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Sample records for reported insomnia symptoms

  1. Sleep apnea in patients reporting insomnia or restless legs symptoms.

    Science.gov (United States)

    Bianchi, M T; Goparaju, B; Moro, M

    2016-01-01

    Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles. We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire. More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk. Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. The Link of Self-Reported Insomnia Symptoms and Sleep Duration with Metabolic Syndrome: A Chinese Population-Based Study.

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    Lin, Shih-Chieh; Sun, Chien-An; You, San-Lin; Hwang, Lee-Ching; Liang, Chun-Yu; Yang, Tsan; Bai, Chyi-Huey; Chen, Chien-Hua; Wei, Cheng-Yu; Chou, Yu-Ching

    2016-06-01

    The aims of this study are to investigate the relationships of metabolic syndrome (MetS) with insomnia symptoms and sleep duration in a Chinese adult population. Data from a nationwide epidemiological survey conducted on residents from randomly selected districts in Taiwan in 2007 were used for this cross-sectional population-based study. A total of 4,197 participants were included in this study. Insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), were assessed using the Insomnia Self-Assessment Inventory questionnaire. Subjects were divided into 3 groups based upon their reported sleep duration (insomnia symptoms (OR [95% CI] was 1.54 [1.05-2.47]). However, there was no significant combined effect of insomnia symptoms and sleep duration on the prevalence of MetS. The current investigation shows that short sleep duration and insomnia symptoms, specifically DIS and DMS, were significant correlates of MetS. These findings should be replicated in prospective studies using both sleep duration and sleep quality measures. © 2016 Associated Professional Sleep Societies, LLC.

  3. The association of mothers' and fathers' insomnia symptoms with school-aged children's sleep assessed by parent report and in-home sleep-electroencephalography.

    Science.gov (United States)

    Urfer-Maurer, Natalie; Weidmann, Rebekka; Brand, Serge; Holsboer-Trachsler, Edith; Grob, Alexander; Weber, Peter; Lemola, Sakari

    2017-10-01

    Sleep plays an essential role for children's well-being. Because children's sleep is associated with parental sleep patterns, it must be considered in the family context. As a first aim of the present study, we test whether parental insomnia symptoms are related to children's in-home sleep-electroencephalography (EEG). Second, we examine the association between parental insomnia symptoms and maternal and paternal perception of children's sleep using actor-partner interdependence models. A total of 191 healthy children enrolled in public school and aged 7-12 years took part in the study. Ninety-six were formerly very preterm born children. Children underwent in-home sleep-EEG, and parents reported children's sleep-related behavior by using the German version of the Children's Sleep Habits Questionnaire. Further, parents completed the Insomnia Severity Index to report their own insomnia symptoms. Maternal but not paternal insomnia symptoms were related to less children's EEG-derived total sleep time, more stage 2 sleep, less slow wave sleep, later sleep onset time, and later awakening time. Mothers' and fathers' own insomnia symptoms were related to their reports of children's bedtime resistance, sleep duration, sleep anxiety, night wakings, and/or daytime sleepiness. Moreover, maternal insomnia symptoms were associated with paternal reports of children's bedtime resistance, sleep anxiety, and sleep-disordered breathing. The associations between parental insomnia symptoms and parents' perception of children's sleep could not be explained by children's objectively measured sleep. Mothers' insomnia symptoms and children's objective sleep patterns are associated. Moreover, the parents' own insomnia symptoms might bias their perception of children's sleep-related behavior problems. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Trends in self-reported sleep duration and insomnia-related symptoms in Finland from 1972 to 2005

    DEFF Research Database (Denmark)

    Kronholm, Erkki; Partonen, Timo; Laatikainen, Tiina

    2008-01-01

    A hypothesis concerning habitual sleep reduction and its adverse consequences among general population in modern societies has received wide publicity in the mass media, although scientific evidence supporting the hypothesis is scarce. Similarly, there is an extensively distributed belief, at least...... in Finland, that the prevalence of insomnia-related symptoms is increasing, but evidence for this is even sparser. These issues are important because of the known increased risk of mortality and health risks associated with sleep duration deviating from 7 to 8 h. To reveal possible trends in self......-reported sleep duration and insomnia-related symptoms, we reanalyzed all available data from surveys carried out in Finland from 1972 to 2005. The main results were that a minor decrease of self-reported sleep duration has taken place in Finland, especially among working aged men. However, the size...

  5. Can Cognitive Behavioral Therapy for Insomnia also treat fatigue, pain, and mood symptoms in individuals with traumatic brain injury? - A multiple case report.

    Science.gov (United States)

    Lu, William; Krellman, Jason W; Dijkers, Marcel P

    2016-01-01

    Individuals with traumatic brain injury (TBI) often develop sleep disorders post-injury. The most common one is insomnia, which can exacerbate other post-injury symptoms, including fatigue, impaired cognition, depression, anxiety, and pain. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a manualized treatment that effectively treats insomnia with secondary effects on cognition, mood, and pain in various populations. This paper reviews the use of CBT-I for three participants with TBI of different severities. Pre- and post-treatment assessments of insomnia, fatigue, depression, anxiety, and pain were conducted. Mood was further assessed at follow-up. Minimal clinically important difference (MCID) scores derived from the research literature were used to establish clinically meaningful symptom improvement on self-report questionnaires. The reduction in insomnia severity scores for all three participants were not large enough to be considered a clinically significant improvement following CBT-I, although trends toward improvement were observed. However, all participants showed clinically significant reductions in anxiety at post-treatment; the effects persisted for 2 participants at follow-up. Reductions in depression symptoms were observed for 2 participants at post-treatment, and treatment effects persisted for 1 participant at follow-up. One participant endorsed clinically significant improvements in fatigue and pain severity. We conclude that CBT-I may provide secondary benefits for symptoms commonly experienced by individuals with TBI, especially mood disturbances.

  6. Behavioral Profiles Associated with Objective Sleep Duration in Young Children with Insomnia Symptoms.

    Science.gov (United States)

    Calhoun, Susan L; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N; Mayes, Susan D; Liao, Duanping; Bixler, Edward O

    2017-02-01

    Based on previous studies reporting on the association of objective sleep duration and physiologic changes (i.e., increased cortisol) in children, we examined the role of objective sleep duration on differentiating behavioral profiles in children with insomnia symptoms. Seven hundred children (ages 5-12, 47.8% male) from the Penn State Child Cohort underwent a nine-hour polysomnography and parent completed Pediatric Behavior Scale. Insomnia symptoms were defined as parent report of difficulty falling and/or staying asleep, sleep disordered breathing as an AHI of ≥1, and objective short sleep duration as a total sleep time insomnia symptoms demonstrated more overall behavioral problems than controls. Significant interactions between insomnia symptoms and objective sleep duration on scores of externalizing behaviors, mood variability and school problems were found. Profile analyses showed that children with insomnia symptoms and normal sleep duration were associated with clinically elevated externalizing behaviors, inattention, mood variability, and school problems, while children with insomnia and short sleep duration were associated with an overall elevated profile in which internalizing behaviors were more prominent. Childhood insomnia symptoms are associated with a wide array of behavioral problems, for which objective sleep duration is useful in differentiating behavioral profiles. Children with insomnia symptoms and normal sleep duration had a behavioral profile consistent with limit-setting and rule-breaking behaviors, while children with insomnia symptoms and short sleep duration had a behavioral profile more consistent with internalizing behaviors resembling that of psychophysiological disorders.

  7. Monthly Fluctuations of Insomnia Symptoms in a Population-Based Sample

    Science.gov (United States)

    Morin, Charles M.; LeBlanc, M.; Ivers, H.; Bélanger, L.; Mérette, Chantal; Savard, Josée; Jarrin, Denise C.

    2014-01-01

    Study Objectives: To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Design: Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. Results: At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an

  8. Heritability of insomnia symptoms in youth and their relationship to depression and anxiety.

    Science.gov (United States)

    Gehrman, Philip R; Meltzer, Lisa J; Moore, Melisa; Pack, Allan I; Perlis, Michael L; Eaves, Lindon J; Silberg, Judy L

    2011-12-01

    Insomnia is a highly prevalent sleep disorder yet little is known about the role of genetic factors in its pathophysiology. The aim of this study was to examine the relative contributions of genetic and environmental factors in explaining variability in insomnia symptoms. Traditional twin design. Academic medical center. 1412 twin pairs aged 8-16 years (48.8% MZ, 47.2% DZ, 4.0% indeterminate). None. Ratings of insomnia symptoms, depression, and overanxious disorder were made by trained interviewers based on DSM-III-R criteria. ACE models were conducted using Mx statistical software. Insomnia symptoms were prevalent in this sample based both on parental (6.6%) and youth (19.5%) reports. The overall heritability of insomnia symptoms was modest (30.7%), with the remaining variance attributed to unique environmental effects. There was no evidence of sex differences in the prevalence of insomnia symptoms or in the contribution of genetic and environmental effects. In multivariate models, there was support for insomnia-specific unique environmental effects over and above overlapping effects with depression and overanxious disorder, but no evidence for insomnia-specific genetic effects. Genetic factors play a modest role in the etiology of insomnia symptoms in 8-16 year-olds. These effects overlap with the genetics of depression and overanxious disorder. Further work is needed to determine which genes confer risk for all three disorders.

  9. An examination of the relationship between binge eating disorder and insomnia symptoms.

    Science.gov (United States)

    Kenny, Therese E; Van Wijk, Megan; Singleton, Christopher; Carter, Jacqueline C

    2018-05-01

    Although studies on sleep difficulties in binge eating disorder (BED) have produced inconsistent findings, research has linked poor sleep to the presence of related concerns (e.g., obesity, anxiety, and depression). To clarify the relationship between BED and sleep problems, this study aimed to compare insomnia symptoms in individuals with BED and those with no history of an eating disorder (NED). An adult community sample of individuals with BED (N = 68) and NED (N = 78) completed measures of insomnia, depression and anxiety, and eating disorder symptoms. Individuals with BED reported significantly greater insomnia symptoms than the NED group. The relationship between BED and insomnia symptoms was partially mediated by anxiety. Depression fully mediated the positive association between insomnia symptom severity and binge frequency in the BED group. These findings suggest that depression, anxiety, and sleep are important constructs to consider in BED development and presentation. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

  10. Monthly fluctuations of insomnia symptoms in a population-based sample.

    Science.gov (United States)

    Morin, Charles M; Leblanc, M; Ivers, H; Bélanger, L; Mérette, Chantal; Savard, Josée; Jarrin, Denise C

    2014-02-01

    To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an interval of 3 months proved the most

  11. Joint associations of sleep duration and insomnia symptoms with subsequent sickness absence: the Helsinki Health Study.

    Science.gov (United States)

    Lallukka, Tea; Haaramo, Peija; Rahkonen, Ossi; Sivertsen, Børge

    2013-07-01

    We aimed to examine the joint associations of sleep duration and insomnia symptoms with subsequent sickness absence of various lengths while considering several covariates. Baseline surveys among 40-60-year-old employees of the City of Helsinki, Finland, (N = 6535) were prospectively linked with employer's personnel register data comprising short self-certified (1-3 days), medically-certified intermediate (4-14 days) and long (15 days or more) sickness absence spells. Average follow-up time was 4.1 years. Sleep duration, insomnia symptoms, sociodemographics, working conditions, health behaviours and health were self-reported in the surveys. Poisson regression analysis was used. Insomnia symptoms were associated with sickness absence at all levels of sleep duration. Adjusting for gender and age, U-shaped associations regarding sleep hours were found. Thus, those reporting short or long sleep and reporting insomnia symptoms had a higher risk for medically-certified intermediate and long sickness absence as compared to those reporting 7 hours of sleep without insomnia symptoms. Also, those reporting 6, 7, and 8 hours of sleep had a higher risk for such sickness absence, if they reported insomnia. Weak associations were also found for self-certified sickness absence, and for those reporting short and long sleep without insomnia. Adjustments attenuated the associations, but they mainly remained. These results suggest primacy of the effects of insomnia symptoms over sleep duration on sickness absence. Although insomnia dominated the joint association, U-shaped associations suggest that both sleep duration and insomnia symptoms need to be considered to promote work ability.

  12. Nighttime Insomnia Symptoms and Perceived Health in the America Insomnia Survey (AIS)

    Science.gov (United States)

    Walsh, James K.; Coulouvrat, Catherine; Hajak, Goeran; Lakoma, Matthew D.; Petukhova, Maria; Roth, Thomas; Sampson, Nancy A.; Shahly, Victoria; Shillington, Alicia; Stephenson, Judith J.; Kessler, Ronald C.

    2011-01-01

    Study Objectives: To explore the distribution of the 4 cardinal nighttime symptoms of insomnia—difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and nonrestorative sleep (NRS)—in a national sample of health plan members and the associations of these nighttime symptoms with sociodemographics, comorbidity, and perceived health. Design/Setting/Participants: Cross-sectional telephone survey of 6,791 adult respondents. Intervention: None. Measurements/Results: Current insomnia was assessed using the Brief Insomnia Questionnaire (BIQ)—a fully structured validated scale generating diagnoses of insomnia using DSM-IV-TR, ICD-10, and RDC/ICSD-2 inclusion criteria. DMS (61.0%) and EMA (52.2%) were more prevalent than DIS (37.7%) and NRS (25.2%) among respondents with insomnia. Sociodemographic correlates varied significantly across the 4 symptoms. All 4 nighttime symptoms were significantly related to a wide range of comorbid physical and mental conditions. All 4 also significantly predicted decrements in perceived health both in the total sample and among respondents with insomnia after adjusting for comorbid physical and mental conditions. Joint associations of the 4 symptoms predicting perceived health were additive and related to daytime distress/impairment. Individual-level associations were strongest for NRS. At the societal level, though, where both prevalence and strength of individual-level associations were taken into consideration, DMS had the strongest associations. Conclusions: The extent to which nighttime insomnia symptoms are stable over time requires future long-term longitudinal study. Within the context of this limitation, the results suggest that core nighttime symptoms are associated with different patterns of risk and perceived health and that symptom-based subtyping might have value. Citation: Walsh JK; Coulouvrat C; Hajak G; Lakoma MD; Petukhova M; Roth T; Sampson NA; Shahly V; Shillington A

  13. Does mental health history explain gender disparities in insomnia symptoms among young adults?

    Science.gov (United States)

    Hale, Lauren; Do, D Phuong; Basurto-Davila, Ricardo; Heron, Melonie; Finch, Brian K; Dubowitz, Tamara; Lurie, Nicole; Bird, Chloe E

    2009-12-01

    Insomnia is the most commonly reported sleep disorder, characterized by trouble falling asleep, staying asleep, or waking up too early. Previous epidemiological data reveal that women are more likely than men to suffer from insomnia symptoms. We investigate the role that mental health history plays in explaining the gender disparity in insomnia symptoms. Using logistic regression, we analyze National Health and Nutritional Examination Survey (NHANES) III interview and laboratory data, merged with data on sociodemographic characteristics of the residential census tract of respondents. Our sample includes 5469 young adults (ages 20-39) from 1429 census tracts. Consistent with previous research, we find that women are more likely to report insomnia symptoms compared to men (16.7% vs. 9.2%). However, in contrast to previous work, we show that the difference between women's and men's odds of insomnia becomes statistically insignificant after adjusting for history of mental health conditions (OR=1.08, p>.05). The gender disparity in insomnia symptoms may be driven by higher prevalence of affective disorders among women. This finding has implications for clinical treatment of both insomnia and depression, especially among women.

  14. Telephone versus internet administration of self-report measures of social anxiety, depressive symptoms, and insomnia: psychometric evaluation of a method to reduce the impact of missing data.

    Science.gov (United States)

    Hedman, Erik; Ljótsson, Brjánn; Blom, Kerstin; El Alaoui, Samir; Kraepelien, Martin; Rück, Christian; Andersson, Gerhard; Svanborg, Cecilia; Lindefors, Nils; Kaldo, Viktor

    2013-10-18

    Internet-administered self-report measures of social anxiety, depressive symptoms, and sleep difficulties are widely used in clinical trials and in clinical routine care, but data loss is a common problem that could render skewed estimates of symptom levels and treatment effects. One way of reducing the negative impact of missing data could be to use telephone administration of self-report measures as a means to complete the data missing from the online data collection. The aim of the study was to compare the convergence of telephone and Internet administration of self-report measures of social anxiety, depressive symptoms, and sleep difficulties. The Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR), Montgomery-Åsberg Depression Rating Scale-Self-Rated (MADRS-S), and the Insomnia Severity Index (ISI) were administered over the telephone and via the Internet to a clinical sample (N=82) of psychiatric patients at a clinic specializing in Internet-delivered treatment. Shortened versions of the LSAS-SR and the ISI were used when administered via telephone. As predicted, the results showed that the estimates produced by the two administration formats were highly correlated (r=.82-.91; PInternet: Cronbach alpha=.79-.93). The correlation coefficients were similar across questionnaires and the shorter versions of the questionnaires used in the telephone administration of the LSAS-SR and ISI performed in general equally well compared to when the full scale was used, as was the case with the MADRS-S. Telephone administration of self-report questionnaires is a valid method that can be used to reduce data loss in routine psychiatric practice as well as in clinical trials, thereby contributing to more accurate symptom estimates.

  15. Symptoms of insomnia among adolescents in the lower Rio Grande Valley of Texas.

    Science.gov (United States)

    Roberts, Robert E; Lee, Eun Sul; Hemandez, Mike; Solari, Ana Cristina

    2004-06-15

    To estimate the prevalence of symptoms of insomnia among adolescents living along the United States-Mexico border and to examine whether ethnicity and birthplace affect risk for such symptoms. Cross-sectional school-based survey using a version of the 2001 Youth Risk Behavior Survey, modified to elicit data on sleep problems. A probability sample of 13 high schools selected from more than 40 high schools in the 4 southernmost counties in Texas-the Lower Rio Grande Valley-contiguous with Mexico. All ninth-grade students who agreed to participate (n = 5,118). The sleep module consisted of queries about trouble initiating asleep, trouble maintaining sleep, early morning waking, nonrestorative sleep, quality of sleep, and amount of sleep. Symptoms of insomnia were common, with 12.4% of respondents meeting symptom criteria for insomnia almost every day of the past month. Females were more likely to report insomnia, as were youths reporting lower socioeconomic status. Crude odds ratios suggested foreign-born and those who identified themselves as "Mexican" rather than "Mexican American" were at lower risk of insomnia. However, multivariate analyses eliminated these differences. More comparative research is needed to ascertain whether and how ethnic culture affects risk for disordered sleep.

