THE WORLD JOURNAL OF BIOLOGICAL PSYCHIATRYTaylor Francishtp5/doi.org/10.1080/15622975.2023.2171479REVIEW ARTICLEOPEN ACCESS價Check for updatesThe potential of biomarkers for diagnosing insomnia:Consensus statementof the WFSBP Task Force on Sleep DisordersDimitris Dikeosa,Adam WichniakD,Periklis Y.Ktonas,Thorsten Mikoteit,Tatjana Cronleine,Anne Eckert Jana KoprivovashD,Maria Ntafoulia,Kai Spiegelhalder',Martin Hatzingerd,Dieter Riemann'and Constantin SoldatosFirst Department of Psychiatry,Eginition Hospital,Medical School,National and Kapodistrian University of Athens,Athens,Greece;Third Department of Psychiatry,Sleep Medicine Center,Institute of Psychiatry and Neurology,Warsaw,Poland;Department ofElectrical and Computer Engineering,University of Houston,Houston,TX,USA;Psychiatric Services Solothurn,Faculty of Medicine,University of Basel,Solothurn,Switzerland;Department of Psychiatry and Psychotherapy,University of Regensburg,Regensburg,Germany;'Neurobiology Lab for Brain Aging and Mental Health,Transfaculty Research Platform Molecular Cognitive Neuroscience(MCN),University of Basel,Basel,Switzerland;9National Institute of Mental Health,Klecany,Czechia;Third Faculty of Medicine,Charles University,Prague,Czechia;'Department of Psychiatry and Psychotherapy,Faculty of Medicine,Medical Centre,University ofFreiburg,Freiburg,GermanyABSTRACTARTICLE HISTORYObjectives:Thus far,the diagnosis of insomnia is based on purely clinical criteria.Although aReceived 21 October 2022broad range of altered physiological parameters has been identified in insomniacs,the evidenceRevised 30 December 2022to establish their diagnostic usefulness is very limited.Purpose of this WFSBP Task Force consen-Accepted 17 January 2023sus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools forinsomnia.KEYWORDSInsomnia;biomarkers;Methods:A newly created grading system was used for assessing the validity of various meas-psychometrics;diagnosticurements in establishing the diagnosis of insomnia;these measurements originated from rele-accuracy;grading systemvant studies selected and reviewed by experts.Results:The measurements with the highest diagnostic performance were those derived frompsychometric instruments.Biological measurements which emerged as potentially useful diag-nostic instruments were polysomnography-derived cyclic alternating pattern,actigraphy,andBDNF levels,followed by heart rate around sleep onset,deficient melatonin rhythm,and certainneuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex,hippocampusand basal ganglia);yet,these findings need replication,as well as establishment of commonlyaccepted methodology and diagnostic cut-off points.Routine polysomnography,EEG spectralanalysis,heart rate variability,skin conductance,thermoregulation,oxygen consumption,HPAaxis,and inflammation indices were not shown to be of satisfactory diagnostic value.Conclusions:Apart from psychometric instruments which are confirm
