Efficacy of dexmedetomidine with cognitive behavioral therapy for treating chronic insomnia related to conditioned arousal: a randomized controlled trial

Comparative efficacy and acceptability of psychotherapies, pharmacotherapies, and their combination for the treatment of adult insomnia: A systematic review and network meta-analysis

This study aims to explore the comparative efficacy and acceptability of psychotherapies, pharmacotherapies, and their combinations for insomnia. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and ClinicalTrials.gov were searched for randomized clinical trials (RCTs) examining the comparative efficacy in which a psychotherapy and a pharmacotherapy for insomnia were directly compared with each other, or in which a combination of psychotherapy and pharmacotherapy was compared with either alone. The analysis included data from 23 RCTs. In 18 of 23 studies, cognitive behavior therapy for insomnia (CBT-I) was the psychotherapy. At post-treatment, CBT-I showed higher subjective sleep efficiency (SE), and lower subjective wake time after sleep onset (WASO) and insomnia severity index (ISI) score. Compared with CBT-I plus pharmacotherapy, pharmacotherapy showed lower subjective SE, and higher subjective sleep latency (SL), PSG measured SL, subjective WASO, and ISI score. Overall, the findings derived from post-treatment data suggested that CBT-I is more beneficial in treating insomnia compared with pharmacotherapy. CBT-I combined with pharmacotherapy is beneficial in improving some sleep parameters (i.e., subjective SE, SL, WASO, and PSG measured SL) compared with pharmacotherapy alone. Daily clinical decisions should consider these findings on the relative efficacy of the principal approaches to insomnia treatment.

Hyperarousal Scale: Italian Cultural Validation, Age and Gender Differences in a Nonclinical Population

Objectives. Studies on hyperarousal have increasingly developed in the last decade. Nevertheless, there are still very few valid measures of hyperarousal. The aim of the study is to verify the psychometric properties of the Italian version of the Hyperarousal Scale (H-Scale), in order to provide researchers with a valid measure for the target population. Method. The questionnaire was translated, back-translated, pre-tested, and cross-culturally adapted. Subsequently, the Italian version of the H-Scale, the Anxiety Sensitivity Index (ASI-3) and the Health Survey Questionnaire (SF-36) were administered to 982 adults, 456 males and 526 females, aged from 18 to 80 years (M = 35.61 ± 12.47). Results. Cronbach’s alpha of the translated H-Scale was 0.81. Furthermore, positive correlations with the ASI-3 and negative correlations with the SF-36 emerged. The H-Scale is also sensitive to catch age and gender differences. Conclusions. The Italian version of the H-Scale demonstrated good reliability and validity. Its sufficient discriminative and evaluative psychometric properties provide the theoretical evidence for further application in evidence-based research studies.