medications. Overall, two treatment options have been accepted widely for the management of insomnia. With such low awareness and knowledge about insomnia, there are no evidence-based clinical guidelines regarding the management of the illness amongst Saudis. The low awareness is also widespread amongst the general public, health care workers and authorities, and the insurance companies in Saudi Arabia. This lack of knowledge is attributed to the poor education received by medical students who transition into practice. Furthermore, awareness about insomnia and other sleep disorders as well as their consequences is low amongst healthcare authorities and practitioners. They include a lack of specialists, few trained technicians, and insufficient funding. Various obstacles have been cited as the factors that hinder the progress of speciality in sleep medicine in Saudi Arabia. A recent study reported the prevalence of insomnia with the presence of daytime dysfunction in 57% of Saudi adults attending primary care services. Nevertheless, according to the available data, it is evident that sleep disorders are increasingly becoming prevalent amongst Saudis, yet sleep medicine services in Saudi Arabia remain below the level of services offered in developed countries. The various studies that have attempted to address the prevalence of sleep disorders in the Kingdom of Saudi Arabia are limited. Insomnia and other sleep disorders are amongst the most neglected illnesses by medical practitioners. The items that achieved the required consensus can be included in future guidelines for the use of BZDs and Z-drugs in the treatment of primary insomnia in adults to standardize best practices in sleep medicine in Saudi Arabia. The five statements that failed to attain the required consensus were rejected as inappropriate for inclusion in Saudi Arabian clinical guidelines. Having obtained the required consensus of 80% or higher in Round 3, these 16 statements fulfilled the criteria to be included in future guidelines. Eleven experts participated in Round 3 and eight statements received 100% agreement, two received 91%, and six received 82%. In Round 2, there were 17 respondents and 16 of the statements obtained the required consensus of 70% or higher. Twenty-one statements originated from participants’ responses. Resultsįifteen experts from four different regions and specialities in Saudi Arabia participated in Round 1. All participants’ details were anonymised except to the researcher. Snowballing was used to forward invitation emails, information sheets, and the survey to known sleep medicine experts and physicians deemed to be interested in the field. The Director of the Saudi Sleep Medicine Group helped recruit the country’s sleep medicine experts. Three rounds of the e-Delphi technique using a Bristol Online Survey (BOS) were conducted between May and August 2018. This study aims to obtain consensus statements required for the development of clinical guidelines for the use of benzodiazepines (BZDs) and Z-drugs for the management of primary insomnia in adults in Saudi Arabia.
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