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Record W4403117503 · doi:10.1016/j.sleep.2024.09.038

Delphi consensus recommendations for the management of chronic insomnia in Canada

2024· article· en· W4403117503 on OpenAlexaffabout
Charles M. Morin, Atul Khullar, Rébecca Robillard, Alex Désautels, Michael Mak, Thien Thanh Dang‐Vu, W.H. Chow, Jeff Habert, Serge Lessard, Lemore Alima, Najib Ayas, James MacFarlane, Tetyana Kendzerska, Elliott K. Lee, Colleen E. Carney

Bibliographic record

VenueSleep Medicine · 2024
Typearticle
Languageen
FieldPsychology
TopicSleep and related disorders
Canadian institutionsRoyal Ottawa Mental Health CentreUniversity of British ColumbiaUniversity of TorontoOttawa HospitalInstitut Universitaire de Gériatrie de MontréalCentre for Addiction and Mental HealthUniversité LavalUniversity of AlbertaUniversité de MontréalConcordia UniversityHôpital du Sacré-Cœur de MontréalUniversity of Ottawa
Fundersnot available
KeywordsChronic insomniaDelphiInsomniaDelphi methodMedicinePsychologyPolitical sciencePsychiatryComputer scienceMathematicsStatisticsSleep disorder

Abstract

fetched live from OpenAlex

The lack of current Canadian practice guidelines for the management of insomnia poses a challenge for healthcare providers (HCP) in selecting the appropriate treatment options. This study aimed to establish expert consensus recommendations for the management of chronic insomnia in Canada. Sixteen multidisciplinary experts in sleep medicine and insomnia across Canada developed consensus recommendations based on their knowledge of the literature and their practical experience. The consensus recommendations were developed through a Delphi method. Consensus was reached if at least 75 % of the voting participants “agreed” or “strongly agreed” with the corresponding statements. The quality of supporting evidence was rated using a GRADE rating system. Among 37 recommendations that reached consensus for the management of chronic insomnia, the experts recommend and agree that. These consensus recommendations highlight the need to increase awareness, capacity for, and access to CBT-I; integrate newly approved pharmacotherapy; reduce both self-medication and medications with limited evidence or low risk/benefit ratio. •Despite the availability of different therapies for managing chronic insomnia, more evidence-based guidance is needed to help healthcare providers select the most suitable interventions, especially with the recent approval of new treatments. • Based on the review of evidence, experts reached a consensus on recommendations that (1) reinforce the role of Cognitive-Behavioural Therapy for Insomnia as a first-line treatment; (2) assist healthcare providers in effectively integrating the newly approved medication therapies in their treatment decisions; and (3) emphasize the importance of exercising caution when prescribing medications for which the evidence is limited or the risk/benefit low.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.863
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.024
GPT teacher head0.319
Teacher spread0.295 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations16
Published2024
Admission routes2
Has abstractyes

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