Complementary and Alternative Medicine in Clinical Practice Guideline for Insomnia

Abstract

Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines

“…Two previous systematic reviews within the same theme were published in 2016 ( 58 ) and 2021 ( 23 ), respectively. The former claimed to have included 11 CPGs which described CAM therapies, but in fact suffered from inappropriate inclusion, i.e., report/handout of treatment options for insomnia ( 59 ) were incorrectly considered as guidelines and included ( 58 ). Furthermore, this review did not evaluate the methodological and reporting quality of the included CPGs ( 58 ).…”

“…The former claimed to have included 11 CPGs which described CAM therapies, but in fact suffered from inappropriate inclusion, i.e., report/handout of treatment options for insomnia ( 59 ) were incorrectly considered as guidelines and included ( 58 ). Furthermore, this review did not evaluate the methodological and reporting quality of the included CPGs ( 58 ). The 2021 review only included six CPGs covering eight CAM modalities and did not perform reporting quality assessment ( 23 ).…”

Prevalence and Treatment Patterns of Sleep Disorders in the Under 20 Population: analysis using a national health insurance claims database

“…Despite the high prevalence and significant impact of sleep problems in children and adolescents, few studies have examined the prevalence of sleep disorders in children and adolescents, especially with regard to non-pharmacological treatments in the Republic of Korea (ROK) [ 8 ]. Clinical practice guidelines for the non-pharmacological treatment of sleep disorders in adults are available and include recommendations for acupuncture, herbal medicine, and moxibustion treatment for adults with insomnia [ 9 ]. However, information on clinical practice guidelines for the non-pharmacological treatment of sleep disorders in children and adolescents is limited.…”

Effects of Audio Brain Entrainment on Korean People with Mild Insomnia

“…In Korea, non-pharmaceutical such as herbal medicine, meditation, acupuncture, exercise, etc. are used (Kwon et al, 2016 ). One alternative method is the use of audio stimulation (Jespersen et al, 2015 ; Lai & Good, 2006 ).…”