  16. Health Correlates of Insomnia Symptoms and Comorbid Mental Disorders in a Nationally Representative Sample of US Adolescents

    Science.gov (United States)

    Blank, Madeleine; Zhang, Jihui; Lamers, Femke; Taylor, Adrienne D.; Hickie, Ian B.; Merikangas, Kathleen R.

    2015-01-01

    Study Objectives: To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. Design: National representative cross-sectional study. Setting: Population-based sample from the US adolescents. Measurements and Results: A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health conditions, risk factors

  17. Social class and gender patterning of insomnia symptoms and psychiatric distress: a 20-year prospective cohort study.

    Science.gov (United States)

    Green, Michael J; Espie, Colin A; Benzeval, Michael

    2014-05-25

    Psychiatric distress and insomnia symptoms exhibit similar patterning by gender and socioeconomic position. Prospective evidence indicates a bi-directional relationship between psychiatric distress and insomnia symptoms so similarities in social patterning may not be coincidental. Treatment for insomnia can also improve distress outcomes. We investigate the extent to which the prospective patterning of distress over 20 years is associated with insomnia symptoms over that period. 999 respondents to the Twenty-07 Study had been followed for 20 years from approximately ages 36-57 (73.2% of the living baseline sample). Psychiatric distress was measured using the GHQ-12 at baseline and at 20-year follow-up. Gender and social class were ascertained at baseline. Insomnia symptoms were self-reported approximately every five years. Latent class analysis was used to classify patterns of insomnia symptoms over the 20 years. Structural Equation Models were used to assess how much of the social patterning of distress was associated with insomnia symptoms. Missing data was addressed with a combination of multiple-imputation and weighting. Patterns of insomnia symptoms over 20 years were classified as either healthy, episodic, developing or chronic. Respondents from a manual social class were more likely to experience episodic, developing or chronic patterns than those from non-manual occupations but this was mostly explained by baseline psychiatric distress. People in manual occupations experiencing psychiatric distress however were particularly likely to experience chronic patterns of insomnia symptoms. Women were more likely to experience a developing pattern than men, independent of baseline distress. Psychiatric distress was more persistent over the 20 years for those in manual social classes and this effect disappeared when adjusting for insomnia symptoms. Irrespective of baseline symptoms, women, and especially those in a manual social class, were more likely than men to

  18. Insomnia symptoms and behavioural health symptoms in veterans 1 year after traumatic brain injury.

    Science.gov (United States)

    Farrell-Carnahan, Leah; Barnett, Scott; Lamberty, Gregory; Hammond, Flora M; Kretzmer, Tracy S; Franke, Laura M; Geiss, Meghan; Howe, Laura; Nakase-Richardson, Risa

    2015-01-01

    Insomnia and behavioural health symptoms 1 year after traumatic brain injury (TBI) were examined in a clinical sample representative of veterans who received inpatient treatment for TBI-related issues within the Veterans Health Administration. This was a cross-sectional sub-study (n = 112) of the Polytrauma Rehabilitation Centres' traumatic brain injury model system programme. Prevalence estimates of insomnia, depression, general anxiety, nightmares, headache and substance use, stratified by injury severity, were derived. Univariate logistic regression was used to examine unadjusted effects for each behavioural health problem and insomnia by injury severity. Participants were primarily male, insomnia; those with mild TBI were significantly more likely to meet criteria (43%) than those with moderate/severe TBI (22%), χ(2)(1, n = 112) = 5.088, p ≤ 0.05. Univariable logistic regression analyses revealed depressive symptoms and general anxiety were significantly associated with insomnia symptoms after TBI of any severity. Headache and binge drinking were significantly inversely related to insomnia symptoms after moderate/severe TBI, but not MTBI. Veterans with history of TBI, of any severity, and current insomnia symptoms may be at increased risk for depression and anxiety 1 year after TBI.

  19. Nocturnal insomnia symptoms and stress-induced cognitive intrusions in risk for depression: A 2-year prospective study.

    Science.gov (United States)

    Kalmbach, David A; Pillai, Vivek; Drake, Christopher L

    2018-01-01

    Nearly half of US adults endorse insomnia symptoms. Sleep problems increase risk for depression during stress, but the mechanisms are unclear. During high stress, individuals having difficulty falling or staying asleep may be vulnerable to cognitive intrusions after stressful events, given that the inability to sleep creates a period of unstructured and socially isolated time in bed. We investigated the unique and combined effects of insomnia symptoms and stress-induced cognitive intrusions on risk for incident depression. 1126 non-depressed US adults with no history of DSM-5 insomnia disorder completed 3 annual web-based surveys on sleep, stress, and depression. We examined whether nocturnal insomnia symptoms and stress-induced cognitive intrusions predicted depression 1y and 2y later. Finally, we compared depression-risk across four groups: non-perseverators with good sleep, non-perseverators with insomnia symptoms, perseverators with good sleep, and perseverators with insomnia symptoms. Insomnia symptoms (β = .10-.13, p good sleeping non-perseverators had the lowest rates (3.3%, Relative Risk = 3.94). Perseverators with sleep latency >30 m reported greater depression than good sleeping perseverators (t = 2.09, p stress creates a depressogenic mindset, and nocturnal wakefulness may augment the effects of cognitive arousal on depression development. Poor sleepers may be especially vulnerable to cognitive intrusions when having difficulty initiating sleep. As treatable behaviors, nighttime wakefulness and cognitive arousal may be targeted to reduce risk for depression in poor sleepers.

  20. Health correlates of insomnia symptoms and comorbid mental disorders in a nationally representative sample of US adolescents.

    Science.gov (United States)

    Blank, Madeleine; Zhang, Jihui; Lamers, Femke; Taylor, Adrienne D; Hickie, Ian B; Merikangas, Kathleen R

    2015-01-01

    To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. National representative cross-sectional study. Population-based sample from the US adolescents. A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health conditions, risk factors, and suicidality. Comorbid mental disorders potentiate the

  1. Insomnia Symptoms, Nightmares, and Suicide Risk: Duration of Sleep Disturbance Matters

    Science.gov (United States)

    Nadorff, Michael R.; Nazem, Sarra; Fiske, Amy

    2013-01-01

    Duration of insomnia symptoms or nightmares was investigated to see if it was related to suicide risk independent of current insomnia symptoms, nightmares, anxiety symptoms, depressive symptoms, and posttraumatic symptoms. The cross-sectional study involved analyses of survey responses from undergraduate students who endorsed either insomnia…

  2. The melatonin receptor agonist ramelteon effectively treats insomnia and behavioral symptoms in autistic disorder.

    Science.gov (United States)

    Kawabe, Kentaro; Horiuchi, Fumie; Oka, Yasunori; Ueno, Shu-Ichi

    2014-01-01

    Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.

  3. Insomnia symptoms and repressive coping in a sample of older Black and White women

    Directory of Open Access Journals (Sweden)

    Pierre-Louis Jessy

    2007-01-01

    Full Text Available Abstract Background This study examined whether ethnic differences in insomnia symptoms are mediated by differences in repressive coping styles. Methods A total of 1274 women (average age = 59.36 ± 6.53 years participated in the study; 28% were White and 72% were Black. Older women in Brooklyn, NY were recruited using a stratified, cluster-sampling technique. Trained staff conducted face-to-face interviews lasting 1.5 hours acquiring sociodemographic data, health characteristics, and risk factors. A sleep questionnaire was administered and individual repressive coping styles were assessed. Fisher's exact test and Spearman and Pearson analyses were used to analyze the data. Results The rate of insomnia symptoms was greater among White women [74% vs. 46%; χ2 = 87.67, p 1,1272 = 304.75, p s = -0.43, p s = -0.18, p Conclusion Relationships between ethnicity and insomnia symptoms are jointly dependent on the degree of repressive coping, suggesting that Black women may be reporting fewer insomnia symptoms because of a greater ability to route negative emotions from consciousness. It may be that Blacks cope with sleep problems within a positive self-regulatory framework, which allows them to deal more effectively with sleep-interfering psychological processes to stressful life events and to curtail dysfunctional sleep-interpreting processes.

  4. A Greater Extent of Insomnia Symptoms and Physician-Recommended Sleep Medication Use Predict Fall Risk in Community-Dwelling Older Adults.

    Science.gov (United States)

    Chen, Tuo-Yu; Lee, Soomi; Buxton, Orfeu M

    2017-11-01

    Cross-sectional studies suggest that insomnia symptoms are associated with falls in later life. This longitudinal study examines the independent and interactive effects of the extent of insomnia symptoms (i.e., multiple co-existing insomnia symptoms) and sleep medications on fall risk over a 2-year follow-up among community-dwelling older adults. Using data from the Health and Retirement Study (2006-2014, N = 6882, Mage = 74.5 years ± 6.6 years), we calculated the extent of insomnia symptoms (range = 0-4) participants reported (i.e., trouble falling asleep, waking up during the night, waking up too early, and not feeling rested). At each wave, participants reported recent sleep medications use and falls since the last wave, and were evaluated for balance and walking speed. A greater burden of insomnia symptoms and using physician-recommended sleep medications at baseline independently predicted falling after adjusting for known risk factors of falling. The effects of insomnia symptoms on fall risk differed by sleep medications use. The extent of insomnia symptoms exhibited a positive, dose-response relation with risk of falling among those not using sleep medications. Older adults using physician-recommended sleep medications exhibited a consistently higher fall risk irrespective of the extent of insomnia symptoms. The number of insomnia symptoms predicts 2-year fall risk in older adults. Taking physician-recommended sleep medications increases the risks for falling in older adults, irrespective of the presence of insomnia symptoms. Future efforts should be directed toward treating insomnia symptoms, and managing and selecting sleep medications effectively to decrease the risk of falling in older adults. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  5. Treating the root cause: acupuncture for the treatment of migraine, menopausal vasomotor symptoms, and chronic insomnia.

    Science.gov (United States)

    Hammes, Amber E; Wahner-Roedler, Dietlind L; Bauer, Brent A

    2014-01-01

    This case report describes the effectiveness of a single intervention, acupuncture, for relieving or abolishing severe migraines, menopausal vasomotor symptoms, and chronic insomnia and, thus, markedly improving quality of life. A 49-year-old woman was referred for acupuncture treatment of her daily migraines, menopausal vasomotor symptoms, and chronic insomnia. The patient had received polypharmacy treatment for these conditions for several years but had rather limited relief of her symptoms. The patient received 10 weekly or biweekly acupuncture treatments over three months. Her migraines reduced in frequency and intensity after her first acupuncture treatment, and she was able to discontinue use of her migraine medications after her eighth treatment. Subsequently, her menopausal vasomotor symptoms and chronic insomnia resolved. This case illustrates successful treatment of the symptoms of three medical conditions with a single complementary, alternative, and integrative medicine procedure, namely, acupuncture, one of the key elements of traditional Chinese medicine. The patient's medical problems had been treated for years with a multitude of medications, which led to adverse effects and little symptomatic improvement. Providers of complementary, alternative, and integrative medicine and providers practicing allopathic medicine should seek treatment options for their patients that promise to be helpful for various symptoms or diseases, that is, treating the root cause rather than using polypharmacy for various symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Dissociative symptoms and sleep parameters--an all-night polysomnography study in patients with insomnia.

    Science.gov (United States)

    Van Der Kloet, Dalena; Giesbrecht, Timo; Franck, Erik; Van Gastel, Ann; De Volder, Ilse; Van Den Eede, Filip; Verschuere, Bruno; Merckelbach, Harald

    2013-08-01

    Dissociative disorders encompass a range of symptoms varying from severe absent-mindedness and memory problems to confusion about one's own identity. Recent studies suggest that these symptoms may be the by-products of a labile sleep-wake cycle. In the current study, we explored this issue in patients suffering from insomnia (N=46). We investigated whether these patients have raised levels of dissociative symptoms and whether these are related to objective sleep parameters. Patients stayed for at least one night in a specialized sleep clinic, while sleep EEG data were obtained. In addition, they completed self-report measures on dissociative symptoms, psychological problems, and sleep characteristics. Dissociative symptom levels were elevated in patients suffering from insomnia, and were correlated with unusual sleep experiences and poor sleep quality. Longer REM sleep periods and less time spent awake during the night were predictive of dissociation. This is the first study to show that insomnia patients have raised dissociative symptom levels and that their dissociative symptoms are related to objective EEG parameters. These findings are important because they may inspire sleep-related treatment methods for dissociative disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence.

    Science.gov (United States)

    Armstrong, Jeffrey M; Ruttle, Paula L; Klein, Marjorie H; Essex, Marilyn J; Benca, Ruth M

    2014-05-01

    To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Community. A total of 396 children (51% female). N/A. Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9-10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18.

  8. Association between Sleep Duration, Insomnia Symptoms and Bone Mineral Density in Older Boston Puerto Rican Adults.

    Directory of Open Access Journals (Sweden)

    Jinya Niu

    Full Text Available To examine the association between sleep patterns (sleep duration and insomnia symptoms and total and regional bone mineral density (BMD among older Boston Puerto Rican adults.We conducted a cross-sectional study including 750 Puerto Rican adults, aged 47-79 y living in Massachusetts. BMD at 3 hip sites and the lumbar spine were measured using dual-energy X-ray absorptiometry. Sleep duration (≤5 h, 6 h, 7 h, 8 h, or ≥9 h/d and insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awaking, and non-restorative sleep were assessed by a questionnaire. Multivariable regression was used to examine sex-specific associations between sleep duration, insomnia symptoms and BMD adjusting for standard confounders and covariates.Men who slept ≥9h/d had significantly lower femoral neck BMD, relative to those reporting 8 h/d sleep, after adjusting for age, education level, smoking, physical activity, depressive symptomatology, comorbidity and serum vitamin D concentration. This association was attenuated and lost significance after further adjustment for urinary cortisol and serum inflammation biomarkers. In contrast, the association between sleep duration and BMD was not significant in women. Further, we did not find any significant associations between insomnia symptoms and BMD in men or women.Our study does not support the hypothesis that shorter sleep duration and insomnia symptoms are associated with lower BMD levels in older adults. However, our results should be interpreted with caution. Future studies with larger sample size, objective assessment of sleep pattern, and prospective design are needed before a conclusion regarding sleep and BMD can be reached.

  9. Associations of protein, fat, and carbohydrate intakes with insomnia symptoms among middle-aged Japanese workers.

    Science.gov (United States)

    Tanaka, Eizaburo; Yatsuya, Hiroshi; Uemura, Mayu; Murata, Chiyoe; Otsuka, Rei; Toyoshima, Hideaki; Tamakoshi, Koji; Sasaki, Satoshi; Kawaguchi, Leo; Aoyama, Atsuko

    2013-01-01

    Diet is a modifiable factor that may affect sleep, but the associations of macronutrient intakes with insomnia are inconsistent. We investigated the associations of protein, fat, and carbohydrate intakes with insomnia symptoms. In this cross-sectional analysis of 4435 non-shift workers, macronutrient intakes were assessed by the brief-type self-administered diet history questionnaire, which requires the recall of usual intakes of 58 foods during the preceding month. Presence of insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and poor quality of sleep (PQS) were self-reported. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for demographic, psychological, and behavioral factors, as well as medical histories. Low protein intake (vs ≥16% of total energy) was associated with DIS (OR 1.24, 95% CI 0.99-1.56) and PQS (OR 1.24, 95% CI 1.04-1.48), while high protein intake (≥19% vs Low carbohydrate intake (vs ≥50% of total energy) was associated with DMS (OR 1.19, 95% CI 0.97-1.45). Protein and carbohydrate intakes in the daily diet were associated with insomnia symptoms. The causality of these associations remains to be explained.

  10. Nocturnal insomnia symptoms and stress-induced cognitive intrusions in risk for depression: A 2-year prospective study

    Science.gov (United States)

    Pillai, Vivek; Drake, Christopher L.

    2018-01-01

    Nearly half of US adults endorse insomnia symptoms. Sleep problems increase risk for depression during stress, but the mechanisms are unclear. During high stress, individuals having difficulty falling or staying asleep may be vulnerable to cognitive intrusions after stressful events, given that the inability to sleep creates a period of unstructured and socially isolated time in bed. We investigated the unique and combined effects of insomnia symptoms and stress-induced cognitive intrusions on risk for incident depression. 1126 non-depressed US adults with no history of DSM-5 insomnia disorder completed 3 annual web-based surveys on sleep, stress, and depression. We examined whether nocturnal insomnia symptoms and stress-induced cognitive intrusions predicted depression 1y and 2y later. Finally, we compared depression-risk across four groups: non-perseverators with good sleep, non-perseverators with insomnia symptoms, perseverators with good sleep, and perseverators with insomnia symptoms. Insomnia symptoms (β = .10–.13, p insomnia had the highest rates of depression (13.0%), whereas good sleeping non-perseverators had the lowest rates (3.3%, Relative Risk = 3.94). Perseverators with sleep latency >30 m reported greater depression than good sleeping perseverators (t = 2.09, p < .04). Cognitive intrusions following stress creates a depressogenic mindset, and nocturnal wakefulness may augment the effects of cognitive arousal on depression development. Poor sleepers may be especially vulnerable to cognitive intrusions when having difficulty initiating sleep. As treatable behaviors, nighttime wakefulness and cognitive arousal may be targeted to reduce risk for depression in poor sleepers. PMID:29438400

  11. Insomnia

    Science.gov (United States)

    ... or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually ... it is not caused by something else. Its cause is not well understood, but ... travel and shift work can be factors. Primary insomnia usually lasts more ...

  12. The predictive power of personality traits on insomnia symptoms: a longitudinal study among shift workers

    OpenAIRE

    Larsgård, Borgar

    2015-01-01

    Shift work can have adverse effects on employees' health, including symptoms of insomnia. This may cause severe problems both for employee and employer. The personality variables morningness, neuroticism and extraversion, along with some demographic variables (e.g. gender, age) have been found to correlate with insomnia symptoms, but predictive data have been scarce. This study sought to discover whether personality variables could predict insomnia. A hierarchical longitudinal (six months)...

