The TF conducted a SR of the published scientific literature, 4 to answer two Patient, Intervention, Comparison, and Outcomes (PICO) questions related to the behavioral and psychological treatments for insomnia in adults. All relevant conflicts of interest reported by the TF are listed in the Disclosures section. Individuals reporting professional or financial conflicts that represented potential bias, but did not prohibit participation in the development of the guideline, were required to recuse themselves from discussion or writing responsibilities related to the conflicts. In accordance with the AASM’s conflicts of interest policy, individuals were not appointed to the TF if they reported a professional or financial conflict that might diminish the integrity, credibility or ethical standards of the guideline. The TF was required to disclose all potential conflicts of interest (COI), per the AASM’s COI policy, prior to being appointed to the TF and throughout the research and writing of the guideline and SR documents. The AASM commissioned a task force (TF) of sleep medicine and sleep psychology clinicians with expertise in chronic insomnia disorder. Follow-up care to evaluate symptoms at the conclusion of treatment is indicated, and residual sleep-related symptoms should be evaluated and addressed.

Historically, in some settings patients have been offered only sleep hygiene as treatment for their chronic insomnia disorder however, standard of care should be to provide one of the recommended interventions discussed within the guideline to patients with chronic insomnia disorder, taking into consideration the accessibility and resource requirements when deciding on the most appropriate treatment for a given patient. The treatment of chronic insomnia disorder should be based on a diagnosis established using ICSD-3 or DSM-5 criteria, 6, 7 and a comprehensive clinical history. Separate clinical practice guidelines for pharmacologic treatment of chronic insomnia disorder are available. It is intended to optimize patient-centered care by providing actionable recommendations for the use of specific behavioral and psychological treatments in adults with chronic insomnia disorder. 3 This updated guideline, in conjunction with the accompanying systematic review (SR), 4 provides a comprehensive update of the available evidence and a synthesis of clinical practice recommendations for the psychological and behavioral treatments of chronic insomnia disorder. 1, 2 This clinical practice guideline is intended to update the previously published American Academy of Sleep Medicine (AASM) guidelines on the psychological and behavioral treatments of insomnia. Chronic insomnia disorder is a common sleep disorder that leads to impairment in health and functioning.

Psychophysiologic insomnia treatment