European guideline for the diagnosis and treatment of insomnia

This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The target audience for this guideline includes all clinicians involved in the management of insomnia, and the target patient population includes adults with chronic insomnia disorder. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the evidence and guide recommendations. The diagnostic procedure for insomnia, and its co-morbidities, should include a clinical interview consisting of a sleep history (sleep habits, sleep environment, work schedules, circadian factors), the use of sleep questionnaires and sleep diaries, questions about somatic and mental health, a physical examination and additional measures if indicated (i.e. blood tests, electrocardiogram, electroencephalogram; strong recommendation, moderate- to high-quality evidence). Polysomnography can be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders), in treatment-resistant insomnia, for professional at-risk populations and when substantial sleep state misperception is suspected (strong recommendation, high-quality evidence). Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence). A pharmacological intervention can be offered if cognitive behavioural therapy for insomnia is not sufficiently effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective in the short-term treatment of insomnia (≤4 weeks; weak recommendation, moderate-quality evidence). Antihistamines, antipsychotics, melatonin and phytotherapeutics are not recommended for insomnia treatment (strong to weak recommendations, low- to very-low-quality evidence). Light therapy and exercise need to be further evaluated to judge their usefulness in the treatment of insomnia (weak recommendation, low-quality evidence). Complementary and alternative treatments (e.g. homeopathy, acupuncture) are not recommended for insomnia treatment (weak recommendation, very-low-quality evidence).

Vibrationally inelastic scattering of high- n Rydberg H atoms from N2 and O2.

The vibrationally inelastic scattering of Rydberg H atoms (n = 30-50) from N2 and O2 at E(coll) = 1.84 eV was studied as a function of laboratory deflection angle. On average, 4 times more vibrational excitation was observed in collisions with O2 than with N2. Vibrational excitation of O2 results largely from collisions in which an electron is briefly transferred from O2 to the proton core, while the Rydberg electron remains a spectator. This provides further evidence that the free electron model applies to low energy collisions involving the ionic core leading to substantial momentum transfer.

Mode-specific energy disposal in the four-atom reaction OH + D2 --> HOD + D.

Experiments, employing crossed molecular beams, with vibrational state resolution have been performed on the simplest four-atom reaction, OH + D2 --> HOD + D. In good agreement with the most recent quantum scattering predictions, mode-specific reaction dynamics is observed, with vibration in the newly formed oxygen-deuterium bond preferentially excited to v = 2. This demonstrates that quantum theoretical calculations, which in the past decade have achieved remarkable accuracy for three-atom reactions involving three dimensions, have progressed to the point where it is now possible to accurately predict energy disposal in four-atom reactions involving six dimensions.