  13. The Effect of Aromatherapy on Insomnia and Other Common Symptoms Among Patients With Acute Leukemia

    Science.gov (United States)

    Blackburn, Lisa; Achor, Sara; Allen, Betty; Bauchmire, Nicole; Dunnington, Danielle; Klisovic, Rebecca; Naber, Steven; Roblee, Kirsten; Samczak, Angela; Tomlinson-Pinkham, Kelly; Chipps, Esther

    2017-07-01

    To determine if the use of aromatherapy improves insomnia and other common symptoms in hospitalized patients with newly diagnosed acute leukemia. A randomized, crossover, washout trial. An inpatient acute leukemia unit at the Arthur G. James Cancer Hospital and Richard L. Solove Research Institute of the Wexner Medical Center at Ohio State University in Columbus. 50 patients who were newly diagnosed with acute leukemia and hospitalized to receive their initial four weeks of intensive induction chemotherapy. Patients were offered a choice of three scents to be used during the trial: lavender, peppermint, or chamomile. Each patient was randomized to receive either the chosen aromatherapy intervention or a placebo intervention during alternate weeks, with a washout period in between. Sleep quality and other common symptoms were measured. Aromatherapy, sleep, insomnia, pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and well-being. Most patients reported poor quality sleep at baseline, but aromatherapy had a statistically significant positive impact. Improvements were noted in tiredness, drowsiness, lack of appetite, depression, anxiety, and well-being because of aromatherapy. Aromatherapy is a viable intervention for improving insomnia and other symptoms commonly experienced by patients with acute leukemia. Oncology nurses can employ aromatherapy safely and inexpensively, and with minimal training, as an effective tool in decreasing many symptoms that plague patients with leukemia. Patients can exercise a greater sense of control over their treatment environments through the use of aromatherapy.

  14. Insomnia

    Science.gov (United States)

    ... and others. Remaining passively awake. Also called paradoxical intention, this involves avoiding any effort to fall asleep. ... person for your sessions. However, phone consultation, CDs, books or websites on CBT techniques and insomnia also ...

  15. Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

    Science.gov (United States)

    Krakow, Barry; Ulibarri, Victor A

    2013-03-01

    Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

  16. Nocturia, Insomnia Symptoms and Mortality among Older Men

    DEFF Research Database (Denmark)

    Endeshaw, Y. W.; Schwartz, A. V.; Stone, K. A.

    2016-01-01

    Study Objectives: To examine the association between nocturia (walking up from sleep for urination) and mortality risk among community dwelling older men. Methods: This is a secondary data analysis using data obtained from the Health Aging Body Composition (Health ABC) study. Frequency of nocturia...... during the day/daytime naps, sleep duration, and use of sleep medications. However, the association between ≥ 3 nocturia episodes per night and mortality risk was no longer statistically significant once prevalent diabetes mellitus and cardiovascular disease were included in the model (HR [CI]: 1.18 [0.......97-1.44], p = 0.100). Conclusions: Nocturia is associated with mortality independent of insomnia symptoms and sleep duration. The relationship is explained in part by prevalent cardiovascular disease and diabetes mellitus. The results underscore the impact of these medical conditions on the association...

  17. The joint association of sleep duration and insomnia symptoms with disability retirement--a longitudinal, register-linked study.

    Science.gov (United States)

    Haaramo, Peija; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea

    2012-09-01

    The aim of this study was to examine the joint association of sleep duration and insomnia symptoms with subsequent disability retirement. Baseline survey data were collected in 2000-2002 from 40-60-year-old employees of the City of Helsinki, all working at baseline. Baseline data were linked with disability retirement data until the end of 2010, obtained from the Finnish Centre for Pensions registers (N=6042). Sleep duration and self-reported insomnia symptoms (non-restorative sleep and difficulties in initiating and maintaining sleep) were derived from the baseline surveys. All-cause disability retirement (N=561) and the most prevalent diagnostic groups - musculoskeletal diseases (43%) and mental disorders (26%) - were examined. Cox regression analysis was used to yield hazard ratios (HR) with 95% confidence intervals (95% CI). A joint association of sleep duration and insomnia symptoms with disability retirement was found, implying a higher risk for those with frequent insomnia symptoms. HR for all-cause disability retirement ranged among those with frequent symptoms from 2.02 (95% CI 1.53-2.68, sleeping 7 hours) to 3.92 (95% CI 2.57-5.97, sleeping ≤ 5 hours). Adjusting for sociodemographic, work, and health-related factors attenuated the associations, which nevertheless remained. The associations were similar for the two diagnostic groups, although stronger for those with mental disorders. Frequent insomnia symptoms dominate the joint association of sleep duration and insomnia symptoms with subsequent disability retirement. Examining exclusively sleep duration would provide an incomplete understanding of the consequences of poor sleep.

  18. Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain.

    Science.gov (United States)

    Generaal, Ellen; Vogelzangs, Nicole; Penninx, Brenda W J H; Dekker, Joost

    2017-01-01

    The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. Effectiveness of Cognitive- behavioral Group Therapy on Insomnia Symptoms in Students

    Directory of Open Access Journals (Sweden)

    A Abollahi

    2015-04-01

    Full Text Available Background & aim: Insomnias is associated with considerable problems in educational, vocational, social and familial performance. The purpose of present research was to investigate the effectiveness of Cognitive-Behavior group therapy on improvement of insomnia symptoms in students. Methods: The present clinical trial study was conducted on twenty-four students who were randomly assigned into two groups of case and the control (n = 12. The experimental group was participated in eight sessions of cognitive behavior therapy, while the control group received no intervention. Research tools include the Pittsburgh Sleep Quality Index and the Insomnia Severity Index that completed by both participants. Data were analyzed using ANOVA, t-test. Results: Analysis of covariance showed that the performance of cognitive behavioral therapy may improve symptoms and reduce the severity of insomnia in the experimental group compared with the control group (p < 0.05. Conclusion: Group cognitive-behavioral therapy is effective on symptoms of insomnia in students.

  20. Brief Behavioral Interventions for Symptoms of Depression and Insomnia in University Primary Care

    Science.gov (United States)

    Funderburk, Jennifer S.; Shepardson, Robyn L.; Krenek, Marketa

    2015-01-01

    Objective: To describe how behavioral activation (BA) for depression and stimulus control (SC) for insomnia can be modified to a brief format for use in a university primary care setting, and to evaluate preliminarily their effectiveness in reducing symptoms of depression and insomnia, respectively, using data collected in routine clinical care.…

  1. Reduced spontaneous neuronal activity in the insular cortex and thalamus in healthy adults with insomnia symptoms.

    Science.gov (United States)

    Liu, Chun-Hong; Liu, Cun-Zhi; Zhang, Jihui; Yuan, Zhen; Tang, Li-Rong; Tie, Chang-Le; Fan, Jin; Liu, Qing-Quan

    2016-10-01

    Poor sleep and insomnia have been recognized to be strongly correlated with the development of depression. The exploration of the basic mechanism of sleep disturbance could provide the basis for improved understanding and treatment of insomnia and prevention of depression. In this study, 31 subjects with insomnia symptoms as measured by the Hamilton Rating Scale for Depression (HAMD-17) and 71 age- and gender-matched subjects without insomnia symptoms were recruited to participate in a clinical trial. Using resting-state functional magnetic resonance imaging (rs-fMRI), we examined the alterations in spontaneous brain activity between the two groups. Correlations between the fractional amplitude of low frequency fluctuations (fALFF) and clinical measurements (e.g., insomnia severity and Hamilton Depression Rating Scale [HAMD] scores) were also tested in all subjects. Compared to healthy participants without insomnia symptoms, participants with insomnia symptoms showed a decreased fALFF in the left ventral anterior insula, bilateral posterior insula, left thalamus, and pons but an increased fALFF in the bilateral middle occipital gyrus and right precentral gyrus. More specifically, a significant, negative correlation of fALFF in the left thalamus with early morning awakening scores and HAMD scores in the overall sample was identified. These results suggest that insomnia symptoms are associated with altered spontaneous activity in the brain regions of several important functional networks, including the insular cortex of the salience and the thalamus of the hyperarousal network. The altered fALFF in the left thalamus supports the "hyperarousal theory" of insomnia symptoms, which could serve as a biomarker for insomnia. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Insomnia

    Science.gov (United States)

    ... Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2017;13:307. Jan. 30, 2018 Original article: http://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/ART-20043959 . Mayo Clinic Footer Legal Conditions and Terms Any use of this site ...

  3. Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia.

    Science.gov (United States)

    Jean-Pierre, Pascal; Grandner, Michael A; Garland, Sheila N; Henry, Elizabeth; Jean-Louis, Girardin; Burish, Thomas G

    2015-07-01

    Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems. To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors. We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health. The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p insomnia were not associated with SRMP (p > 0.05). We could not determine severity and time-related changes in SRMP. Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Change in Job Strain as A Predictor of Change in Insomnia Symptoms

    DEFF Research Database (Denmark)

    Halonen, Jaana I.; Lallukka, Tea; Pentti, Jaana

    2017-01-01

    STUDY OBJECTIVES: To examine whether change in job strain lead to change in insomnia symptoms. METHODS: Among 24,873 adults (82% women, mean age 44 years) who participated in a minimum of three consecutive study waves (2000-2012), job strain was assessed at the first and second wave and insomnia.......16-1.51). The disappearance of job strain was associated with lower odds of repeated insomnia symptoms (odds ratio compared to no disappearance of job strain 0.78, 95% CI 0.65-0.94). Further adjustment for shift work or sleep apnea did not change these associations. CONCLUSIONS: These results suggest that job strain...

  5. Insomnia and Neuroticism are Related with Depressive Symptoms of Medical Students

    Directory of Open Access Journals (Sweden)

    Changnam Kim

    2017-06-01

    Full Text Available Background and Objective Insomnia is very common in depression and especially medical students are easy to experience sleep disturbance because of their studies. Also depressive symptoms are closely related to stress. Stress is an interaction between an individual and the environment, involving subjective perception and assessment of stressors, thus constituting a highly personalized process. Different personality traits can create different levels of stress. In this study, we tried to explore the relationship between insomnia and depressive symptoms or stress of medical students, and whether their personality may play a role on this relationship or not. Methods We enrolled 154 medical students from University of Ulsan College of Medicine. We used the Medical Stress Scale, the Multidimensional Perfectionism Scale, the Patient Health Questionnaire-9, the Academic Motivation Scale, the Insomnia Severity Index, and The revised NEO Personality Inventory (PI. Results Insomnia severity, amotivation, medical stress, mental health index and neuroticism traits of NEO-PI significantly correlated with depressive symptom severity (p < 0.001. And stepwise linear regression analysis indicated insomnia, amotivation and neuroticism traits of NEO-PI are expecting factors for students’ depressive symptoms is related to (p < 0.001. Conclusions Student who tend to be perfect feel more academic stress. The high level of depressive symptom is associated with insomnia, amotivation, academic stress in medical student. Moreover, personality trait also can influence their depressive symptoms.

  6. Characteristics and correlates of sleep duration, daytime napping, snoring and insomnia symptoms among 0.5 million Chinese men and women.

    Science.gov (United States)

    Chen, Yiping; Kartsonaki, Christiana; Clarke, Robert; Guo, Yu; Yu, Canqing; Bian, Zheng; Jiang, Qilian; Li, Shanpeng; Chen, Junshi; Li, Liming; Chen, Zhengming

    2018-04-01

    Inadequate sleep duration and insomnia can affect both physical and mental health. There is limited evidence, however, on characteristics and correlates of sleep patterns and insomnia in urban and rural China. This cross-sectional study, involving 512,891 adults aged 30-79 years from ten (five urban and five rural) diverse areas in China, recorded detailed information, using interviewer-administered laptop-based questionnaires, on sleep patterns (duration, daytime napping and snoring) and insomnia symptoms. Logistic regression was used to examine the associations of sleep patterns and insomnia symptoms with a range of socio-economic, lifestyle, behaviour and health-related factors. Overall, the mean (SD) sleep duration was 7.38 (1.37) h, with 23% reporting short (≤6 h) and 16% reporting long (≥9 h) sleep duration, 21% taking daytime naps and 22% having frequent snoring. Overall, 17% reported having insomnia symptoms, with a higher proportion in women than in men (19% vs 13%), in rural than in urban residents (19% vs 15%), and in individuals who were living alone (23%). The adjusted odds ratios (ORs) of having insomnia symptoms were significantly higher among people with major depressive episodes (6.10, 95% CI: 5.69-6.55), generalised anxiety disorders (7.46, 6.65-8.37) and any chronic diseases (1.46; 1.44-1.49). In contrast, the ORs of insomnia symptoms were significantly lower among those reporting napping (0.77, 0.75-0.78) and frequent snoring (0.86, 0.84-0.87). Among Chinese adults, sleep patterns varied greatly by socio-economic, lifestyle and health-related factors. The risk of insomnia symptoms was associated with both poor mental and physical health status. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Dietary Patterns and Insomnia Symptoms in Chinese Adults: The China Kadoorie Biobank

    Directory of Open Access Journals (Sweden)

    Canqing Yu

    2017-03-01

    Full Text Available Limited attention has been paid to the effect of dietary patterns on sleep problems. In the present study, we analyzed the cross-sectional data of 481,242 adults aged 30–79 years from the China Kadoorie Biobank. A laptop-based questionnaire was administered to collect information on food intakes and insomnia symptoms. Logistic regression was used to estimate the odds ratios of each insomnia symptom according to quartiles of each dietary pattern, with adjustment for potential confounders. Two major dietary patterns were derived by factor analysis. The traditional northern dietary pattern was characterized by high intakes of wheat and other staple food, whereas the modern dietary pattern was characterized by high intakes of meat, poultry, fish, eggs, fresh fruit, and dairy products. Both dietary patterns were associated with a decreased prevalence of insomnia symptoms (p for trend < 0.001; after adjustment for potential confounders, individuals who had the highest quartile score of traditional northern dietary pattern were 12%–19% less likely to have insomnia symptoms compared to those in the lowest quartile (odds ratio: 0.81–0.88, and the corresponding values for the modern dietary pattern were 0.89–1.01. Furthermore, interactions of these two dietary patterns on insomnia symptoms were observed. Further prospective studies are needed to elucidate the relationship between diet and insomnia.

  8. Association between report of insomnia and daytime functioning.

    Science.gov (United States)

    Ustinov, Yuriy; Lichstein, Kenneth L; Wal, Gregory S Vander; Taylor, Daniel J; Riedel, Brant W; Bush, Andrew J

    2010-01-01

    The relationship between reports of insomnia and daytime functioning was investigated using hierarchical regression. The presence or absence of a report of insomnia was the predictor of primary interest. A number of covariates were included in the model: demographic variables, health variables, and quantitative sleep parameters. Data were collected from a community sample in the Memphis, Tennessee area. Data from 734 volunteers, ranging in age from 20 to 96years were analyzed. The sample included 235 individuals who reported having chronic insomnia and 499 individuals who reported no sleep problems. Participants completed a 2-week sleep diary, a battery of daytime functioning questionnaires, and a medical disorders checklist. Demographic information was also collected. The daytime functioning assessment included the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Epworth Sleepiness Scale, the Insomnia Impact Scale, and the Fatigue Severity Scale. The hierarchical regression model included four sets. The first three sets consisted of 18 variables capturing demographic, health, and sleep diary parameters. The fourth set included a single dichotomous variable representing the presence or absence of a report of insomnia. Reports of insomnia were a significant predictor of all five daytime functioning measures, which is consistent with previous research. We also showed that reports of insomnia were able to uniquely explain a significant amount of variability in self-reported daytime functioning after controlling for demographics, health, and sleep diary variables. The pattern of individual variables that reached significance in the first three sets varied depending on which daytime functioning measure was predicted, however, age, the presence of pain, the presence of mental health problems, SOL, and WASO were the most commonly significant predictors of poor daytime functioning from these sets across measures. Individuals' perceptions of their sleep are

  9. Effectiveness of Cognitive- behavioral Group Therapy on Insomnia Symptoms in Students

    OpenAIRE

    A Abollahi; AM Nazar; J Hasani; M Darharaj; A Behnam Moghadam

    2015-01-01

    Background & aim: Insomnias is associated with considerable problems in educational, vocational, social and familial performance. The purpose of present research was to investigate the effectiveness of Cognitive-Behavior group therapy on improvement of insomnia symptoms in students. Methods: The present clinical trial study was conducted on twenty-four students who were randomly assigned into two groups of case and the control (n = 12). The experimental group was participated in eight se...

  10. Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

    OpenAIRE

    Lallukka Tea; Sares-Jäske Laura; Kronholm Erkki; Sääksjärvi Katri; Lundqvist Annamari; Partonen Timo; Rahkonen Ossi; Knekt Paul

    2012-01-01

    BACKGROUND: Poor sleep tends to be patterned by sociodemographic and socioeconomic factors. The aim of this study was to examine the associations of sociodemographic and socioeconomic factors with sleep duration and insomnia-related symptoms across life course. METHODS: We used cross-sectional Health 2000 Survey (2000-2001) among a total of 5,578 adult Finns, aged 30-79 years, representative of adult Finnish population. Data about sociodemographic and socioeconomic circumstances, insomnia-rel...

  11. Insomnia in shift work.

    Science.gov (United States)

    Vallières, Annie; Azaiez, Aïda; Moreau, Vincent; LeBlanc, Mélanie; Morin, Charles M

    2014-12-01

    Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers. Work productivity and absenteeism were more strongly related to insomnia. The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Insomnia Symptoms and Cardiovascular Disease among Older American Indians: The Native Elder Care Study

    International Nuclear Information System (INIS)

    Sabanayagam, Ch.; Shankar, A.; Sabanayagam, Ch.; Buchwald, D.; Goins, R.T.

    2011-01-01

    Background. Cardiovascular disease (CVD) is the leading cause of death among American Indians. It is not known if symptoms of insomnia are associated with CVD in this population. Methods. We examined 449 American Indians aged =55 years from the Native Elder Care Study. The main outcome-of-interest was self-reported CVD. Results. Short sleep duration, daytime sleepiness, and difficulty falling asleep were positively associated with CVD after adjusting for demographic, lifestyle, and clinical risk factors. Compared with a sleep duration of 7 h, the multivariable odds ratio (OR) (95% confidence interval [CI]) of CVD among those with sleep duration =5 h was 2.89 (1.17-7.16). Similarly, the multivariable OR (95% CI) of CVD was 4.45 (1.85-10.72) and 2.60 (1.25-5.42) for daytime sleepiness >2 h and difficulty falling asleep often/always. Conclusion. Symptoms of insomnia including short sleep duration, daytime sleepiness, and difficulty falling asleep are independently associated with CVD in American Indians aged =55 years

  13. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

    Science.gov (United States)

    Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

    2016-01-01

    Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

  14. Insomnia symptoms and risk for unintentional fatal injuries--the HUNT Study.

    Science.gov (United States)

    Laugsand, Lars Erik; Strand, Linn B; Vatten, Lars J; Janszky, Imre; Bjørngaard, Johan Håkon

    2014-11-01

    To assess the association between insomnia symptoms and risk of fatal unintentional injuries. Population-based prospective cohort study with a mean follow-up of 14 y, linking health survey data with information on insomnia symptoms to the National Cause of Death Registry. Nord-Trøndelag County, Norway. A total of 54,399 men and women 20-89 y of age who participated in the Nord-Trøndelag Health Study between 1995 and 1997. N/A. There were 277 unintentional fatal injuries, including 57 fatal motor vehicle injuries during follow-up. There was a dose-dependent association between the number of insomnia symptoms and risk of unintentional fatal injuries (P for trend 0.001) and fatal motor vehicle injuries (P for trend 0.023), respectively. The proportion of unintentional fatal injuries cases that could have been prevented in the absence of difficulties initiating sleep, difficulties maintaining sleep, and having a feeling of nonrestorative sleep were 8%, 9%, and 8%, respectively. The corresponding estimates for motor vehicle injuries were 34%, 11%, and 10%. Insomnia is a major contributor to both unintentional fatal injuries in general as well as fatal motor vehicle injuries. Increasing public health awareness about insomnia and identifying persons with insomnia may be important in preventing unintentional fatal injuries.

