<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2022000300035</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.458</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Tratamento da Insónia no Doente Idoso Hospitalizado]]></article-title>
<article-title xml:lang="en"><![CDATA[Management of Insomnia in Hospitalized Elderly Patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Távora]]></surname>
<given-names><![CDATA[Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paiva]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pulido Valente Centro Hospitalar e Universitário de Lisboa Norte Serviço de Medicina III]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade de Lisboa Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidade de Lisboa Instituto de Saúde Ambiental - Faculdade de Medicina Sleep and Medicine Center (CENC), Comprehensive Health Research Center (CHRC)]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2022</year>
</pub-date>
<volume>29</volume>
<numero>3</numero>
<fpage>35</fpage>
<lpage>40</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2022000300035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2022000300035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2022000300035&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Existem múltiplos fatores que podem contribuir para uma má qualidade de sono no doente idoso hospitalizado. Os clínicos têm à disposição várias intervenções não farmacológicas e farmacológicas. O presente artigo pretende fazer uma revisão narrativa das diferentes opções terapêuticas. No tratamento da insónia do doente idoso hospitalizado deve ser dada primazia às medidas não farmacológicas que irão melhorar a qualidade do sono e consequentemente melhorar o bem-estar e a sua recuperação. Algumas medidas podem ser aplicadas durante o dia sendo disso exemplo minimizar sestas diurnas, prevenir e tratar delirium bem como pesquisar e tratar doenças do sono que não estejam diagnosticadas. Relativamente às medidas farmacológicas, mais do que salientar os fármacos com menos efeitos prejudiciais, pretendemos reforçar a evicção de alguns fármacos, pelos seus efeitos adversos e impacto nas outras comorbilidades destes doentes, como as benzodiazepinas com semivida longa e os anti-histamínicos. Outros fármacos a considerar na prática clínica são os não-benzodiazepinicos como o zolpidem e antidepressivos com efeito sedativo como a mirtazapina e a trazodona.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract There are several factors that can contribute to poor sleep quality in hospitalized elderly patients. Clinicians have a variety of non-pharmacological and pharmacological in-terventions available. This article aims to review the different therapeutic options. In the treatment of insomnia in hospitalized elderly patients, priority should be given to non-pharmacological mea-sures that will improve sleep quality and improve well-being and health recovery. Some measures can be applied during the day, such as minimizing daytime naps, preventing and treating delirium as well as looking for and treat undiagnosed sleeping disorders. Regarding the pharmacological measures, more than emphasize the less harmful medicines, we intend to reinforce medicines to be avoided due to side effects and impact on patients&#8217; comorbidities, like benzodiazepines with a long half-life and antihistamines. Other drugs to consider in clinical practice are non-benzodiazepine drugs such as zolpidem and antidepressants with sedative effects such as mirtazapine and trazodone.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Distúrbios do Início e da Manutenção do Sono]]></kwd>
<kwd lng="pt"><![CDATA[Hospitalização]]></kwd>
<kwd lng="pt"><![CDATA[Idoso.]]></kwd>
<kwd lng="en"><![CDATA[Aged]]></kwd>
<kwd lng="en"><![CDATA[Hospitalization]]></kwd>
<kwd lng="en"><![CDATA[Sleep Initiation and Maintenance Disorders.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berlin]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of insomnia in hospitalized patients]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>1984</year>
<volume>100</volume>
<page-range>398-404</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meissner]]></surname>
<given-names><![CDATA[HH]]></given-names>
</name>
<name>
<surname><![CDATA[Riemer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Santiago]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Goldman]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Failure of physician documentation of sleep complaints in hospitalized patients]]></article-title>
<source><![CDATA[West J Med]]></source>
<year>1998</year>
<volume>169</volume>
<page-range>146-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Isaia]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Corsinovi]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia among hospitalized elderly pa-tients Prevalence, clinical characteristics and risk factors]]></article-title>
<source><![CDATA[Arch Gerontol Geriatr]]></source>
<year>2011</year>
<volume>52</volume>
<page-range>133-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reis]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Santos-Pereira]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Michelis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Aimonino]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sleep duration, lifestyles and chronic diseases A cross-sectional population-based study]]></article-title>
<source><![CDATA[Sleep Sci]]></source>
<year>2018</year>
<volume>11</volume>
