Artículos de revisión/actualización
Intervenciones no farmacológicas en el insomnio primario: la evidencia de los ensayos clínicos controlados en los últimos diez años (1998–2008)
Non-pharmacological Interventions in Primary Insomnia: Controlled Clinical Trial Findings (1998–2008)
Silvia Aracely Tafoya Ramos1,
, María del Carmen Lara Muñoz2
Autor para correspondencia
psiquiatria_unam@yahoo.com.mx
Correspondencia: Silvia Aracely Tafoya Ramos, Departamento de Psiquiatría y Salud Mental, Circuito Interior S/N, Edificio F de la Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, México D. F. Código postal 04510
Correspondencia: Silvia Aracely Tafoya Ramos, Departamento de Psiquiatría y Salud Mental, Circuito Interior S/N, Edificio F de la Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, México D. F. Código postal 04510
1 Maestra en Psicología. Departamento de Psiquiatría y Salud Mental de la Facultad de Medicina, Universidad Nacional Autónoma de México
2 Doctora en Ciencias Médicas. Departamento de Psiquiatría y Salud Mental de la Universidad Nacional Autónoma de México, y Facultad de Medicina de la Benemérita Universidad Autónoma de Puebla, México
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Departamento de Psiquiatría y Salud Mental de la Facultad de Medicina, Universidad Nacional Autónoma de México" "etiqueta" => "1" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Doctora en Ciencias Médicas. Departamento de Psiquiatría y Salud Mental de la Universidad Nacional Autónoma de México, y Facultad de Medicina de la Benemérita Universidad Autónoma de Puebla, México" "etiqueta" => "2" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondencia: Silvia Aracely Tafoya Ramos, Departamento de Psiquiatría y Salud Mental, Circuito Interior S/N, Edificio F de la Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, México D. F. Código postal 04510" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Non-pharmacological Interventions in Primary Insomnia: Controlled Clinical Trial Findings (1998–2008)" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-02-06" "fechaAceptado" => "2011-04-20" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec333677" "palabras" => array:3 [ 0 => "Insomnio" 1 => "revisión" 2 => "intervención no farmacológica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec333678" "palabras" => array:3 [ 0 => "Primary" 1 => "review" 2 => "non-pharmacological intervention" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="cestitle20">Introducción</span><p id="spara10" class="elsevierStyleSimplePara elsevierViewall">El insomnio es un trastorno del sueño que afecta al 10% de la población general e impacta a quien lo padece emocional, física y socialmente, por lo que es importante su adecuado diagnóstico y tratamiento.</p> <span class="elsevierStyleSectionTitle" id="cestitle30">Objetivo</span><p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Describir los principales hallazgos de las intervenciones no farmacológicas sobre insomnio primario según la metodología de ensayos clínicos controlados.</p> <span class="elsevierStyleSectionTitle" id="cestitle40">Método</span><p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Revisión sistemática durante febrero del 2009 en la base de datos de Ensayos Clínicos Controlados de Cochrane. Se seleccionaron artículos escritos en inglés, portugués o español publicados entre 1998 y 2008. Las palabras clave utilizadas fueron: <span class="elsevierStyleItalic">primary insomnia, management, treatment y nonpharmacological.</span> Se descartaron artículos sobre insomnio secundario, con sólo resultados preliminares y aquellos escritos en idioma diferente a los establecidos. Al final se analizaron 37 artículos.</p> <span class="elsevierStyleSectionTitle" id="cestitle50">Resultados</span><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">La modalidad de intervención más usada fue la combinación de técnicas cognitivo-conductuales (TCC). De manera general, todas las intervenciones tuvieron resultados positivos en la calidad del sueño. Las mejorías fueron de moderadas a altas y se mantuvieron a través del seguimiento. Según lo obtenido, el mejor tratamiento para el insomnio es la TCC, aunque otras opciones, como la máscara de luz, presentan resultados alentadores.</p> <span class="elsevierStyleSectionTitle" id="cestitle60">Conclusiones</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Hay hallazgos ciertos sobre los beneficios de las intervenciones no farmacológicas en el insomnio primario, con más estudios referentes a la TCC. Se plantea la necesidad de realizar estudios que evalúen dosis respuesta y la costo-efectividad de estas intervenciones.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="cestitle80">Introduction</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">Insomnia is the most common sleep disorder and it affects approximately 10% of the world's population causing a negative impact on sufferers' emotional, physical, and social wellbeing. Several non–pharmacological treatments have been developed that appear to be effective.