  15. Symptoms of insomnia among patients with obstructive sleep apnea before and after two years of positive airway pressure treatment.

    Science.gov (United States)

    Björnsdóttir, Erla; Janson, Christer; Sigurdsson, Jón F; Gehrman, Philip; Perlis, Michael; Juliusson, Sigurdur; Arnardottir, Erna S; Kuna, Samuel T; Pack, Allan I; Gislason, Thorarinn; Benediktsdóttir, Bryndis

    2013-12-01

    To assess the changes of insomnia symptoms among patients with obstructive sleep apnea (OSA) from starting treatment with positive airway pressure (PAP) to a 2-y follow-up. Longitudinal cohort study. Landspitali--The National University Hospital of Iceland. There were 705 adults with OSA who were assessed prior to and 2 y after starting PAP treatment. PAP treatment for OSA. All patients underwent a medical examination along with a type 3 sleep study and answered questionnaires on health and sleep before and 2 y after starting PAP treatment. The change in prevalence of insomnia symptoms by subtype was assessed by questionnaire and compared between individuals who were using or not using PAP at follow-up. Symptoms of middle insomnia were most common at baseline and improved significantly among patients using PAP (from 59.4% to 30.7%, P insomnia tended to persist regardless of PAP treatment, and symptoms of late insomnia were more likely to improve among patients not using PAP. Patients with symptoms of initial and late insomnia at baseline were less likely to adhere to PAP (odds ratio [OR] 0.56, P = 0.007, and OR 0.53, P insomnia. Symptoms of initial and late insomnia, however, tended to persist regardless of positive airway pressure treatment and had a negative effect on adherence. Targeted treatment for insomnia may be beneficial for patients with obstructive sleep apnea comorbid with insomnia and has the potential to positively affect adherence to positive airway pressure.

  16. Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study.

    Science.gov (United States)

    Green, Michael J; Espie, Colin A; Popham, Frank; Robertson, Tony; Benzeval, Michaela

    2017-03-16

    Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence. A prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. 996 respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA 1c  ≥ 6.5% or 48 mmol/mol). Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress) as well as for gender and baseline occupational class. Traditional regression yielded an odds ratio (OR) of 1.34 (95% CI: 1.06-1.70) for type 2 diabetes incidence for each additional survey wave in which insomnia was reported. Marginal structural models adjusted for prior covariates (assuming concurrently measured covariates were potential mediators), reduced this OR to 1.20 (95% CI: 0.98-1.46), and when concurrent covariates were also included (viewing them as potential confounders) this dropped further to 1.08 (95% CI: 0.85-1.37). The association between cumulative experience of insomnia and type 2 diabetes incidence appeared confounded. Evidence for a residual causal effect depended on assumptions as to whether concurrently measured covariates were confounders or mediators.

  17. Investigation of maternal psychopathological symptoms, dream anxiety and insomnia in preeclampsia.

    Science.gov (United States)

    Cetin, Orkun; Guzel Ozdemir, Pınar; Kurdoglu, Zehra; Sahin, Hanım Guler

    2017-10-01

    The aim of the current study was to investigate the psychopathological symptoms, psycho-emotional state, dream anxiety, and insomnia in healthy, mild and severe preeclamptic postpartum women and their relation to the severity of preeclampsia (PE). This observational study included 45 healthy, 41 mild preeclamptic and 44 severe preeclamptic postpartum women. The 90-item Symptom Checklist Revised, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Van Dream Anxiety Scale (VDAS) were used to evaluate the psychopathological symptoms, psycho-emotional state, insomnia, and dream anxiety of the participants after delivery. Severe preeclamptic women had higher VDAS scores than mild preeclamptic and healthy postpartum women (p: 0.001). The psychopathological symptoms were more frequent in preeclamptic women than in healthy controls (p: 0.001). Severe preeclamptic women had the highest scores in Hospital Anxiety-Depression Scale and Insomnia Severity Index (p: 0.001, p: 0.001, respectively). Preeclampsia negatively affects the psycho-emotional state, psychopathological symptoms and sleep patterns. Further, disturbed dreaming was more frequent in PE and also, all of these conditions became worse with the severity of PE. We speculated that the obstetricians should offer their preeclamptic patients an appropriate mental health care at bedside and postpartum period as needed.

  18. The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype.

    Science.gov (United States)

    Fossum, Ingrid Nesdal; Nordnes, Linn Tinnesand; Storemark, Sunniva Straume; Bjorvatn, Bjørn; Pallesen, Ståle

    2014-09-03

    This study investigated whether the use of a television, computer, gaming console, tablet, mobile phone, or audio player in bed before going to sleep was associated with insomnia, daytime sleepiness, morningness, or chronotype. 532 students aged 18-39 were recruited from lectures or via e-mail. Respondents reported the frequency and average duration of their in-bed media use, as well as insomnia symptoms, daytime sleepiness, morningness-eveningness preference and bedtime/rise time on days off. Mean time of media use per night was 46.6 minutes. The results showed that computer usage for playing/surfing/reading was positively associated with insomnia, and negatively associated with morningness. Mobile phone usage for playing/surfing/texting was positively associated with insomnia and chronotype, and negatively associated with morningness. None of the other media devices were related to either of these variables, and no type of media use was related to daytime sleepiness.

  19. Higher sleep reactivity and insomnia mutually aggravate depressive symptoms: a cross-sectional epidemiological study in Japan.

    Science.gov (United States)

    Nakajima, Shun; Komada, Yoko; Sasai-Sakuma, Taeko; Okajima, Isa; Harada, Yutaka; Watanabe, Kazue; Inoue, Yuichi

    2017-05-01

    Sleep reactivity assessed using the Ford Insomnia Response to Stress Test (FIRST) is associated with depression. This study clarified stress reactivity and insomnia effects on depressive symptoms. A cross-sectional questionnaire survey was administered to 2645 participating government employees (35.4% female, mean age 42.8 years) during health checks conducted at Tottori prefecture, Japan, in June 2012. Questionnaire items included: demographic information; the FIRST; the Pittsburgh Sleep Quality Index (PSQI); and a 12-item version of the Center for Epidemiological Studies Depression scale (CES-D). The study defined CES-D scores of ≥12 points as positive for depression, PSQI scores of ≥5.5 points as positive for insomnia symptoms, and FIRST scores of ≥19 points as indicating higher sleep reactivity. Multivariate logistic regression analysis revealed insomnia (adjusted OR = 3.40), higher sleep reactivity (adjusted OR = 1.78), presence of disease currently being treated (adjusted OR = 1.84), and being female (adjusted OR = 1.53) as independently associated with depression. Participants with insomnia and a high FIRST score showed higher CES-D scores than those with insomnia alone and those with high FIRST without insomnia (all p insomnia. Elevated sleep reactivity and insomnia symptoms are thought to aggravate depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Acupuncture Treatment of Insomnia-A Report of 28 Cases

    Institute of Scientific and Technical Information of China (English)

    时冬丽

    2003-01-01

    @@ Insomnia, also called hyposomnia, refers to the disorder characterized by failure to obtain a normal sleep. For mild cases, the patients are slow to go into sleep, or in an oneirism or with very short sleep. For severe cases, the patients can only have a sleep of 2 to 3 hours or even no sleep during the night, which inserts a serious impact on the normal life of the patients. Using Shenmen (HT 7) and Benshen (GB 13) as the main points, the author has treated 28 cases of insomnia with quick and satisfactory therapeutic effect. A report follows.

  1. Association between sleep duration, insomnia symptoms and bone mineral density in older Puerto Rican adults

    Science.gov (United States)

    Objective: To examine the association between sleep patterns (sleep duration and insomnia symptoms) and total and regional bone mineral density (BMD) among older Boston Puerto Rican adults. Materials/Methods: We conducted a cross-sectional study including 750 Puerto Rican adults, aged 47–79 y livi...

  2. Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients.

    Science.gov (United States)

    Philip, Pierre; Bioulac, Stéphanie; Altena, Elemarije; Morin, Charles M; Ghorayeb, Imad; Coste, Olivier; Monteyrol, Pierre-Jean; Micoulaud-Franchi, Jean-Arthur

    2018-01-01

    This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (pCPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

  3. Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

    Directory of Open Access Journals (Sweden)

    Lallukka Tea

    2012-07-01

    Full Text Available Abstract Background Poor sleep tends to be patterned by sociodemographic and socioeconomic factors. The aim of this study was to examine the associations of sociodemographic and socioeconomic factors with sleep duration and insomnia-related symptoms across life course. Methods We used cross-sectional Health 2000 Survey (2000–2001 among a total of 5,578 adult Finns, aged 30–79 years, representative of adult Finnish population. Data about sociodemographic and socioeconomic circumstances, insomnia-related symptoms over the previous month as well as average sleep duration were collected by questionnaires. Multinomial logistic regression models were adjusted first for gender and age, second for sociodemographic factors, third additionally for socioeconomic factors, and fourth for all covariates and self-perceived health simultaneously. Results On average 70% of Finnish adults slept 7–8 hours a day. Frequent insomnia-related symptoms were more prevalent among women (14% than men (10%. Not being married, not having children, having low education, low income, being unemployed, and being a disability retiree were associated with frequent insomnia-related symptoms. Similar factors were associated with short and long sleep duration. However, childhood socioeconomic position was mostly unrelated to sleep in adulthood except parental education had some associations with short sleep duration. Conclusions Disadvantaged socioeconomic position in adulthood, in particular income and employment status, is associated with poorer sleep. When promoting optimal sleep duration and better sleep quality, families with low incomes, unemployed people, and disability retirees should be targeted.

  4. Effects of estradiol and venlafaxine on insomnia symptoms and sleep quality in women with hot flashes.

    Science.gov (United States)

    Ensrud, Kristine E; Guthrie, Katherine A; Hohensee, Chancellor; Caan, Bette; Carpenter, Janet S; Freeman, Ellen W; LaCroix, Andrea Z; Landis, Carol A; Manson, JoAnn; Newton, Katherine M; Otte, Julie; Reed, Susan D; Shifren, Jan L; Sternfeld, Barbara; Woods, Nancy F; Joffe, Hadine

    2015-01-01

    Determine effects of low-dose estradiol and low-dose venlafaxine on self-reported sleep measures in menopausal women with hot flashes. 3-arm double-blind randomized trial. Participants assigned in a 2:2:3 ratio to 17β estradiol 0.5 mg/day (n = 97), venlafaxine XR 75 mg/day (n = 96), or placebo (n = 146) for 8 weeks. Academic research centers. 339 community-dwelling perimenopausal and postmenopausal women with ≥2 bothersome hot flashes per day. Insomnia symptoms (Insomnia Severity Index [ISI]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) at baseline, week 4 and 8; 325 women (96%) provided ISI data and 312 women (92%) provided PSQI data at baseline and follow-up. At baseline, mean (SD) hot flash frequency was 8.1/day (5.3), mean ISI was 11.1 (6.0), and mean PSQI was 7.5 (3.4). Mean (95% CI) change from baseline in ISI at week 8 was -4.1 points (-5.3 to -3.0) with estradiol, -5.0 points (-6.1 to -3.9) with venlafaxine, and -3.0 points (-3.8 to -2.3) with placebo (P overall treatment effect vs. placebo 0.09 for estradiol and 0.007 for venlafaxine). Mean (95% CI) change from baseline in PSQI at week 8 was -2.2 points (-2.8 to -1.6) with estradiol, -2.3 points (-2.9 to -1.6) with venlafaxine, and -1.2 points (-1.7 to -0.8) with placebo (P overall treatment effect vs. placebo 0.04 for estradiol and 0.06 for venlafaxine). Among perimenopausal and postmenopausal women with hot flashes, both low dose oral estradiol and low-dose venlafaxine compared with placebo modestly reduced insomnia symptoms and improved subjective sleep quality. NCT01418209 at www.clinicaltrials.gov. © 2014 Associated Professional Sleep Societies, LLC.

  5. [Association between insomnia symptoms, daytime napping, and falls in community-dwelling elderly].

    Science.gov (United States)

    Pereira, Alexandre Alves; Ceolim, Maria Filomena; Neri, Anita Liberalesso

    2013-03-01

    This study focused on associations between insomnia symptoms, daytime napping, and falls in community-dwelling elderly, using a population-based cross-sectional design and probability sample with 689 community-dwelling elders. The protocol consisted of self-reported and physical performance variables. The study used univariate and multivariate logistic regression analysis with statistical significance set at p napping were 49.9% (n = 339) and 62.8% (n = 432), respectively. 14.4% reported a single fall and 11.9% reported multiple falls. Falls were associated with female gender (OR = 7.73; 95%CI: 3.03-19.72), age > 80 (OR = 3.48; 95%CI: 1.54-7.85), napping (OR = 2.24; 95%CI: 1.24-4.05), and depressive symptoms (OR = 1.98; 95%CI: 1.11-3.53). The association between daytime napping and falls corroborates data from international research. Identifying modifiable risk factors may help programs to prevent falls in the elderly.

  6. Neural Reward Processing Mediates the Relationship between Insomnia Symptoms and Depression in Adolescence.

    Science.gov (United States)

    Casement, Melynda D; Keenan, Kate E; Hipwell, Alison E; Guyer, Amanda E; Forbes, Erika E

    2016-02-01

    Emerging evidence suggests that insomnia may disrupt reward-related brain function-a potentially important factor in the development of depressive disorder. Adolescence may be a period during which such disruption is especially problematic given the rise in the incidence of insomnia and ongoing development of neural systems that support reward processing. The present study uses longitudinal data to test the hypothesis that disruption of neural reward processing is a mechanism by which insomnia symptoms-including nocturnal insomnia symptoms (NIS) and nonrestorative sleep (NRS)-contribute to depressive symptoms in adolescent girls. Participants were 123 adolescent girls and their caregivers from an ongoing longitudinal study of precursors to depression across adolescent development. NIS and NRS were assessed annually from ages 9 to 13 years. Girls completed a monetary reward task during a functional MRI scan at age 16 years. Depressive symptoms were assessed at ages 16 and 17 years. Multivariable regression tested the prospective associations between NIS and NRS, neural response during reward anticipation, and the mean number of depressive symptoms (omitting sleep problems). NRS, but not NIS, during early adolescence was positively associated with late adolescent dorsal medial prefrontal cortex (dmPFC) response to reward anticipation and depressive symptoms. DMPFC response mediated the relationship between early adolescent NRS and late adolescent depressive symptoms. These results suggest that NRS may contribute to depression by disrupting reward processing via altered activity in a region of prefrontal cortex involved in affective control. The results also support the mechanistic differentiation of NIS and NRS. © 2016 Associated Professional Sleep Societies, LLC.

  7. Comorbid insomnia symptoms predict lower 6-month adherence to CPAP in US veterans with obstructive sleep apnea.

    Science.gov (United States)

    Wallace, Douglas M; Sawyer, A M; Shafazand, S

    2018-03-01

    There is limited information on the association between pre-treatment insomnia symptoms and dysfunctional sleep beliefs with continuous positive airway pressure (CPAP) adherence in veterans with obstructive sleep apnea (OSA). Our aims were to describe demographic and sleep characteristics of veterans with and without comorbid insomnia and determine whether pre-treatment insomnia symptoms and dysfunctional sleep beliefs predict CPAP use after 6 months of therapy. Hispanic veterans attending the Miami VA sleep clinic were recruited and completed the insomnia severity index, the dysfunctional sleep belief and attitude scale (DBAS), and other questionnaires. Participants were asked to return after 7 days and 1 and 6 months to repeat questionnaires and for objective CPAP adherence download. Hierarchical regression models were performed to determine adjusted associations of pre-treatment insomnia symptoms and DBAS sub-scores on 6-month mean daily CPAP use. Fifty-three participants completed the 6-month follow-up visit with a mean CPAP use of 3.4 ± 1.9 h. Veterans with comorbid insomnia had lower mean daily CPAP use (168 ± 125 vs 237 ± 108 min, p = 0.04) and lower percent daily CPAP use ≥ 4 h (32 ± 32 vs 51 ± 32%, p = 0.05) compared to participants without insomnia. In adjusted analyses, pre-treatment insomnia symptoms (early, late, and aggregated nocturnal symptoms) and sleep dissatisfaction were predictive of lower CPAP use at 6 months. Pre-treatment dysfunctional sleep beliefs were not associated with CPAP adherence. Pre-treatment nocturnal insomnia symptoms and sleep dissatisfaction predicted poorer 6- month CPAP use. Insomnia treatment preceding or concurrent with CPAP initiation may eliminate a barrier to regular use.

  8. Insomnia Symptoms, Daytime Naps And Physical Leisure Activities In The Elderly: FIBRA Study Campinas

    Directory of Open Access Journals (Sweden)

    Natália Tonon Monteiro

    2014-04-01

    Full Text Available The practice of physical activities contributes to reducing the risk of chronic diseases and improves sleep patterns in the elderly. This research aimed to investigate the association between insomnia symptoms and daytime nap and the participation in physical leisure activities in elderly community residents. Data from the Studies Network of the Fragility in Brazilian Elderly (Campinas site, were used. Information from 689 elderly was analyzed, regarding sociodemographic characterization, physical leisure activity, occurrence of daytime napping and its duration, symptoms of insomnia and use of sleep medication. A significant association was found between the practice of walking and the daytime nap of short duration. Studies indicate that a short nap can benefit the quality of sleep and health of the elderly. Therefore, promoting the practice of walking can be a nursing intervention that favors the sleep patterns of the elderly.

  9. Predictors of insomnia symptoms and nightmares among individuals with post-traumatic stress disorder: an ecological momentary assessment study.