<page-range>217-30</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Riemann]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Baglioni]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bassetti]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bjorvatn]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Dolenc Groselj]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ellis]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European guideline for the diagnosis and treatment of insomnia]]></article-title>
<source><![CDATA[J Sleep Res]]></source>
<year>2017</year>
<volume>26</volume>
<page-range>675-700</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flaherty]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia Among Hospitalized Older Persons]]></article-title>
<source><![CDATA[Clin Geriatr Med]]></source>
<year>2008</year>
<volume>24</volume>
<page-range>51-67</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hshieh]]></surname>
<given-names><![CDATA[TT]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Gartaganis]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Yue]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Inouye]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hospital Elder Life Program Systematic Review and Meta-analysis of Effectiveness]]></article-title>
<source><![CDATA[Am J Ge-riatr Psychiatry]]></source>
<year>2018</year>
<volume>26</volume>
<page-range>1015-33</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lenhart]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Buysse]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of insomnia in hospitalized patients]]></article-title>
<source><![CDATA[Ann Pharmacother]]></source>
<year>2001</year>
<volume>35</volume>
<page-range>1449-57</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koski]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of Insomnia in Hospitalized Patients]]></article-title>
<source><![CDATA[US Pharm]]></source>
<year>2011</year>
<volume>36</volume>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Riemann]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Baglioni]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bassetti]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bjorvatn]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Dolenc Groselj]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ellis]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European guideline for the diagnosis and treatment of insomnia]]></article-title>
<source><![CDATA[J Sleep Res]]></source>
<year>2017</year>
<volume>26</volume>
<page-range>675-700</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Woodward]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypnosedatives in the Elderly]]></article-title>
<source><![CDATA[CNS Drugs]]></source>
<year>1999</year>
<volume>11</volume>
<page-range>263-79</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grunstein]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia Diagnosis and management]]></article-title>
<source><![CDATA[Aust Fam Physician]]></source>
<year>2002</year>
<volume>31</volume>
<page-range>995-1000</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kamel]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
<name>
<surname><![CDATA[Gammack]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia in the Elderly Cause, Approa-ch, and Treatment]]></article-title>
<source><![CDATA[Am J Med]]></source>
<year>2006</year>
<volume>119</volume>
<page-range>463-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laugsand]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Strand]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Platou]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Vatten]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Janszky]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia and the risk of incident heart failure A population study]]></article-title>
<source><![CDATA[Eur Heart J]]></source>
<year>2014</year>
<volume>35</volume>
<page-range>1382-93</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<collab>Direção Geral da Saúde</collab>
<source><![CDATA[Norma - tratamento sintomático da ansiedade e insónia com benzodiazepinas e fármacos análogos. Número 055/2011]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[DGS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiaro]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Castelnovo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bianco]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Maffei]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Manconi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe Chro-nic Abuse of Zolpidem in Refractory Insomnia]]></article-title>
<source><![CDATA[J Clin Sleep Med]]></source>
<year>2018</year>
<volume>14</volume>
<page-range>1257-9</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sateia]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Buysse]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Krystal]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Neubauer]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Heald]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical Prac-tice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults An American Academy of Sleep Medicine Clinical Practice Guideline]]></article-title>
<source><![CDATA[J Clin Sleep Med]]></source>
<year>2017</year>
<volume>13</volume>
<page-range>307-49</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Steinberg]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia in the Elderly A Review]]></article-title>
<source><![CDATA[J Clin Sleep Med]]></source>
<year>2018</year>
<volume>14</volume>
<page-range>1017-24</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="">
<collab>Infarmed</collab>
