Alternative remedies for insomnia: a proposed method for personalized therapeutic trials

DSpace/Manakin Repository

Alternative remedies for insomnia: a proposed method for personalized therapeutic trials

Citable link to this page

 

 
Title: Alternative remedies for insomnia: a proposed method for personalized therapeutic trials
Author: Romero, Kate; Goparaju, Balaji; Russo, Kathryn; Westover, M Brandon; Bianchi, Matt T

Note: Order does not necessarily reflect citation order of authors.

Citation: Romero, Kate, Balaji Goparaju, Kathryn Russo, M Brandon Westover, and Matt T Bianchi. 2017. “Alternative remedies for insomnia: a proposed method for personalized therapeutic trials.” Nature and Science of Sleep 9 (1): 97-108. doi:10.2147/NSS.S128095. http://dx.doi.org/10.2147/NSS.S128095.
Full Text & Related Files:
Abstract: Insomnia is a common symptom, with chronic insomnia being diagnosed in 5–10% of adults. Although many insomnia patients use prescription therapy for insomnia, the health benefits remain uncertain and adverse risks remain a concern. While similar effectiveness and risk concerns exist for herbal remedies, many individuals turn to such alternatives to prescriptions for insomnia. Like prescription hypnotics, herbal remedies that have undergone clinical testing often show subjective sleep improvements that exceed objective measures, which may relate to interindividual heterogeneity and/or placebo effects. Response heterogeneity can undermine traditional randomized trial approaches, which in some fields has prompted a shift toward stratified trials based on genotype or phenotype, or the so-called n-of-1 method of testing placebo versus active drug in within-person alternating blocks. We reviewed six independent compendiums of herbal agents to assemble a group of over 70 reported to benefit sleep. To bridge the gap between the unfeasible expectation of formal evidence in this space and the reality of common self-medication by those with insomnia, we propose a method for guided self-testing that overcomes certain operational barriers related to inter- and intraindividual sources of phenotypic variability. Patient-chosen outcomes drive a general statistical model that allows personalized self-assessment that can augment the open-label nature of routine practice. The potential advantages of this method include flexibility to implement for other (nonherbal) insomnia interventions.
Published Version: doi:10.2147/NSS.S128095
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364017/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:32072051
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)

 
 

Search DASH


Advanced Search
 
 

Submitters