    Science.gov (United States)

    Short, Nicole A; Allan, Nicholas P; Stentz, Lauren; Portero, Amberly K; Schmidt, Norman B

    2018-02-01

    Despite the high levels of comorbidity between post-traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD-specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia-specific (i.e. dysfunctional beliefs about sleep, insomnia-related safety behaviours and daily stressors) predictors of sleep quality, efficiency and nightmares in a sample of 30 individuals with PTSD. Participants participated in ecological momentary assessment to determine how daily changes in PTSD- and insomnia-related factors lead to changes in sleep. Multi-level modelling analyses indicated that, after accounting for baseline PTSD symptom severity, PTSD-specific factors were associated with insomnia symptoms, but insomnia-specific factors were not. Only daytime PTSD symptoms and fear of sleep predicted nightmares. Both sleep- and PTSD-related factors play a role in maintaining insomnia among those with PTSD, while nightmares seem to be linked more closely with only PTSD-related factors. © 2017 European Sleep Research Society.

  10. Yoga for the Treatment of Insomnia among Cancer Patients: Evidence, Mechanisms of Action, and Clinical Recommendations

    OpenAIRE

    Mustian, Karen M.; Janelsins, Michelle; Peppone, Luke J.; Kamen, Charles

    2014-01-01

    Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing and persistent cancer- and cancer treatment-related toxicities reported by patients, and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are under-sc...

  11. Insomnia and Neuroticism are Related with Depressive Symptoms of Medical Students

    OpenAIRE

    Changnam Kim; Suyeon Lee; Soyoung Youn; Boram Park; Seockhoon Chung

    2017-01-01

    Background and Objective Insomnia is very common in depression and especially medical students are easy to experience sleep disturbance because of their studies. Also depressive symptoms are closely related to stress. Stress is an interaction between an individual and the environment, involving subjective perception and assessment of stressors, thus constituting a highly personalized process. Different personality traits can create different levels of stress. In this study, we tried to explor...

  12. Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

    Science.gov (United States)

    Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

    2015-02-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P insomnia. © 2014 European Sleep Research Society.

  13. Internet-delivered cognitive-behavioral therapy for insomnia and comorbid symptoms

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    Susanne Hagatun

    2018-06-01

    Full Text Available Background: Cognitive-behavioral therapy for insomnia (CBTi is considered the standard treatment. The internet has proven to be a useful and successful tool of providing CBTi. However, few studies have investigated the possible effect of unguided internet-delivered CBTi (ICBTi on comorbid psychological symptoms and fatigue. Methods: Based on a randomized controlled trial, we investigated whether unguided ICBTi had an effect on comorbid psychological symptoms. Adults with insomnia (n = 181; 67% women; mean age 44.9 years [SD 13.0] were randomized to ICBTi (n = 95 or to an online patient education condition (n = 86 for a nine-week period. Results: The results from mixed linear modelling yielded medium to large between-group effect sizes from pre- to post-treatment for symptoms of anxiety or depression (d = −0.57; 95% CI = 0.79–0.35 and fatigue (d = 0.92; 95% CI = 1.22–0.62. The ICBTi group was reassessed at a 6-month non-randomized follow-up, and the completing participants had on the average a significant increase (from the post-assessment on symptoms of anxiety or depression, while the reduction in symptoms of fatigue (on post-assessment was maintained. However, due to high dropout attrition and no control group data, caution should be made regarding the long-term effects. In conclusion, the present findings show that unguided ICBTi positively influence comorbid symptoms in the short-term, thereby emphasizing the clinical relevance of unguided ICBTi. Trial registration: ClinicalTrials.gov identifier: NCT02261272 Keywords: Cognitive-behavioral therapy for insomnia, Internet-based intervention, Fatigue, Depression, Anxiety

  14. Heritability and mortality risk of insomnia-related symptoms: a genetic epidemiologic study in a population-based twin cohort.

    Science.gov (United States)

    Hublin, Christer; Partinen, Markku; Koskenvuo, Markku; Kaprio, Jaakko

    2011-07-01

    Our aim was to estimate heritability in phenotypic insomnia and the association between insomnia and mortality. Representative follow-up study. 1990 survey of the Finnish Twin Cohort (N = 12502 adults; 1554 monozygotic and 2991 dizygotic twin pairs). Current insomnia-related symptoms (insomnia in general, difficulty in initiating sleep, sleep latency, nocturnal awakening, early morning awakening, and non-restorative sleep assessed in the morning and during the day) were asked. Latent class analysis was used to classify subjects into different sleep quality classes. Quantitative genetic modelling was used to estimate heritability. Mortality data was obtained from national registers until end of April 2009. The heritability estimates of each symptom were similar in both genders varying from 34% (early morning awakening) to 45% (nocturnal awakening). The most parsimonious latent class analysis produced 3 classes: good sleepers (48%), average sleepers (up to weekly symptoms, 40%), and poor sleepers (symptoms daily or almost daily, 12%). The heritability estimate for the cluster was 46% (95% confidence interval 41% to 50%). In a model adjusted for smoking, BMI, and depressive symptoms, the all-cause mortality of poor sleepers was elevated (excess mortality 55% in men and 51% in women). Further adjustment for sleep length, use of sleep promoting medications, and sleep apnea-related symptoms did not change the results. Insomnia-related symptoms were common in both genders. The symptoms and their clusters showed moderate heritability estimates. A significant association was found between poor sleep and risk of mortality, especially in those with somatic disease.

  15. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance.

    Science.gov (United States)

    Alsaggaf, Mohammed A; Wali, Siraj O; Merdad, Roah A; Merdad, Leena A

    2016-02-01

    To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep.

  16. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance

    Directory of Open Access Journals (Sweden)

    Mohammed A. Alsaggaf

    2016-02-01

    Full Text Available Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320 were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep.

  17. Diffusion Tensor Imaging Tractography Reveals Disrupted White Matter Structural Connectivity Network in Healthy Adults with Insomnia Symptoms

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    Feng-Mei Lu

    2017-11-01

    Full Text Available Neuroimaging studies have revealed that insomnia is characterized by aberrant neuronal connectivity in specific brain regions, but the topological disruptions in the white matter (WM structural connectivity networks remain largely unknown in insomnia. The current study uses diffusion tensor imaging (DTI tractography to construct the WM structural networks and graph theory analysis to detect alterations of the brain structural networks. The study participants comprised 30 healthy subjects with insomnia symptoms (IS and 62 healthy subjects without IS. Both the two groups showed small-world properties regarding their WM structural connectivity networks. By contrast, increased local efficiency and decreased global efficiency were identified in the IS group, indicating an insomnia-related shift in topology away from regular networks. In addition, the IS group exhibited disrupted nodal topological characteristics in regions involving the fronto-limbic and the default-mode systems. To our knowledge, this is the first study to explore the topological organization of WM structural network connectivity in insomnia. More importantly, the dysfunctions of large-scale brain systems including the fronto-limbic pathways, salience network and default-mode network in insomnia were identified, which provides new insights into the insomnia connectome. Topology-based brain network analysis thus could be a potential biomarker for IS.

  18. Neurobehavioral Performance Impairment in Insomnia: Relationships with Self-Reported Sleep and Daytime Functioning

    Science.gov (United States)

    Shekleton, Julia A.; Flynn-Evans, Erin E.; Miller, Belinda; Epstein, Lawrence J.; Kirsch, Douglas; Brogna, Lauren A.; Burke, Liza M.; Bremer, Erin; Murray, Jade M.; Gehrman, Philip; Lockley, Steven W.; Rajaratnam, Shantha M. W.

    2014-01-01

    . Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning. SLEEP 2014;37(1):107-116. PMID:24470700

  19. [Insomnia associated with psychiatric disorders].

    Science.gov (United States)

    Suzuki, Masahiro; Konno, Chisato; Furihata, Ryuji; Osaki, Koichi; Uchiyama, Makoto

    2009-08-01

    Most psychiatric disorders, such as schizophrenia, mood disorders, or neurotic disorders are associated with sleep disorders of various kinds, among which insomnia is most prevalent and important in psychiatric practice. Almost all patients suffering from major depression complain of insomnia. Pharmacological treatment of insomnia associated with major depression shortens the duration to achieve remission of depression. Insomnia has been recently reported to be a risk factor for depression. In patients with schizophrenia, insomnia is often an early indicator of the aggravation of psychotic symptoms. Electroencephalographic sleep studies have also revealed sleep abnormalities characteristic to mood disorders, schizophrenia and anxiety disorders. A shortened REM sleep latency has been regarded as a biological marker of depression. Reduced amount of deep non-REM sleep has been reported to be correlated with negative symptoms of schizophrenia. Recently, REM sleep abnormalities were found in teenagers having post-traumatic stress disorder after a boat accident. Although these facts indicate that insomnia plays an important role in the development of psychiatric disorders, there are few hypotheses explaining the cause and effect of insomnia in these disorders. Here, we reviewed recent articles on insomnia associated with psychiatric disorders together with their clinical managements.

  20. Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania.

    Science.gov (United States)

    Lallukka, Tea; Podlipskytė, Aurelija; Sivertsen, Børge; Andruškienė, Jurgita; Varoneckas, Giedrius; Lahelma, Eero; Ursin, Reidun; Tell, Grethe S; Rahkonen, Ossi

    2016-02-01

    Evidence on the association between insomnia symptoms and mortality is limited and inconsistent. This study examined the association between insomnia symptoms and mortality in cohorts from three countries to show common and unique patterns. The Finnish cohort comprised 6605 employees of the City of Helsinki, aged 40-60 years at baseline in 2000-2002. The Norwegian cohort included 6236 participants from Western Norway, aged 40-45 years at baseline in 1997-1999. The Lithuanian cohort comprised 1602 participants from the City of Palanga, aged 35-74 years at baseline in 2003. Mortality data were derived from the Statistics Finland and Norwegian Cause of Death Registry until the end of 2012, and from the Lithuanian Regional Mortality Register until the end of 2013. Insomnia symptoms comprised difficulties initiating sleep, nocturnal awakenings, and waking up too early. Covariates were age, marital status, education, smoking, alcohol, physical inactivity, obesity, diabetes, cardiovascular diseases, depression, shift work, sleep duration, and self-rated health. Cox regression analysis was used. Frequent difficulties initiating sleep were associated with all-cause mortality among men after full adjustments in the Finnish (hazard ratio 2.51; 95% confidence interval 1.07-5.88) and Norwegian (hazard ratio 3.42; 95% confidence interval 1.03-11.35) cohorts. Among women and in Lithuania, insomnia symptoms were not statistically significantly associated with all-cause mortality after adjustments. In conclusion, difficulties initiating sleep were associated with mortality among Norwegian and Finnish men. Variation and heterogeneity in the association between insomnia symptoms and mortality highlights that further research needs to distinguish between men and women, specific symptoms and national contexts, and focus on more chronic insomnia. © 2015 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

  1. Experience of insomnia, symptom attribution and treatment preferences in individuals with moderate to severe COPD: a qualitative study

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    Kauffman KS

    2014-12-01

    Full Text Available Karen S Kauffman,1 Megan Doede,1 Montserrat Diaz-Abad,2 Steven M Scharf,2,3 Wanda Bell-Farrell,2 Valerie E Rogers,1 Jeanne Geiger-Brown1 1Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA; 2Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, MD, USA; 3The University of Maryland Sleep Disorders Center, Baltimore, MD, USA Abstract: Persons with chronic obstructive pulmonary disease (COPD are known to have poor sleep quality. Acceptance of and adherence to therapies for sleep problems may depend on how the person with COPD regards the source of his sleep problem, yet little is known about their attribution as to the cause of these sleep symptoms. The objective of this study was to describe the subjective sleep complaints of individuals with COPD along with their attributions as to the cause of these symptoms, and their treatment preferences for insomnia. Three focus groups were conducted (N=18 with participants who have moderate to severe COPD. Focus group data were transcribed, compared and contrasted to identify themes of attribution. Participants reported difficulty falling asleep, staying asleep, and daytime sleepiness. They attributed their sleep problems primarily to their pulmonary symptoms, but also poor air quality (thick humid air and death anxiety when awake during the night. There was no clear preference for type of treatment to remedy this problem (medication, cognitive therapy, although they indicated that traveling to the clinic was difficult and should be avoided as much as possible. These data suggest that environmental manipulation to improve air quality (eg, air conditioning and modifications to reduce death anxiety could be beneficial to persons with COPD. In-person multi-session therapy may not be acceptable to persons with moderate to severe COPD, however internet-based therapy might make treatment more accessible. Keywords

  2. Individuals with clinically significant insomnia symptoms are characterised by a negative sleep-related expectancy bias: Results from a cognitive-experimental assessment.

    Science.gov (United States)

    Courtauld, Hannah; Notebaert, Lies; Milkins, Bronwyn; Kyle, Simon D; Clarke, Patrick J F

    2017-08-01

    Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). The task involved the presentation of scenarios describing the consequences of poor sleep, and non-sleep related activities, which could be resolved in a benign or a negative manner. The results demonstrated that the high insomnia symptoms group were disproportionately fast to resolve sleep-related scenarios in line with negative outcomes, as compared to benign outcomes, relative to the low insomnia symptoms group. The two groups did not differ in their pattern of resolving non-sleep related scenarios. This pattern of findings is entirely consistent with a sleep-specific expectancy bias operating in individuals with clinically significant insomnia symptoms, and highlights the potential of cognitive-experimental assessment tasks to objectively index patterns of biased cognition in insomnia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Patient-reported outcomes in insomnia: development of a conceptual framework and endpoint model.

    Science.gov (United States)

    Kleinman, Leah; Buysse, Daniel J; Harding, Gale; Lichstein, Kenneth; Kalsekar, Anupama; Roth, Thomas

    2013-01-01

    This article describes qualitative research conducted with patients with clinical diagnoses of insomnia and focuses on the development of a conceptual framework and endpoint model that identifies a hierarchy and interrelationships of potential outcomes in insomnia research. Focus groups were convened to discuss how patients experience insomnia and to generate items for patient-reported questionnaires on insomnia and associated daytime consequences. Results for the focus group produced two conceptual frameworks: one for sleep and one for daytime impairment. Each conceptual framework consists of hypothesized domains and items in each domain based on patient language taken from the focus group. These item pools may ultimately serve as a basis to develop new questionnaires to assess insomnia.

  4. Health Correlates of Insomnia Symptoms and Comorbid Mental Disorders in a Nationally Representative Sample of US Adolescents

    NARCIS (Netherlands)

    Blank, M.; Zhang, J.H.; Lamers, F.; Taylor, A.D.; Hickie, I.B.; Merikangas, K.R.

    2015-01-01

    Study Objectives: To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States. Design: National representative cross-sectional study. Setting: Population-based

  5. Identifying At-Risk Individuals for Insomnia Using the Ford Insomnia Response to Stress Test.

    Science.gov (United States)

    Kalmbach, David A; Pillai, Vivek; Arnedt, J Todd; Drake, Christopher L

    2016-02-01

    A primary focus of the National Institute of Mental Health's current strategic plan is "predicting" who is at risk for disease. As such, the current investigation examined the utility of premorbid sleep reactivity in identifying a specific and manageable population at elevated risk for future insomnia. A community-based sample of adults (n = 2,892; 59.3% female; 47.9 ± 13.3 y old) with no lifetime history of insomnia or depression completed web-based surveys across three annual assessments. Participants reported parental history of insomnia, demographic characteristics, sleep reactivity on the Ford Insomnia in Response to Stress Test (FIRST), and insomnia symptoms. DSM-IV diagnostic criteria were used to determine insomnia classification. Baseline FIRST scores were used to predict incident insomnia at 1-y follow-up. Two clinically meaningful FIRST cutoff values were identified: FIRST ≥ 16 (sensitivity 77%; specificity 50%; odds ratio [OR] = 2.88, P insomnia onset, even after controlling for stress exposure and demographic characteristics. Of the incident cases, insomniacs with highly reactive sleep systems reported longer sleep onset latencies (FIRST ≥ 16: 65 min; FIRST ≥ 18: 68 min) than participants with nonreactive insomnia (FIRST insomnia based on trait sleep reactivity. The FIRST accurately identifies a focused target population in which the psychobiological processes complicit in insomnia onset and progression can be better investigated, thus improving future preventive efforts. © 2016 Associated Professional Sleep Societies, LLC.

  6. Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes

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    Palmieri G

    2017-05-01

    Full Text Available Giancarlo Palmieri,1,2 Paola Contaldi,1 Giuseppe Fogliame1 1ANARDI Medical and Scientific Association, Scafati, Italy; 2Department of Internal Medicine, Niguarda Cà Granda Hospital, Milan, Italy Background and purpose: Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, botanicals can represent an alternative treatment for those kinds of symptoms. The scope of the present study is to evaluate safety and effectiveness of a herbal compound composed of valerian, hop, and jujube (Vagonotte® on primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes.Patients and methods: One hundred and twenty subjects with sleep disturbances symptoms were randomized in two branches of 60 persons each, receiving the herbal compound or placebo at dosage of two pills per day 30 minutes before their scheduled bedtime. All subjects were screened for precise items related to sleep quality and daytime activity at the beginning, after 10 days, and after 20 days of consecutive dietary supplement (or placebo consumption. The participants remained blind to group assignment until all of them completed the trial.Results: Sleep onset, numbers of nocturnal awakenings, and overall nocturnal slept time were assessed. A statistically significant difference between the two groups emerged. The group receiving the herbal compound showed a lower time of sleep onset compared to placebo group, the same result was obtained for total slept time and night awakenings frequency (p<0.001. Daily symptom improvement in subjects receiving the herbal compound showed significant reduction in tension and irritability, difficulty in concentration, and fatigue intensity, if compared to placebo scores (p<0.001. None of the 60 subjects in the verum group

  7. Change in organizational justice as a predictor of insomnia symptoms: longitudinal study analysing observational data as a non-randomized pseudo-trial.