<source><![CDATA[Circular Informativa N.o 111/CD/8.1.7. Zolpidem - Conclusão Da Revisão de Segurança]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dolder]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypnosedative-induced complex behaviours in-cidence, mechanisms and management]]></article-title>
<source><![CDATA[CNS Drugs]]></source>
<year>2008</year>
<volume>22</volume>
<page-range>1021-36</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stranks]]></surname>
<given-names><![CDATA[EK]]></given-names>
</name>
<name>
<surname><![CDATA[Crowe]]></surname>
<given-names><![CDATA[SF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The acute cognitive effects of zopiclone, zolpidem, zaleplon, and eszopiclone a systematic review and meta-analysis]]></article-title>
<source><![CDATA[J Clin Exp Neuropsychol]]></source>
<year>2014</year>
<volume>36</volume>
<page-range>691-700</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tom]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Wickwire]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Albrecht]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nonbenzodiazepine seda-tive hypnotics and risk of fall-related injury]]></article-title>
<source><![CDATA[Sleep]]></source>
<year>2016</year>
<volume>39</volume>
<page-range>1009-14</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sun]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hsu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kao]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association Between Zolpidem and Suicide A Nationwide Population-Based Case-Control Study]]></article-title>
<source><![CDATA[Mayo Clin Proc]]></source>
<year>2015</year>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kripke]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Langer]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Kline]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypnotics' association with mortality or cancer: A matched cohort study.]]></article-title>
<source><![CDATA[BMJ Open]]></source>
<year>2012</year>
<volume>2</volume>
</nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Bourgeois]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Hilty]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Hardin]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sleep in hospitalized medi-cal patients, Part 2 Behavioral and pharmacological management of sleep disturbances]]></article-title>
<source><![CDATA[J Hosp Med]]></source>
<year>2009</year>
<volume>4</volume>
<page-range>50-9</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jaffer]]></surname>
<given-names><![CDATA[KY]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Vanle]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Dang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Steiner]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Loera]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trazodone for Insomnia A Systematic Review]]></article-title>
<source><![CDATA[Innov Clin Neurosci]]></source>
<year>2017</year>
<volume>14</volume>
<page-range>24-34</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Leonard]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Karlamangla]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dose-Dependent Sedating and Stimulating Effects of Mirtazapine.]]></article-title>
<source><![CDATA[Proc UCLA Heal]]></source>
<year>2015</year>
<volume>19</volume>
</nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Altinyazar]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Kiylioglu]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insomnia and dementia is agomelatine treatment helpful? Case report and review of the literature]]></article-title>
<source><![CDATA[Ther Adv Psychopharma-col]]></source>
<year>2016</year>
<volume>6</volume>
<page-range>263-8</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="">
<collab>Infarmed</collab>
<source><![CDATA[Circular Informativa N.o 211/CD/8.1.7. Agomelatina - Recomendações de Segurança]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Auld]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Maschauer]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
<name>
<surname><![CDATA[Morrison]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Skene]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Riha]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evidence for the ef fi cacy of melatonin in the treatment of primary adult sleep disorders]]></article-title>
<source><![CDATA[Sleep Med Rev]]></source>
<year>2017</year>
<volume>34</volume>
<page-range>10-22</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="">
<collab>European Medicines Agency.</collab>
<source><![CDATA[Anexo I - Resumo das Características do Medicamento - Circardin]]></source>
<year>2012</year>
<page-range>1-29</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Snyder]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of Medications Used for Hospitalized Patients With Sleep Disturbances A Frequency Analy-sis and Literature Review]]></article-title>
<source><![CDATA[J Pharm Pract]]></source>
<year>2021</year>
<page-range>089719002110178</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Olde Rikkert]]></surname>
<given-names><![CDATA[MGM]]></given-names>
</name>
<name>
<surname><![CDATA[Rigaud]]></surname>
<given-names><![CDATA[ASP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Melatonin in elderly patients with insom-nia A systematic review]]></article-title>
<source><![CDATA[Z Gerontol Geriatr]]></source>
<year>2001</year>
<volume>34</volume>
<page-range>491-7</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schroeck]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Ford]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Conway]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Review of Safety and Effica-cy of Sleep Medicines in Older Adults]]></article-title>