</p> <span class="elsevierStyleSectionTitle" id="cestitle90">Objective</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">To analyze the main findings on primary insomnia. Methodology: During February 2009, a systematic review was undertaken using the Cochrane Database of Controlled Clinical Trials. A selection was made of articles written in English, Portuguese, and Spanish published between 1998 and 2008. The key words used were: <span class="elsevierStyleItalic">primary insomnia, management, treatment and non–pharmacological.</span> An analysis was carried out on 37 articles.</p> <span class="elsevierStyleSectionTitle" id="cestitle100">Results</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">In general, all interventions had positive effects on the quality of sleep. With most of the combined techniques, the improvements were moderate–to–high and they were maintained through follow-up. According to the evidence gathered, the best non–pharmacological treatment was Cognitive Behavioral Therapy (CBT) although other intervention options such as Light Exposure produced encouraging results. The non–pharmacological approach gave better long–term results than pharmacological treatments.</p> <span class="elsevierStyleSectionTitle" id="cestitle110">Conclusions</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">There is evidence of the benefits of non–pharmacological interventions for primary insomnia. Further research is necessary to evaluate the dose–response ratio and the cost–effectiveness of treatments.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">Conflictos de interés: las autoras manifiestan que no tienen conflictos de interés en este artículo.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:61 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "American Academy of Sleep Medicine (AASM)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "2ed" "titulo" => "International classification of sleep disorders: Diagnostic and coding manual" "fecha" => "2005" "editorial" => "AASM" "editorialLocalizacion" => 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 1 | 1 | 2 |
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| 2023 Diciembre | 0 | 9 | 9 |
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| 2023 Octubre | 2 | 12 | 14 |
| 2023 Septiembre | 2 | 5 | 7 |
| 2023 Agosto | 0 | 1 | 1 |
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| 2023 Junio | 1 | 4 | 5 |
| 2023 Mayo | 3 | 1 | 4 |
| 2023 Abril | 0 | 6 | 6 |
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| 2023 Febrero | 2 | 3 | 5 |
| 2023 Enero | 0 | 4 | 4 |
| 2022 Diciembre | 2 | 5 | 7 |
| 2022 Noviembre | 4 | 3 | 7 |
| 2022 Octubre | 1 | 3 | 4 |
| 2022 Septiembre | 1 | 6 | 7 |
| 2022 Agosto | 1 | 8 | 9 |
| 2022 Julio | 1 | 8 | 9 |
| 2022 Junio | 0 | 13 | 13 |
| 2022 Mayo | 0 | 5 | 5 |
| 2022 Abril | 3 | 20 | 23 |
| 2022 Marzo | 0 | 11 | 11 |
| 2022 Febrero | 0 | 17 | 17 |
| 2022 Enero | 1 | 9 | 10 |
| 2021 Diciembre | 0 | 14 | 14 |
| 2021 Noviembre | 0 | 9 | 9 |
| 2021 Octubre | 3 | 14 | 17 |
| 2021 Septiembre | 0 | 6 | 6 |
| 2021 Agosto | 0 | 5 | 5 |
| 2021 Julio | 0 | 10 | 10 |
| 2021 Junio | 2 | 7 | 9 |
| 2021 Mayo | 1 | 5 | 6 |
| 2021 Abril | 0 | 7 | 7 |
| 2021 Marzo | 2 | 9 | 11 |
| 2021 Febrero | 0 | 5 | 5 |
| 2021 Enero | 0 | 7 | 7 |
| 2020 Diciembre | 0 | 6 | 6 |
| 2020 Noviembre | 1 | 7 | 8 |
| 2020 Octubre | 0 | 6 | 6 |
| 2020 Septiembre | 3 | 10 | 13 |
| 2020 Agosto | 0 | 6 | 6 |
| 2020 Julio | 0 | 5 | 5 |
| 2020 Junio | 1 | 2 | 3 |
| 2020 Mayo | 0 | 11 | 11 |
| 2020 Abril | 1 | 4 | 5 |
| 2020 Marzo | 1 | 9 | 10 |
| 2020 Febrero | 2 | 4 | 6 |
| 2020 Enero | 0 | 9 | 9 |
| 2019 Diciembre | 3 | 13 | 16 |
| 2019 Noviembre | 3 | 3 | 6 |
| 2019 Octubre | 2 | 8 | 10 |
| 2019 Septiembre | 8 | 11 | 19 |
| 2019 Agosto | 4 | 3 | 7 |
| 2019 Julio | 5 | 18 | 23 |
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| 2019 Mayo | 53 | 41 | 94 |
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| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 5 | 6 | 11 |
| 2018 Noviembre | 8 | 7 | 15 |
| 2018 Octubre | 7 | 12 | 19 |
| 2018 Septiembre | 2 | 11 | 13 |
| 2018 Agosto | 2 | 16 | 18 |
| 2018 Julio | 3 | 5 | 8 |
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| 2018 Mayo | 4 | 8 | 12 |
| 2018 Abril | 3 | 14 | 17 |
| 2018 Marzo | 0 | 1 | 1 |
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| 2018 Enero | 0 | 1 | 1 |
| 2017 Diciembre | 2 | 4 | 6 |
| 2017 Noviembre | 4 | 5 | 9 |
| 2017 Octubre | 3 | 6 | 9 |
| 2017 Septiembre | 7 | 7 | 14 |
| 2017 Agosto | 2 | 3 | 5 |
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| 2017 Marzo | 3 | 28 | 31 |
| 2017 Febrero | 1 | 3 | 4 |
| 2017 Enero | 0 | 2 | 2 |
| 2016 Diciembre | 0 | 7 | 7 |
| 2016 Noviembre | 2 | 9 | 11 |
| 2016 Octubre | 4 | 3 | 7 |
| 2016 Septiembre | 5 | 6 | 11 |
| 2016 Agosto | 2 | 19 | 21 |
| 2016 Julio | 3 | 6 | 9 |
| 2016 Junio | 3 | 4 | 7 |
| 2016 Mayo | 8 | 17 | 25 |
| 2016 Abril | 3 | 6 | 9 |
| 2016 Marzo | 6 | 10 | 16 |
| 2016 Febrero | 3 | 9 | 12 |
| 2016 Enero | 4 | 14 | 18 |
| 2015 Diciembre | 13 | 7 | 20 |
| 2015 Noviembre | 9 | 10 | 19 |
| 2015 Octubre | 8 | 4 | 12 |
| 2015 Septiembre | 6 | 8 | 14 |
| 2015 Agosto | 4 | 7 | 11 |
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| 2015 Junio | 2 | 2 | 4 |
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| 2015 Marzo | 2 | 2 | 4 |
| 2015 Febrero | 3 | 5 | 8 |
| 2015 Enero | 1 | 1 | 2 |
| 2014 Diciembre | 2 | 2 | 4 |
| 2014 Noviembre | 2 | 4 | 6 |
| 2014 Octubre | 0 | 2 | 2 |
| 2014 Septiembre | 1 | 0 | 1 |
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