Aten Primaria. 2015 Jun-Jul;47(6):351-8. doi: 10.1016/j.aprim.2014.07.009. Epub 2014 Oct 28.
[Abordaje integrativo del insomnio en
atención primaria: medidas no farmacológicas y fitoterapia frente al
tratamiento convencional].
[Article in Spanish]
- a Médico
especialista en Medicina Familiar y Comunitaria, Tutora docente de
residentes en Medicina Familiar y Comunitaria, CAP María Bernades,
Viladecans, Barcelona, España
- b Especialista en Salud Pública, Técnico de salud en DAP Costa de Ponent, L’Hospitalet de Llobregat, Barcelona, España
- c Médico
especialista en Medicina Familiar y Comunitaria, Residente de Medicina
de Familia entre 2009 y 2013, CAP María Bernades, Viladecans, Barcelona,
España
- d Médico
especialista en Medicina Familiar y Comunitaria, ABS Sant Climent de
Llobregat, Sant Climent de Llobregat, Barcelona, España
- Received 28 February 2014, Accepted 25 July 2014, Available online 27 October 2014
Abstract
INTRODUCTION:
Insomnia
is a sleep disorder in which there is an inability to fall asleep or to
stay asleep. At some point in life, 50% of adults suffer from it,
usually in stress situations.
AIM:
To evaluate the impact of sleep hygiene measures, relaxations techniques, and herbal medicine to deal with insomnia, compared with standard measures (drug treatment).
METHODOLOGY:
An experimental, retrospective, non-randomized study was conducted by means of a review of patients diagnosed with insomnia (2008-2010). Patients in the intervention group (IG) received an integrative approach (hygiene measures, relaxation techniques, and herbal medicine) and a control group (CG) with conventional treatment.
A comparison was made of the resources used in the two groups (average
monthly visits pre- and post-diagnosis), type of prescribed drug therapy
and total dose. Sleep quality was evaluated at 18-24 months (Epworth
test).
RESULTS:
A
total of 48 patients were included in the IG and 47 in the CG (70%
women, mean age 46 years (SD: 14.3). Average monthly visit pre-diagnosis
was 0.54 (SD: 0.42) in the IG and 0.53 (SD: 0.53) in the CG (P=.88).
Post-diagnosis it was 0.36 (SD: 0.24) and 0.65 (SD: 0.46), respectively
(P<.0001), with a statistically significant reduction being observed
in the IG. More than half (52.5%) of the IG patients and 93.6% in the CG
had received a benzodiazepine (P<.0001). Alprazolam and lorazepam
were the most prescribed in the CG and with higher cumulative dose. In
the subsequent evaluation, 17% of patients in the IG and 5% in CG did
not have insomnia. Severe insomnia was present in 13% of patients in the IG and none in CG (P<.0001).
CONCLUSIONS:
The integrative approach to insomnia may be worthwhile as it reduces resource use and side effects, as well as dependence to benzodiazepines.
Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
KEYWORDS:
Benzodiacepinas; Benzodiazepines; Fitoterapia; Insomnia; Insomnio; Integrative medicine; Medicina integrativa; Phytotherapy