    Science.gov (United States)

    Lallukka, Tea; Halonen, Jaana I; Sivertsen, Børge; Pentti, Jaana; Stenholm, Sari; Virtanen, Marianna; Salo, Paula; Oksanen, Tuula; Elovainio, Marko; Vahtera, Jussi; Kivimäki, Mika

    2017-08-01

    Despite injustice at the workplace being a potential source of sleep problems, longitudinal evidence remains scarce. We examined whether changes in perceived organizational justice predicted changes in insomnia symptoms. Data on 24 287 Finnish public sector employees (82% women), from three consecutive survey waves between 2000 and 2012, were treated as 'pseudo-trials'. Thus, the analysis of unfavourable changes in organizational justice included participants without insomnia symptoms in Waves 1 and 2, with high organizational justice in Wave 1 and high or low justice in Wave 2 (N = 6307). In the analyses of favourable changes in justice, participants had insomnia symptoms in Waves 1 and 2, low justice in Wave 1 and high or low justice in Wave 2 (N = 2903). In both analyses, the outcome was insomnia symptoms in Wave 3. We used generalized estimating equation models to analyse the data. After adjusting for social and health-related covariates in Wave 1, unfavourable changes in relational organizational justice (i.e. fairness of managerial behaviours) were associated with increased odds of developing insomnia symptoms [odds ratio = 1.15; 95% confidence interval (CI) 1.02-1.30]. A favourable change in relational organizational justice was associated with lower odds of persistent insomnia symptoms (odds ratio = 0.83; 95% CI 0.71-0.96). Changes in procedural justice (i.e. the fairness of decision-making procedures) were not associated with insomnia symptoms. These data suggest that changes in perceived relational justice may affect employees' sleep quality. Decreases in the fairness of managerial behaviours were linked to increases in insomnia symptoms, whereas rises in fairness were associated with reduced insomnia symptoms. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association.

  8. Insomnia in Sweden: A Population-Based Survey

    OpenAIRE

    Mallon, Lena; Broman, Jan-Erik; Åkerstedt, Torbjörn; Hetta, Jerker

    2014-01-01

    Aims. Estimate the prevalence of insomnia and examine effects of sex, age, health problems, sleep duration, need for treatment, and usage of sleep medication. Methods. A sample of 1,550 subjects aged 18–84 years was selected for a telephone interview. The interview was completed by 1,128 subjects (72.8%). Results. 24.6% reported insomnia symptoms. Insomnia disorder, that is, insomnia symptoms and daytime consequences, was reported by 10.5%. The prevalence was similar among all age groups, wit...

  9. MANAGEMENT OF INSOMNIA

    Directory of Open Access Journals (Sweden)

    Liya Rosdiana Sholehah

    2013-04-01

    Full Text Available Sleep is an essential component of health and well-being. The effects of insomnia, Whether as a primary or secondary symptoms, is a major health concern and should be closely studied and Examined across all age groups. There is growing evidence that the effects of insomnia on Adolescent's functioning is comparable to that of other major psychiatric disorders (eg, mood disorders, anxiety disorders, etc... Insomnia is associated with significant negative Consequences, impairing functioning across a number of emotional, social, cognitive, and physical domains (Carskadon, 1999; Johnson, Roth, Schultz, & Breslau, 2006; Roberts, Roberts, & Duong, 2008b; Wolfson & Carskadon, 1998. Based on the academic literature to date, it is hypothesized that insomnia will be Significantly more prevalent   among   Adolescents   of   the   female   sex   and   among   those   reporting psychological and / or physical health concerns. The analyzes conducted included basic descriptive statistics (frequencies / percentages, bivariate analyzes (Chi-square tests, and a multiple logistic regression. The prevalence rate of insomnia in adolescents was 9.5%, with no significant association found between sex and insomnia. The multivariate analysis Showed Significantly insomnia to be associated with the presence of a chronic condition, selected mood disorders (12 months, in adolescents  who  are  experiencing  "quite  a  bit"  to  "extreme"  life  stress,  and  in adolescents who were living in than other households with both parents. Insomnia was not found to be associated Significantly with sex, selected anxiety disorder (12 months, heavy drinking, heavy cannabis use, and in Adolescents who were only experiencing "some life stress".  heavy cannabis  use  and  having  a selected  anxiety Significantly disorder was associated with insomnia. More informed knowledge can be used to create prevention and treatment strategies to address

  10. Insomnia and paranoia

    OpenAIRE

    Freeman, Daniel; Pugh, Katherine; Vorontsova, Natasha; Southgate, Laura

    2009-01-01

    Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services....

  11. Socio-economic differences in self-reported insomnia and stress in Finland from 1979 to 2002: a population-based repeated cross-sectional survey

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    Talala Kirsi M

    2012-08-01

    Full Text Available Abstract Background Over the decades, global public health efforts have sought to reduce socio-economic health differences, including differences in mental health. Only a few studies have examined changes in socio-economic differences in psychological symptoms over time. The aim of this study was to assess trends in socio-economic differences in self-reported insomnia and stress over a 24-year time period in Finland. Methods The data source is a repeated cross-sectional survey “Health Behaviour and Health among the Finnish Adult Population” (AVTK, from the years 1979 to 2002, divided into five study periods. Indicators for socio-economic status included employment status from the survey, and educational level and household income from the Statistics Finland register data. We studied the age group of 25–64 years (N = 70115; average annual response rate 75%. Outcome measures were single questions of self-reported insomnia and stress. Results The overall prevalence of insomnia was 18-19% and that of stress 16-19%. Compared to the first study period, 1979–1982, the prevalence of stress increased until study period 1993–1997. The prevalence of insomnia increased during the last study period, 1998–2002. Respondents who were unemployed or had retired early reported more insomnia and stress over time among both men and women. Lower education was associated with more insomnia especially among men; and conversely, with less stress among both sexes. Compared to the highest household income level, those in the intermediate levels of income had less stress whereas those in the lowest income levels had more stress among both sexes. Income level differences in insomnia were less consistent. In general, socio-economic differences in self-reported insomnia and stress fluctuated some, but did not change substantially over the study period 1979–2002. Conclusions Self-reported insomnia and stress were more common during later study periods. The

  12. Insomnia in people with epilepsy: A review of insomnia prevalence, risk factors and associations with epilepsy-related factors.

    Science.gov (United States)

    Macêdo, Philippe Joaquim Oliveira Menezes; Oliveira, Pedro Sudbrack de; Foldvary-Schaefer, Nancy; Gomes, Marleide da Mota

    2017-09-01

    Insomnia is a common sleep complaint in the general population, and sleep loss may be a trigger for epileptic seizures. To conduct a comprehensive review of the literature of insomnia symptoms and insomnia disorder, their prevalence and epilepsy-related risk factors in people with epilepsy (PWE). A PUBMED search was performed for articles indexed to June 2016 involving human subjects, excluding papers in languages other than English, Spanish and Portuguese and case reports. Eligible studies were those using a clear definition of insomnia and reporting quantitative data on prevalence rates and risk factors. The search included the following terms: insomnia, sleep disorder(s), sleep disturbance(s) and sleep-wake in the title and abstract; and epilep* in the title. 425 papers were reviewed and 31 were selected for the final analysis (21 adult and 10 paediatric). Twenty-one studies used a control group. Two reviewer authors independently extracted all data and a third author resolved disagreements. Most studies were hospital-based, cross-sectional and evaluated convenience samples representing highly select populations. Various insomnia inventories were used. Fourteen assessed insomnia (10 in adults, four, children), but only five as primary outcome (none in children). Four evaluated insomnia disorder based on international classification criteria (International Classification of Sleep Disorders - ICSD-2-in 3, and DSM-IV-TR, in 1). In adults, insomnia prevalence was 28.9-51% based on the Insomnia Severity Index ≥15 and 36-74.4% based on DSM-IV-TR or ICSD-2. The prevalence of insomnia in children was 13.1-31.5% using the Sleep Disturbance Scale for Children and 11% based on ICSD-2 diagnostic criteria. Compared to control groups, PWE usually had higher frequencies of insomnia symptoms and disorder. Insomnia was associated with greater impairment in quality of life and higher degree of depressive symptoms in several studies, and was inconsistently related to female

  13. Telehealth Cognitive Behavior Therapy for Co-Occurring Insomnia and Depression Symptoms in Older Adults

    Science.gov (United States)

    Lichstein, Kenneth L.; Scogin, Forrest; Thomas, S. Justin; DiNapoli, Elizabeth A.; Dillon, Haley R.; McFadden, Anna

    2015-01-01

    Objective Telehealth has proven effective with a wide range of disorders, but there is a paucity of data on the use of telehealth using cognitive-behavior therapy (CBT) with late-life insomnia and depression. This pilot study was designed to examine the feasibility and effectiveness of using telehealth to treat older adults with comorbid insomnia and depression living in rural Alabama. Method Five patients received 10 sessions of CBT for insomnia and depression. Patients were engaged in treatment via Skype from their primary care physician’s office. Assessments were conducted at baseline, posttreatment, and 2-month follow-up. Results Patients exhibited clinically significant improvement in both insomnia (sleep diaries and Insomnia Severity Index) and depression (Hamilton Rating Scale for Depression) at posttreatment, and these gains were well maintained at 2-month follow-up. Conclusions These preliminary data suggest that telehealth may be an effective means of providing treatment to older adults, including underserved populations. PMID:24014056

  14. Identifying At-Risk Individuals for Insomnia Using the Ford Insomnia Response to Stress Test

    Science.gov (United States)

    Kalmbach, David A.; Pillai, Vivek; Arnedt, J. Todd; Drake, Christopher L.

    2016-01-01

    Study Objectives: A primary focus of the National Institute of Mental Health's current strategic plan is “predicting” who is at risk for disease. As such, the current investigation examined the utility of premorbid sleep reactivity in identifying a specific and manageable population at elevated risk for future insomnia. Methods: A community-based sample of adults (n = 2,892; 59.3% female; 47.9 ± 13.3 y old) with no lifetime history of insomnia or depression completed web-based surveys across three annual assessments. Participants reported parental history of insomnia, demographic characteristics, sleep reactivity on the Ford Insomnia in Response to Stress Test (FIRST), and insomnia symptoms. DSM-IV diagnostic criteria were used to determine insomnia classification. Results: Baseline FIRST scores were used to predict incident insomnia at 1-y follow-up. Two clinically meaningful FIRST cutoff values were identified: FIRST ≥ 16 (sensitivity 77%; specificity 50%; odds ratio [OR] = 2.88, P insomnia onset, even after controlling for stress exposure and demographic characteristics. Of the incident cases, insomniacs with highly reactive sleep systems reported longer sleep onset latencies (FIRST ≥ 16: 65 min; FIRST ≥ 18: 68 min) than participants with nonreactive insomnia (FIRST insomnia based on trait sleep reactivity. The FIRST accurately identifies a focused target population in which the psychobiological processes complicit in insomnia onset and progression can be better investigated, thus improving future preventive efforts. Citation: Kalmbach DA, Pillai V, Arnedt JT, Drake CL. Identifying at-risk individuals for insomnia using the ford insomnia response to stress test. SLEEP 2016;39(2):449–456. PMID:26446111

  15. Insomnia disorder and endogenous neurophysiological dynamics

    NARCIS (Netherlands)

    Colombo, M.

    2018-01-01

    Insomnia symptoms are the most common medical complaints, affecting up to a third of the general population. Insomnia symptoms include sleep problems (initiating or maintaining sleep) as well their repercussions on wake-time functioning. Insomnia Disorder can be diagnosed when insomnia symptoms are

  16. Using Mid-Sleep Time to Determine Chronotype in Young Adults with Insomnia-Related Symptoms

    Directory of Open Access Journals (Sweden)

    Sooyeon Suh

    2017-12-01

    Full Text Available The Munich Chronotype Questionnaire (MCTQ uses sleep behavior to assess chronotype, but the extent to which such sleep behavior based assessments might be useful in populations with sleep disorders, such as insomnia, is currently unclear. We thus systematically assessed sleep disorders, MCTQ and the Morningness-Eveningness Questionnaire (MEQ, another behavioral preferencebased assessment of chronotype, in 310 individuals. In a smaller substudy (n = 121, we compared the MCTQ to sleep diaries in insomnia patients and good sleepers. Insomnia patients had overall lower consistency in chronotypes compared to good sleepers on the MCTQ compared to the MEQ, which was also evident when compared to sleep diaries. As insomnia disorder is characterized by time gaps spent awake during the night due to difficulty maintaining sleep, there may be limitations in using mid-sleep time as an accurate indicator of chronotype in insomnia patients. Our study suggests that the MCTQ should be used in conjunction with another existing questionnaire or assessment tool when assessing chronotype in insomnia patients.

  17. The Effect of Ramelteon on Heartburn Symptoms of Patients With Gastroesophageal Reflux Disease and Chronic Insomnia: A Pilot Study.

    Science.gov (United States)

    Jha, Lokesh K; Fass, Ronnie; Gadam, Rakshith; Maradey-Romero, Carla; Nasrollah, Laya; Hershcovici, Tiberiu; Quan, Stuart F; Dickman, Ram

    2016-02-01

    There is a bidirectional relationship between gastroesophageal reflux disease (GERD) and sleep. It has been demonstrated that antireflux treatment can improve sleep quality in GERD patients with nighttime reflux. Patients with heartburn and/or regurgitation ≥3 times/week and insomnia for ≥3 months were included. Patients were assessed at baseline with the demographic, GERD symptom assessment scale, Epworth sleepiness scale, Berlin sleep apnea, Pittsburgh sleep quality index, and the Insomnia severity index questionnaires. Subjects underwent an upper endoscopy followed by pH testing. Subsequently, subjects were randomized, in a double-blind, placebo-controlled trial, to receive either ramelteon 8 mg or placebo before bedtime for 4 weeks. During the last week of treatment, subjects completed a daily GERD symptom and sleep diary and underwent actigraphy. Sixteen patients completed the study, 8 in each arm (mean age and M/F were 48.5 vs. 57.8 y, and 8/0 vs. 6/2, respectively). Patients who received ramelteon demonstrated a statistically significant decrease in symptom score as compared with those who received placebo for daytime heartburn (-42% vs. -29%), nighttime heartburn (-42% vs. 78%), 24-hour heartburn (-42% vs. -3%), and 24-hour acid regurgitation (-26% vs. 19%) (all P<0.05). Insomnia severity index score was significantly reduced in patients receiving ramelteon as compared with placebo (-46% vs. -5%, P<0.05). Ramelteon group also demonstrated a significant improvement in sleep efficiency and sleep latency, as compared with placebo, P<0.05). No significant adverse events were observed with ramelteon. Ramelteon significantly improved symptoms in patients with GERD. In addition, ramelteon significantly improved patients' sleep experience. Further studies are needed in the future (NCT01128582).

  18. Insomnia in a chronic musculoskeletal pain with disability population is independent of pain and depression.

    Science.gov (United States)

    Asih, Sali; Neblett, Randy; Mayer, Tom G; Brede, Emily; Gatchel, Robert J

    2014-09-01

    Insomnia is frequently experienced by patients suffering from chronic musculoskeletal disorders but is often seen as simply a symptom of pain or depression and not as an independent disorder. Compared with those who experience only chronic pain, patients with both chronic pain and insomnia report higher pain intensity, more depressive symptoms, and greater distress. However, insomnia has not yet been systematically studied in a chronic musculoskeletal pain with disability population. This study assessed the prevalence and severity of patient-reported insomnia, as well as the relationship among insomnia, pain intensity, and depressive symptoms, in a chronic musculoskeletal pain with disability population. This was a retrospective study of prospectively captured data. A consecutive cohort of 326 chronic musculoskeletal pain with disability patients (85% with spinal injuries) entered a functional restoration treatment program. All patients signed a consent form to participate in this protocol. Insomnia was assessed with the Insomnia Severity Index, a validated patient-report measure of insomnia symptoms. Four patient groups were formed: no clinically significant insomnia (score, 0-7); subthreshold insomnia (score, 8-14); moderate clinical insomnia (score, 15-21); and severe clinical insomnia (score, 22-28). Three patterns of sleep disturbance were also evaluated: early, middle, and late insomnia. Additional validated psychosocial patient-reported data were collected, including the Pain Visual Analog Scale, the Beck Depression Inventory, the Oswestry Disability Index, and the Pain Disability Questionnaire. Patients completed a standard psychosocial assessment battery on admission to the functional restoration program. The program included a quantitatively directed exercise process in conjunction with a multimodal disability management approach. The four insomnia groups were compared on demographic and psychosocial variables. The shared variances among insomnia

  19. Gastroesophageal reflux disease as an etiology of sleep disturbance in subjects with insomnia and minimal reflux symptoms: a pilot study of prevalence and response to therapy.

    Science.gov (United States)

    Shaheen, Nicholas J; Madanick, Ryan D; Alattar, Maha; Morgan, Douglas R; Davis, Paris H; Galanko, Joseph A; Spacek, Melissa B; Vaughn, Bradley V

    2008-06-01

    Gastroesophageal reflux disease (GERD) is a well-recognized cause of impaired sleep in patients with frequent GERD symptoms, as well as those with sleep apnea. GERD's role in sleep disturbance of minimally symptomatic patients with poor sleep quality is less clear. We aimed to define the prevalence of GERD-related sleep disturbance in minimally-symptomatic subjects with demonstrated insomnia, and to assess the changes in sleep efficiency in these subjects after vigorous acid suppression. We recruited subjects aged 18-75 years reporting at least 6 months of insomnia, and sleep difficulty at least three nights per week. Subjects with a BMI > 30, a history of snoring or ongoing use of proton pump inhibitor or H2 receptor antagonist were excluded. Subjects underwent concurrent sleep study with dual channel 24-h pH study. Sleep efficiency, defined as the percentage of time after sleep initiation that the subject actually slept, and spontaneous arousal index, defined as the number of arousals per hour, were calculated. Those with a sleep study demonstrating poor sleep quality (sleep efficiency of 10 arousals/h for those aged 15 for those who were 45 or older) and no obstructive sleep apnea were treated with rabeprazole 20 mg PO BID x 14 days. After 14 days, the subjects underwent repeat sleep study with pH monitoring. The GERD Symptom Assessment Scale (GSAS), the Epworth Sleepiness Scale (ESS) and the Functional Outcomes of Sleep Questionnaire (FOSQ) were administered to subjects at study inception and after 2 weeks of therapy. Twenty-four subjects reporting insomnia were enrolled, and 20 met criteria for disordered sleep and no OSA. Seventeen completed both the first and second studies, and 16 were adequate for analysis. Baseline GSAS demonstrated trivial or no reflux symptoms in the cohort (no subject scored > 8 out of 45 on GSAS, corresponding to a median rating of reflux symptoms of "not at all"). Four of 16 subjects (25%) demonstrated abnormal pH studies at baseline

  20. Cortical Thinning and Altered Cortico-Cortical Structural Covariance of the Default Mode Network in Patients with Persistent Insomnia Symptoms.