<source><![CDATA[Clin Ther]]></source>
<year>2016</year>
<volume>38</volume>
<page-range>2340-72</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alves]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Macedo]]></surname>
<given-names><![CDATA[IM]]></given-names>
</name>
<name>
<surname><![CDATA[Távora]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sleep Distur-bances Management in Elderly Hospitalized Patients.]]></article-title>
<source><![CDATA[J Pharm Pract]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bromley]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Chronic Insomnia A Practical Review]]></article-title>
<source><![CDATA[Am Fam Physician]]></source>
<year>1999</year>
<volume>60</volume>
<page-range>1431-8</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Staevska]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gugutkova]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lazarova]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kralimarkova]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Dimitrov]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Zu-berbier]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Night-time sedating H1 -antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urtica-ria a randomized controlled trial]]></article-title>
<source><![CDATA[Br J Dermatol]]></source>
<year>2014</year>
<volume>171</volume>
<page-range>148-54</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hayley]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kennedy]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Holloway]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Berk]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Brennan-Ol-sen]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Excessive daytime sleepiness and falls among older men and women cross-sectional examination of a population-based sample]]></article-title>
<collab>etal</collab>
<source><![CDATA[BMC Geriatr]]></source>
<year>2015</year>
<volume>15</volume>
<page-range>74</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<collab>American Geriatrics Society 2012 Beers Criteria Update Expert Panel</collab>
<article-title xml:lang=""><![CDATA[American Geriatrics Society updated Beers Criteria for potentially inappro-priate medication use in older adults]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>2012</year>
<volume>60</volume>
<page-range>616-31</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thannickal]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[RY]]></given-names>
</name>
<name>
<surname><![CDATA[Nienhuis]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ramanathan]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Gulyani]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Aldrich]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reduced number of hypocretin neurons in human narcolepsy]]></article-title>
<source><![CDATA[Neuron]]></source>
<year>2000</year>
<volume>27</volume>
<page-range>469-74</page-range></nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Janto]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Prichard]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Pusalavidyasagar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An update on dual orexin re-ceptor antagonists and their potential role in insomnia therapeutics]]></article-title>
<source><![CDATA[J Clin Sleep Med]]></source>
<year>2018</year>
<volume>14</volume>
<page-range>1399-408</page-range></nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Herring]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
<name>
<surname><![CDATA[Snyder]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Budd]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hutzelmann]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Snavely]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Orexin receptor antagonism for treatment of insomnia a randomized clinical trial of suvorexant]]></article-title>
<source><![CDATA[Neurology]]></source>
<year>2012</year>
<volume>79</volume>
<page-range>2265-74</page-range></nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mignot]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mayleben]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fietze]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Leger]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Zammit]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bassetti]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Safety and efficacy of daridorexant in patients with insomnia disorder re-sults from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials]]></article-title>
<source><![CDATA[Lancet Neurol]]></source>
<year>2022</year>
<volume>21</volume>
<page-range>125-39</page-range></nlm-citation>
</ref>
<ref id="B44">
<label>44</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mieda]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tsujino]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Sakurai]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differential roles of orexin receptors in the regulation of sleep / wakefulness]]></article-title>
<source><![CDATA[Front Endocrinol]]></source>
<year>2013</year>
<volume>4</volume>
<page-range>57</page-range></nlm-citation>
</ref>
<ref id="B45">
<label>45</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campos]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Protocolos em Medicina interna]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Lisboa ]]></publisher-loc>
<publisher-name><![CDATA[Lidel]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
