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El reto del insomnio crónico: ¿es el tratamiento hipnótico discontinuo una opción’ viable?
Published online by Cambridge University Press: 12 May 2020
Resumen
Los efectos adversos del insomnio sobre la salud y la calidad de vida son asuntos que reciben una atención cada vez mayor. Sin embargo, los estudios han mostrado uniformemente que la mayoría de las personas que sufren de insomnio no buscan ayuda médica, quizá, en parte, a causa de una preocupación por volverse dependientes de la medicación hipnótica. El tratamiento del insomnio crónico plantea un dilema particular, ya que el tratamiento hipnótico continuo está limitado en muchos países a un máximo de cuatro semanas, y no es fácil disponer de tratamiento conductual. El tratamiento hipnótico discontinuo del insomnio crónico ofrece una opción distinta prometedora para los numerosos pacientes cuyos síntomas no requieren el consumo de fármacos todas las noches, aliviando los temores de dependencia psicológica de la medicación y respetando los límites regulatorios sobre el uso de hipnóticos al tiempo que proporciona a los pacientes alivio adecuado de los síntomas. La viabilidad práctica y la eficacia de este enfoque se han demostrado con zolpidem, utilizando diversos regímenes de tratamiento y diseños de estudio. Hasta ahora, se han finalizado seis ensayos clínicos en más de 4.000 pacientes. Los resultados publicados muestran que el tratamiento del insomnio es efectivo, sin datos de asociación de acontecimientos adversos con un régimen discontinuo o de aumento de uso del hipnótico durante el periodo de tratamiento.
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