    Science.gov (United States)

    Suh, Sooyeon; Kim, Hosung; Dang-Vu, Thien Thanh; Joo, Eunyeon; Shin, Chol

    2016-01-01

    Recent studies have suggested that structural abnormalities in insomnia may be linked with alterations in the default-mode network (DMN). This study compared cortical thickness and structural connectivity linked to the DMN in patients with persistent insomnia (PI) and good sleepers (GS). The current study used a clinical subsample from the longitudinal community-based Korean Genome and Epidemiology Study (KoGES). Cortical thickness and structural connectivity linked to the DMN in patients with persistent insomnia symptoms (PIS; n = 57) were compared to good sleepers (GS; n = 40). All participants underwent MRI acquisition. Based on literature review, we selected cortical regions corresponding to the DMN. A seed-based structural covariance analysis measured cortical thickness correlation between each seed region of the DMN and other cortical areas. Association of cortical thickness and covariance with sleep quality and neuropsychological assessments were further assessed. Compared to GS, cortical thinning was found in PIS in the anterior cingulate cortex, precentral cortex, and lateral prefrontal cortex. Decreased structural connectivity between anterior and posterior regions of the DMN was observed in the PIS group. Decreased structural covariance within the DMN was associated with higher PSQI scores. Cortical thinning in the lateral frontal lobe was related to poor performance in executive function in PIS. Disrupted structural covariance network in PIS might reflect malfunctioning of antero-posterior disconnection of the DMN during the wake to sleep transition that is commonly found during normal sleep. The observed structural network alteration may further implicate commonly observed sustained sleep difficulties and cognitive impairment in insomnia. © 2016 Associated Professional Sleep Societies, LLC.

  1. Nonpharmacologic Management of Chronic Insomnia.

    Science.gov (United States)

    Maness, David L; Khan, Muneeza

    2015-12-15

    Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are difficulty falling asleep, difficulty staying asleep, or early awakening despite the opportunity for sleep; symptoms must be associated with impaired daytime functioning and occur at least three times per week for at least one month. Factors associated with the onset of insomnia include a personal or family history of insomnia, easy arousability, poor self-reported health, and chronic pain. Insomnia is more common in women, especially following menopause and during late pregnancy, and in older adults. A comprehensive sleep history can confirm the diagnosis. Psychiatric and medical problems, medication use, and substance abuse should be ruled out as contributing factors. Treatment of comorbid conditions alone may not resolve insomnia. Patients with movement disorders (e.g., restless legs syndrome, periodic limb movement disorder), circadian rhythm disorders, or breathing disorders (e.g., obstructive sleep apnea) must be identified and treated appropriately. Chronic insomnia is associated with cognitive difficulties, anxiety and depression, poor work performance, decreased quality of life, and increased risk of cardiovascular disease and all-cause mortality. Insomnia can be treated with nonpharmacologic and pharmacologic therapies. Nonpharmacologic therapies include sleep hygiene, cognitive behavior therapy, relaxation therapy, multicomponent therapy, and paradoxical intention. Referral to a sleep specialist may be considered for refractory cases.

  2. Individual, lifestyle, and psychosocial factors related to insomnia among Norwegian musicians

    OpenAIRE

    Saksvik-Lehouillier, Ingvild; Bjerkeset, Ottar; Vaag, Jonas

    2017-01-01

    Musicians report a considerably higher prevalence of insomnia symptoms compared to community samples in the general workforce. The aim of this study was to investigate the association between insomnia and health, work-related, and lifestyle factors among musicians. A total of 645 full-time musicians completed a questionnaire measuring insomnia symptoms: personality, psychosocial factors (perceived job demands, job control, effort-reward imbalance, and general social support), and lifestyle (s...

  3. Association between insomnia symptoms, job strain and burnout syndrome: a cross-sectional survey of 1300 financial workers.

    Science.gov (United States)

    Metlaine, Arnaud; Sauvet, Fabien; Gomez-Merino, Danielle; Elbaz, Maxime; Delafosse, Jean Yves; Leger, Damien; Chennaoui, Mounir

    2017-01-13

    Professional burnout is closely related to work stress but less frequently associated with disturbed sleep. This study determines whether job strain and sleep disturbances are associated risk factors of burnout among financial workers. Observational study. 1300 employees (725 female) of a financial company. Self-reported questionnaires (Maslach Burnout Inventory, Job Content Questionnaire, Sleep questionnaire based on ICSD-3 classification), the Epworth sleepiness scale and the Hospital Anxiety and Depression Scale (HADS). The prevalence of burnout was 10.2% (9.0% moderate and 1.2% severe). 23.3% of workers were considered with high job strain, and 93.1% had a high level of job satisfaction. 16.8% of individuals had insomnia and 97% reported non-restorative sleep. The bivariate analyses demonstrate a higher risk of burnout in participants with insomnia (OR=14.7, 95% CI 9.8 to 21.9), non-restorative sleep (OR=9.9, 95% CI 5.1 to 19.5) and anxiety (OR=10.2, 95% CI 6.8 to 15.3). High job strain was associated with burnout (OR=1.9, 95% CI 1.1 to 3.6). This association was not maintained after adjustment for sleep parameters. Job satisfaction was another independent risk factor for burnout (OR=124, 95% CI 65 to 237). In our sample of financial workers, job strain represents a burnout risk factor only if associated with insomnia. Insomnia can be considered as a relevant clinical marker that should be targeted in mental health prevention programmes at the workplace. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Relationship between subtypes and symptoms of ADHD, insomnia, and nightmares in connection with quality of life in children

    Directory of Open Access Journals (Sweden)

    Grünwald J

    2017-09-01

    Full Text Available Julia Grünwald,1 Angelika Anita Schlarb2 1Department of Psychology, Faculty of Science, University of Tübingen, Tübingen, 2Department of Clinical Psychology and Psychotherapy, Faculty of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany Objectives: This study examined the links between sleep disorders and subtypes of attention deficit-hyperactivity disorder (ADHD-inattention, ADHD-combined, ADHD-hyperactive/impulsive in childhood. We set up a hypothetical model linking different symptoms of both disorders to construct the underlying and shared pathways. By examining a sample of children with ADHD we firstly tested parts of the model.Methods: A total of 72 children with symptoms of ADHD (aged 6–13 years; 79.2% boys were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and the International Classification of Sleep Disorders, third edition in regards to ADHD and sleep disorders via standardized parent-rated questionnaires. Additionally, quality of life (QoL was assessed. Overall, 46 children fulfilled the criteria of ADHD and were medication-naive.Results: On average, the whole sample had clinically elevated total scores of the Children’s Sleep Habits Questionnaire in the validated German version (CSHQ-DE, indicating an increased prevalence of sleep disorders in children with ADHD. In accordance to our hypothetical model, children with primarily hyperactive–impulsive ADHD showed the highest CSHQ-DE scores. Moreover, we found a high impact for insomnia in this subgroup and a high comorbid load for the mutual occurrence of insomnia and nightmares. Furthermore, QoL was reduced in our whole sample, and again intensified in children with comorbid insomnia and nightmares.Conclusion: We verified an elevated occurrence of sleep disorders in children with ADHD and were able to link them to specific subtypes of ADHD. These results were in line with our hypothetical model

  5. Qigong program on insomnia and stress in cancer patients: A case series report

    Directory of Open Access Journals (Sweden)

    Seungmo Kim

    2015-01-01

    Full Text Available Background: In recent years, the interest in Qigong as an alternative therapy has grown following reports of its ability to regulate psychological factors in cancer patients. This is a case series to evaluate the outcome measures of Qigong when used as an adjunct to standard medical care to treat insomnia and stress in cancer patients. Patients and methods: The Qigong program was applied to four cancer patients with insomnia, stress, and anxiety. The program consisted of 30-min sessions involving exercise, patting of the 12 meridians, and spontaneous breathing exercises three times a week for a period of 4 weeks. The Pittsburgh Sleep Quality Index was measured as the primary outcome, while the Stress Scale, the State–Trait Anxiety Inventory, and the Functional Assessment Cancer Therapy–General determined the secondary outcomes. Insomnia, stress, and anxiety levels were examined weekly, while quality of life was examined on the first visit and the last visit. Results: The Pittsburgh Sleep Quality Index and Stress Scale scores were reduced after conduct of the Qigong program. Conclusion: This study could provide a better understanding of Qigong’s influence on insomnia and stress in cancer patients. However, a larger controlled trial should be conducted to confirm these findings.

  6. [Management of insomnia and hypersomnia associated with psychiatric disorders].

    Science.gov (United States)

    Uchiyama, Makoto; Suzuki, Masahiro; Konno, Chisato; Furihata, Ryuji; Osaki, Koichi; Konno, Michiko; Takahashi, Sakae

    2010-01-01

    Most psychiatric disorders, such as schizophrenia, mood disorders, or neurotic disorders are associated with sleep disorders of various kinds, among which insomnia is most prevalent and important in psychiatric practice. Almost all patients suffering from major depression complain of insomnia. Pharmacological treatment of insomnia associated with major depression shortens the duration to achieve remission of depression. Insomnia has been recently reported to be a risk factor for depression. Hypersomnia is also a major sleep problem in patient suffering from depression. There have been no clinical guide to treat the symptoms of hypersomnia in depression, but some clinical trials treating them with NDRI or adjunctive administration of psychostimulants. In patients with schizophrenia, insomnia is often an early indicator of the aggravation of psychotic symptoms. Electroencephalographic sleep studies have also revealed sleep abnormalities characteristic to mood disorders, schizophrenia and anxiety disorders. A shortened REM sleep latency has been regarded as a biological marker of depression. Reduced amount of deep Non-REM sleep has been reported to be correlated with negative symptoms of schizophrenia. Recently, REM sleep abnormalities were found in teenagers having post-traumatic stress disorder after a boat accident. Although these facts indicate that insomnia plays an important role in the development of psychiatric disorders, there are few hypotheses explaining the cause and effect of insomnia in these disorders. Here, we reviewed recent articles on insomnia and hypersomnia associated with psychiatric disorders together with their clinical managements.

  7. Insomnia and paranoia.

    Science.gov (United States)

    Freeman, Daniel; Pugh, Katherine; Vorontsova, Natasha; Southgate, Laura

    2009-03-01

    Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services. Assessments of insomnia, persecutory ideation, anxiety, and depression were completed by 300 individuals from the general population and 30 individuals with persecutory delusions and a diagnosis of non-affective psychosis. Insomnia symptoms were clearly associated with higher levels of persecutory ideation. Consistent with the theoretical understanding of paranoia, the association was partly explained by the presence of anxiety and depression. Moderate or severe insomnia was present in more than 50% of the delusions group. The study provides the first direct evidence that insomnia is common in individuals with high levels of paranoia. It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia.

  8. Can Insomnia in Pregnancy Predict Postpartum Depression? A Longitudinal, Population-Based Study

    Science.gov (United States)

    Dørheim, Signe K.; Bjorvatn, Bjørn; Eberhard-Gran, Malin

    2014-01-01

    Background Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. Methods A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS) was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms. Results After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours), and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS) improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. Limitations Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. Conclusions Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous depression. PMID

  9. Effect of Six-Month Diet Intervention on Sleep among Overweight and Obese Men with Chronic Insomnia Symptoms: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Xiao Tan

    2016-11-01

    Full Text Available Growing evidence suggests that diet alteration affects sleep, but this has not yet been studied in adults with insomnia symptoms. We aimed to determine the effect of a six-month diet intervention on sleep among overweight and obese (Body mass index, BMI ≥ 25 kg/m2 men with chronic insomnia symptoms. Forty-nine men aged 30–65 years with chronic insomnia symptoms were randomized into diet (n = 28 or control (n = 21 groups. The diet group underwent a six-month individualized diet intervention with three face-to-face counseling sessions and online supervision 1–3 times per week; 300–500 kcal/day less energy intake and optimized nutrient composition were recommended. Controls were instructed to maintain their habitual lifestyle. Sleep parameters were determined by piezoelectric bed sensors, a sleep diary, and a Basic Nordic sleep questionnaire. Compared to the controls, the diet group had shorter objective sleep onset latency after intervention. Within the diet group, prolonged objective total sleep time, improved objective sleep efficiency, lower depression score, less subjective nocturnal awakenings, and nocturia were found after intervention. In conclusion, modest energy restriction and optimized nutrient composition shorten sleep onset latency in overweight and obese men with insomnia symptoms.

  10. Maternal Insomnia and Children's Family Socialization Environments

    Science.gov (United States)

    Gregory, Alice M.; Moffitt, Terrie E.; Ambler, Antony; Arseneault, Louise; Houts, Renate M.; Caspi, Avshalom

    2012-01-01

    Study Objectives: To examine concurrent associations between maternal insomnia and different aspects of the family socialization environment. Design: Mothers reported on their symptoms of insomnia in a private standardized interview and interviewers evaluated the family socialization environment using the Coder's Inventory. Setting: Assessments were conducted in participants' homes within the U.K. Patients or Participants: One thousand one hundred sixteen mothers of British children enrolled in the Environmental Risk (E-Risk) study were invited to participate when their children were aged 12 years. Interventions: N/A. Measurements and Results: After controlling for family socioeconomic status (SES), mothers' relationship status, and maternal depression, maternal insomnia was associated with a poorer family socialization environment (β = −0.10, [95% confidence intervals (CI) = −0.16, −0.04], P Ambler A; Arseneault L; Houts RM; Caspi A. Maternal insomnia and children's family socialization environments. SLEEP 2012;35(4):579-582. PMID:22467996

  11. Scalp and Body Acupuncture for Treatment of Senile Insomnia-A Report of 83 Cases

    Institute of Scientific and Technical Information of China (English)

    卢泽强

    2002-01-01

    @@ The author has in recent years treated 83 cases of senile insomnia with scalp and body acupuncture. Meanwhile, 35 cases in the control group were treated with western and Chinese drugs. The therapeutic results in the treatment group were superior to that of nitrazapam and An Shen Bu Nao Ye (安神补脑液Sedative and Brain-invigorating Fluid) used in the control group. A report of the treatment follows.

  12. Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population

    Science.gov (United States)

    Seow, Lee Seng Esmond; Verma, Swapna Kamal; Mok, Yee Ming; Kumar, Sunita; Chang, Sherilyn; Satghare, Pratika; Hombali, Aditi; Vaingankar, Janhavi; Chong, Siow Ann; Subramaniam, Mythily

    2018-01-01

    Study Objectives: With the introduction of insomnia disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), greater emphasis has been placed on the diagnosis and treatment of sleep disorder even in the presence of a coexisting mental disorder. The current study seeks to explore the clinical picture of insomnia in the context of psychiatric disorders commonly associated with sleep complaints by assessing the prevalence and correlates of DSM-5 insomnia disorder, and examining the extent to which insomnia symptoms have been addressed in this population. Methods: Four hundred treatment-seeking outpatients suffering from depressive, bipolar affective, anxiety, and schizophrenia spectrum disorders were recruited. DSM-5 insomnia was established using the modified Brief Insomnia Questionnaire. Differences in sociodemographic factors, clinical status, impairment outcomes, and mental health services utilization were compared. Information on patients' help-seeking experiences for insomnia-related symptoms was collected to determine the treatment received and treatment effectiveness. Results: Almost one-third of our sample (31.8%) had DSM-5 insomnia disorder. Those with insomnia disorder had significantly higher impairment outcomes than their counterparts but no group difference was observed for mental health services utilization. Findings based on past treatment contact for sleep problems suggest that diagnosis and treatment of insomnia is lacking in this population. Conclusions: With the new calling from DSM-5, clinicians treating psychiatric patients should view insomnia less as a symptom of their mental illnesses and treat clinical insomnia as a primary disorder. Patients should also be educated on the importance of reporting and treating their sleep complaints. Nonmedical (cognitive and behavioral) interventions for insomnia need to be further explored given their proven clinical effectiveness. Citation: Seow LSE, Verma SK, Mok YM, Kumar

  13. Prevalence of insomnia and its impact on daily function amongst Malaysian primary care patients

    Directory of Open Access Journals (Sweden)

    Zailinawati Abu-Hassan

    2012-11-01

    Full Text Available Abstract Background Insomnia is a common public health problem and the prevalence and impact of insomnia in primary care attendees is not well documented in the Asian population. Objectives To determine the prevalence of self-reported insomnia symptoms amongst adult primary care attendees and the association with socio-demographic factors; to ascertain the impact of insomnia on daily functioning and to describe the psychological profile of patients with insomnia. Methods In this cross-sectional survey, 2049 adult patients (≥18 year old attending seven primary care clinics in Peninsular Malaysia, completed the questionnaire asking about symptoms of insomnia (defined according to the International Classification of Sleep Disorders and DSM IV criteria daytime impairment and psychological symptoms (assessed by Hospital Anxiety and Depression Scale. Results The response rate was 86.2%. A total of 60% reported insomnia symptoms, 38.9% had frequent insomnia symptoms (>3 times per week, 30.7% had chronic insomnia without daytime consequences and 28.6% had chronic insomnia with daytime dysfunction. Indian ethnicity (OR 1.79; 95%CI, 1.28-2.49, age ≥ 50 or older (OR 1.82; 95%CI, 1.10-3.01, anxiety symptoms (OR 1.65; 95%CI, 1.21-2.22 and depression symptoms (OR 1.65; 95%CI, 1.21-2.26 were risk factors for chronic insomnia with daytime dysfunction. Amongst those with chronic insomnia with daytime dysfunction, 47.8% had anxiety symptoms (OR, 2.01; 95%CI, 1.57-2.59 and 36.5% had depression symptoms (OR, 2.74; 95%CI, 2.04-3.68 based on HADs score. They also had tendency to doze off while driving and to be involved in road traffic accidents. Conclusions A third of primary care attendees have insomnia symptoms and chronic insomnia, associated with significant daytime dysfunction and psychological morbidity. By identifying those at risk of having chronic insomnia, appropriate interventions can be commenced.

