Clinical Report: Insomnia Outcomes May Vary by Measurement Method
Overview
Revise to emphasize the importance of capturing daytime symptoms in treatment assessments.
Background
Insomnia affects a significant portion of the adult population, leading to diminished quality of life and various health complications. Accurate assessment of insomnia treatment outcomes is crucial for effective management, particularly as insomnia often co-occurs with other psychiatric disorders. The reliance on standard patient-reported outcomes may obscure important daytime effects of insomnia therapies.
Data Highlights
| Measurement Method | Findings |
|---|---|
| Standard Questionnaires | Reduced insomnia severity; no significant differences in daytime fatigue, mood, or cognition |
| EMA | Greater morning fatigue and reduced alert cognition; lower fatigue and sleepiness later in the day |
Key Findings
- EMA detected significant time-of-day-specific treatment effects of suvorexant.
- Standard questionnaires showed reduced insomnia severity but missed daytime symptom changes.
- Participants reported greater morning fatigue and reduced cognition earlier in the day with suvorexant.
- High completion rates of EMA indicate its feasibility in older adults.
- Reliance on retrospective measures may obscure clinically relevant daytime effects.
Clinical Implications
Clinicians should consider integrating EMA into routine assessments of insomnia treatments to capture nuanced daytime symptoms. This approach may enhance the understanding of treatment impacts and support more informed clinical decisions regarding ongoing medication use.
Conclusion
The findings highlight the importance of refining outcome measurement in insomnia research and clinical practice, advocating for broader adoption of EMA to improve patient-centered treatment decisions.
Related Resources & Content
- Wickwire EM, et al., JAMA Network Open, 2023 -- Smartphone-Based Real-Time Assessment of Daytime Insomnia Symptoms With Suvorexant: A Randomized Clinical Trial
- BMC Psychiatry (Springer) — Digital multi-modal approaches to subtyping insomnia disorder (DIMOSI): study design, rationale, digital platform, and preliminary baseline characteristics of a national prospective cohort study
- BMC Psychiatry (Springer) — Objectively measured cognitive function in insomnia patients with and without comorbid depression treated with cognitive behavioral therapy for insomnia
- Open Forum Infectious Diseases — Individuals with HIV Experience Delayed and Weaker Sleep and Activity Patterns
- BMC Psychiatry (Springer) — The PAPPI cross-sectional study: prevalence, associated factors and care management for insomnia in outpatient public psychiatric services
- Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline - PMC
- Safety and efficacy of daridorexant in patients with insomnia disorder: results from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials - PubMed
- Smartphone-Based Real-Time Assessment of Daytime Insomnia Symptoms With Suvorexant: A Randomized Clinical Trial | Clinical Pharmacy and Pharmacology | JAMA Network Open | JAMA Network
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