  14. Childhood adversity and insomnia in adolescence.

    Science.gov (United States)

    Wang, Yan; Raffeld, Miriam R; Slopen, Natalie; Hale, Lauren; Dunn, Erin C

    2016-05-01

    The study aims to evaluate the association between exposure to childhood adversity and insomnia, with an emphasis on the role of adversity type, timing, and accumulation (i.e., the number of specific types of adversities the child reported being exposed to). Our analytic sample comprised 9582 adolescents from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative population-based sample. We examined the association between 18 different types of retrospectively reported adversities (capturing interpersonal violence, accidents and injuries, social network or witnessing events, and other adverse events) and risk of self-reported past-year insomnia. We also examined whether the age at first exposure to adversity was associated with the risk of insomnia, and whether exposure to a greater number of different types of adversities (ie, accumulation) conferred an elevated risk of insomnia. In addition, we performed a sensitivity analysis excluding adolescents with a past-year diagnosis of major depression, dysthymia, post-traumatic stress disorder (PTSD), or generalized anxiety disorder. Almost one-third of adolescents reported insomnia, with a higher prevalence among girls and those from racial/ethnic minority groups. Adolescents exposed to at least one childhood adversity of any type (59.41%) were more likely than their nonexposed peers to experience insomnia (across adversities, prevalence ratios (PRs) ranged from 1.31 to 1.89). Risk of insomnia differed based on the age at first exposure to adversity as well as the type of adversity. Adolescents exposed to a greater number of different types of adversities had a higher risk of insomnia compared to those experiencing fewer adversities. These results were similar, by and large, to those obtained after excluding adolescents with at least one of the four past-year psychiatric disorders. Exposure to adversity confers an elevated risk of insomnia. This association varied by type

  15. Insomnia Phenotypes Based on Objective Sleep Duration in Adolescents: Depression Risk and Differential Behavioral Profiles

    Directory of Open Access Journals (Sweden)

    Julio Fernandez-Mendoza

    2016-12-01

    Full Text Available Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12–23, 54.7% male underwent a nine-hour polysomnography (PSG, clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric Behavior Scale. Insomnia symptoms were defined as a self-report of difficulty falling and/or staying asleep and objective “short” sleep duration as a PSG total sleep time ≤7 h. A significant interaction showed that objective short sleep duration modified the association of insomnia symptoms with internalizing problems. Consistently, adolescents with insomnia symptoms and short sleep duration were characterized by depression, rumination, mood dysregulation and social isolation, while adolescents with insomnia symptoms and normal sleep duration were characterized by rule-breaking and aggressive behaviors and, to a lesser extent, rumination. These findings indicate that objective sleep duration is useful in differentiating behavioral profiles among adolescents with insomnia symptoms. The insomnia with objective short sleep duration phenotype is associated with an increased risk of depression earlier in the lifespan than previously believed.

  16. Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population.

    Science.gov (United States)

    Seow, Lee Seng Esmond; Verma, Swapna Kamal; Mok, Yee Ming; Kumar, Sunita; Chang, Sherilyn; Satghare, Pratika; Hombali, Aditi; Vaingankar, Janhavi; Chong, Siow Ann; Subramaniam, Mythily

    2018-02-15

    With the introduction of insomnia disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), greater emphasis has been placed on the diagnosis and treatment of sleep disorder even in the presence of a coexisting mental disorder. The current study seeks to explore the clinical picture of insomnia in the context of psychiatric disorders commonly associated with sleep complaints by assessing the prevalence and correlates of DSM-5 insomnia disorder, and examining the extent to which insomnia symptoms have been addressed in this population. Four hundred treatment-seeking outpatients suffering from depressive, bipolar affective, anxiety, and schizophrenia spectrum disorders were recruited. DSM-5 insomnia was established using the modified Brief Insomnia Questionnaire. Differences in sociodemographic factors, clinical status, impairment outcomes, and mental health services utilization were compared. Information on patients' help-seeking experiences for insomnia-related symptoms was collected to determine the treatment received and treatment effectiveness. Almost one-third of our sample (31.8%) had DSM-5 insomnia disorder. Those with insomnia disorder had significantly higher impairment outcomes than their counterparts but no group difference was observed for mental health services utilization. Findings based on past treatment contact for sleep problems suggest that diagnosis and treatment of insomnia is lacking in this population. With the new calling from DSM-5, clinicians treating psychiatric patients should view insomnia less as a symptom of their mental illnesses and treat clinical insomnia as a primary disorder. Patients should also be educated on the importance of reporting and treating their sleep complaints. Nonmedical (cognitive and behavioral) interventions for insomnia need to be further explored given their proven clinical effectiveness. © 2018 American Academy of Sleep Medicine

  17. Online insomnia treatment and the reduction of anxiety symptoms as a secondary outcome in a randomised controlled trial: The role of cognitive-behavioural factors.

    Science.gov (United States)

    Gosling, John A; Batterham, Phil; Ritterband, Lee; Glozier, Nick; Thorndike, Frances; Griffiths, Kathleen M; Mackinnon, Andrew; Christensen, Helen M

    2018-04-01

    Insomnia and anxiety commonly co-occur, yet the mechanisms underlying this remain unclear. The current paper describes the impact of an Internet-based intervention for insomnia on anxiety, and explores the influence of two cognitive-behavioural constructs - dysfunctional beliefs about sleep and sleep-threat monitoring. A large-scale, 9-week, two-arm randomised controlled trial ( N = 1149) of community-dwelling Australian adults with insomnia and elevated yet subclinical depression symptoms was conducted, comparing a cognitive behavioural therapy-based online intervention for insomnia (Sleep Healthy Using The Internet) with an attention-matched online control intervention (HealthWatch). Symptoms of anxiety were assessed at pretest, posttest, and 6-month follow-up. Dysfunctional beliefs about sleep and sleep threat monitoring were assessed only at pretest. Sleep Healthy Using The Internet led to a greater reduction in anxiety symptoms at both posttest ( t 724.27  = -6.77, p < 0.001) and at 6-month follow-up ( t 700.67  = -4.27, p < 0.001) than HealthWatch. At posttest and follow-up, this effect was found to moderated by sleep-threat monitoring ( t 713.69  = -2.39, p < 0.05 and t 694.77  = -2.98, p < 0.01 respectively) but not by dysfunctional beliefs about sleep at either posttest or follow-up ( t 717.53  = -0.61, p = 0.55 and t 683.79  = 0.22, p = 0.83 respectively). Participants in the Sleep Healthy Using The Internet condition with higher levels of sleep-threat monitoring showed a greater reduction in anxiety than those with lower levels from pretest to posttest, ( t 724.27  = -6.77, p < 0.001) and through to 6-month follow-up ( t 700.67  = -4.27, p < 0.001). This result remained after controlling for baseline anxiety levels. The findings suggest that online cognitive behavioral therapy interventions for insomnia are beneficial for reducing anxiety regardless of people's beliefs about their sleep

  18. Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning.

    Science.gov (United States)

    Shekleton, Julia A; Flynn-Evans, Erin E; Miller, Belinda; Epstein, Lawrence J; Kirsch, Douglas; Brogna, Lauren A; Burke, Liza M; Bremer, Erin; Murray, Jade M; Gehrman, Philip; Lockley, Steven W; Rajaratnam, Shantha M W

    2014-01-01

    Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. Cross-sectional, multicenter study. Three sleep laboratories in the USA and Australia. Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ± 12.0 years [mean ± SD]) and 20 healthy controls (14F, 34.8 ± 12.1 years). N/A. Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency.

  19. Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes

    OpenAIRE

    Palmieri, Giancarlo; Contaldi, Paola; Fogliame, Giuseppe

    2017-01-01

    Giancarlo Palmieri,1,2 Paola Contaldi,1 Giuseppe Fogliame1 1ANARDI Medical and Scientific Association, Scafati, Italy; 2Department of Internal Medicine, Niguarda Cà Granda Hospital, Milan, Italy Background and purpose: Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, ...

  20. Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes.

    Science.gov (United States)

    Palmieri, Giancarlo; Contaldi, Paola; Fogliame, Giuseppe

    2017-01-01

    Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, botanicals can represent an alternative treatment for those kinds of symptoms. The scope of the present study is to evaluate safety and effectiveness of a herbal compound composed of valerian, hop, and jujube (Vagonotte ® ) on primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes. One hundred and twenty subjects with sleep disturbances symptoms were randomized in two branches of 60 persons each, receiving the herbal compound or placebo at dosage of two pills per day 30 minutes before their scheduled bedtime. All subjects were screened for precise items related to sleep quality and daytime activity at the beginning, after 10 days, and after 20 days of consecutive dietary supplement (or placebo) consumption. The participants remained blind to group assignment until all of them completed the trial. Sleep onset, numbers of nocturnal awakenings, and overall nocturnal slept time were assessed. A statistically significant difference between the two groups emerged. The group receiving the herbal compound showed a lower time of sleep onset compared to placebo group, the same result was obtained for total slept time and night awakenings frequency ( p Botanicals dietary supplement with relaxing and soothing properties can help practitioner to treat primary insomnia, especially when the risk/benefit profile of a patient does not sustain hypnotic drugs prescription. This clinical investigation on safety and effectiveness of a herbal compound made of valerian, hop, and jujube opens interesting perspectives on usage of herbal compound to manage primary insomnia. Further investigations could help in understanding herbal compounds' effectiveness on sleep disturbances.

  1. The Pathophysiology of Insomnia

    Science.gov (United States)

    Levenson, Jessica C.; Kay, Daniel B.

    2015-01-01

    Insomnia disorder is characterized by chronic dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep, frequent nighttime awakenings with difficulty returning to sleep, and/or awakening earlier in the morning than desired. Although progress has been made in our understanding of the nature, etiology, and pathophysiology of insomnia, there is still no universally accepted model. Greater understanding of the pathophysiology of insomnia may provide important information regarding how, and under what conditions, the disorder develops and is maintained as well as potential targets for prevention and treatment. The aims of this report are (1) to summarize current knowledge on the pathophysiology of insomnia and (2) to present a model of the pathophysiology of insomnia that considers evidence from various domains of research. Working within several models of insomnia, evidence for the pathophysiology of the disorder is presented across levels of analysis, from genetic to molecular and cellular mechanisms, neural circuitry, physiologic mechanisms, sleep behavior, and self-report. We discuss the role of hyperarousal as an overarching theme that guides our conceptualization of insomnia. Finally, we propose a model of the pathophysiology of insomnia that integrates the various types of evidence presented. PMID:25846534

  2. WHAT IS INSOMNIA

    Directory of Open Access Journals (Sweden)

    Nurzakiah binti Zaini

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Insomnia is a sleep disorder with recurrent difficulty to sleep or maintaining sleep with symptoms tired all day. There are several types of insomnia, transient insomnia which is temporary insomnia, short-term insomnia that can last for several weeks, and chronic insomnia that can last for more than four weeks. Insomnia is caused by several factors, including physical factors such as suffering from certain diseases, environmental factors, psychological factors and psychiatric problems. To overcome this disorder we can use relaxation techniques, subconscious programming, and drug therapy. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  3. Sporadic fatal insomnia in a young woman: A diagnostic challenge: Case Report

    Directory of Open Access Journals (Sweden)

    Cracco Laura

    2011-10-01

    Full Text Available Abstract Background Sporadic fatal insomnia (sFI and fatal familial insomnia (FFI are rare human prion diseases. Case Presentation We report a case of a 33-year-old female who died of a prion disease for whom the diagnosis of sFI or FFI was not considered clinically. Following death of this patient, an interview with a close family member indicated the patient's illness included a major change in her sleep pattern, corroborating the reported autopsy diagnosis of sFI. Genetic tests identified no prion protein (PrP gene mutation, but neuropathological examination and molecular study showed protease-resistant PrP (PrPres in several brain regions and severe atrophy of the anterior-ventral and medial-dorsal thalamic nuclei similar to that described in FFI. Conclusions In patients with suspected prion disease, a characteristic change in sleep pattern can be an important clinical clue for identifying sFI or FFI; polysomnography (PSG, genetic analysis, and nuclear imaging may aid in diagnosis.

  4. Pharmacologic Treatment of Insomnia Disorder: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians.

    Science.gov (United States)

    Wilt, Timothy J; MacDonald, Roderick; Brasure, Michelle; Olson, Carin M; Carlyle, Maureen; Fuchs, Erika; Khawaja, Imran S; Diem, Susan; Koffel, Erin; Ouellette, Jeannine; Butler, Mary; Kane, Robert L

    2016-07-19

    Pharmacologic interventions are often prescribed for insomnia disorder. To assess the benefits, harms, and comparative effectiveness of pharmacologic treatments for adults with insomnia disorder. Several electronic databases (2004-September 2015), reference lists, and U.S. Food and Drug Administration (FDA) documents. 35 randomized, controlled trials of at least 4 weeks' duration that evaluated pharmacotherapies available in the United States and that reported global or sleep outcomes; 11 long-term observational studies that reported harm information; FDA review data for nonbenzodiazepine hypnotics and orexin receptor antagonists; and product labels for all agents. Data extraction by single investigator confirmed by a second reviewer; dual-investigator assessment of risk of bias; consensus determination of strength of evidence. Eszopiclone, zolpidem, and suvorexant improved short-term global and sleep outcomes compared with placebo, although absolute effect sizes were small (low- to moderate-strength evidence). Evidence for benzodiazepine hypnotics, melatonin agonists, and antidepressants, and for most pharmacologic interventions in older adults, was insufficient or low strength. Evidence was also insufficient to compare efficacy within or across pharmacotherapy classes or versus behavioral therapy. Harms evidence reported in trials was judged insufficient or low strength; observational studies suggested that use of hypnotics for insomnia was associated with increased risk for dementia, fractures, and major injury. The FDA documents reported that most pharmacotherapies had risks for cognitive and behavioral changes, including driving impairment, and other adverse effects, and they advised dose reduction in women and in older adults. Most trials were small and short term and enrolled individuals meeting stringent criteria. Minimum important differences in outcomes were often not established or reported. Data were scant for many treatments. Eszopiclone, zolpidem, and

  5. A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety.

    Science.gov (United States)

    Fißler, Maria; Quante, Arnim

    2014-02-01

    Symptoms of agitation, anxiety and insomnia are frequent among patients with major depressive disorder (MDD) during the first weeks of psychiatric care. But a substantial number of patients declines taking pharmaceutical medication to avoid side effects. Therefore, an alternative herbal medication is needed. Clinical studies demonstrated that lavender oil capsules, termed Lasea®, have an anxiolytic effect comparable to Lorazepam and significantly reduce insomnia and agitation in non-depressed patients. Therefore, the aim of this retrospective case series was to analyze the effectiveness of Lasea® for patients with MDD and symptoms of anxiety, insomnia and psychomotor agitation. Eight cases were analyzed retrospectively regarding the dosage, length of treatment, possible side effects and effectiveness of Lasea®. All cases were treated at the Department of Psychiatry at Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin in a naturalistic setting. Effectiveness was measured by a change in the Hamilton Rating Scale for Depression (HAMD-17) total score and subscores. In 6 cases, the combination of Lasea® and an antidepressant resulted in a reduction of MDD. Lasea® also reduced agitation in 6 cases. Psychological anxiety was reduced in 5, somatic anxiety in 4 cases whereas sleep-onset and sleep-maintenance insomnia improved in 3 cases each. The results demonstrate that Lasea® reduces some of the anxiety related symptoms and sleep disturbances in MDD patients. Furthermore Lasea® significantly reduces psychomotor agitation. Additionally, the results indicate a significant global improvement stemming from the combinational therapy of Lasea® and antidepressant medication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Insomnia symptoms and their association with workplace productivity: cross-sectional and pre-post intervention analyses from a large multinational manufacturing company.

    Science.gov (United States)

    Espie, Colin A; Pawlecki, Brent; Waterfield, Dickon; Fitton, Kit; Radocchia, Michael; Luik, Annemarie I

    2018-06-01

    Symptoms of insomnia are common and might impact work productivity. We investigated the relationship between insomnia symptoms and workplace productivity in a global manufacturing company. Within an uncontrolled, cross-sectional study, employees from a US-based company were invited to participate in an online evaluation comprising the Sleep Condition Indicator (SCI) measuring symptoms of insomnia (high score indicating better sleep), 2 items of the Work Productivity and Impairment Index (WPAI) measuring 'presenteeism' and 'absenteeism' (high score indicating loss of work productivity) and 1 item of the Perceived Stress Scale (PSS) from January 2015 onwards. Pre-post, within-subject data were collected to preliminary test effects of 'sleep tips' and digital cognitive behavioral therapy (dCBT). In 2798 employees [72% male; mean age 46.3(SD11.8) yrs] sleep was poorest in plant staff [SCI = 3.70(2.73)], then retail staff [4.34(3.02)], then office staff [4.95(2.83): overall F(2,2786) = 43.7, P work-related productivity, with stress only contributing a further 9%. A regression model for 'absenteeism' was statistically significant but of limited predictive value (R 2 = 3.4%). In a sample of 214 employees with pre- and post-intervention data, the SCI of those exposed to sleep tips significantly increased from 5.36(3.28) to 6.01(3.22), [t(123) = -3.02, P = .003] and from 3.08(2.24) to 6.03(2.97) for those who accessed dCBT [t(89) = -8.40, P work productivity. Additionally, targeted insomnia interventions may offer potential to improve sleep and work productivity. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  7. Insomnia and endothelial function - the HUNT 3 fitness study.

    Directory of Open Access Journals (Sweden)

    Linn B Strand

    Full Text Available BACKGROUND: Insomnia is associated with increased risk of coronary heart disease (CHD, but the underlying mechanisms are not understood. To our knowledge, no previous studies have examined insomnia in relation to endothelial function, an indicator of preclinical atherosclerosis. Our aim was to assess the association of insomnia with endothelial function in a large population based study of healthy individuals. METHODS: A total of 4 739 participants free from known cardiovascular or pulmonary diseases, cancer, and sarcoidosis, and who were not using antihypertensive medication were included in the study. They reported how often they had experienced difficulties falling asleep at night, repeated awakenings during the night, early awakenings without being able to go back to sleep, and daytime sleepiness. Endothelial function was measured by flow mediated dilation (FMD derived from the brachial artery. RESULTS: We found no consistent association between the insomnia symptoms and endothelial function in multiadjusted models, but individual insomnia symptoms may be related to endothelial function. Among women who reported early awakenings, endothelial function may be lower than in women without this symptom (p = 0.03. CONCLUSIONS: This study provided no evidence that endothelial function, an early indicator of atherosclerosis, is an important linking factor between insomnia and CHD. Further studies are needed to explore the complex interrelation between sleep and cardiovascular pathology.

  8. Severe, childhood-onset, idiopathic, life-long insomnia responding selectively to opiate therapy: case report with 19 year follow-up.

    Science.gov (United States)

    Schenck, C H; Mahowald, M W

    2001-11-01

    Idiopathic (primary) insomnia can be difficult to treat; only two prior cases responsive to opiate therapy have been reported. A case is now presented of severe, idiopathic, childhood-onset, familial insomnia, with increased libido, absence of psychopathology, tardive emergence of restless legs syndrome (RLS), and selective response to opiate therapy. A 39-year-old woman was referred in 1981 by her physician who had discovered 3 years earlier that propoxyphene treatment of migraines also controlled her chronic insomnia. She had experienced severe insomnia since childhood, and during early adulthood the insomnia intensified, as she would sleep 0-3 h nightly and never napped. Daily generalized motor restlessness resulted in her frequently walking around the house while feeling exhausted. The quality of her life was considerably compromised by her insomnia, motor restlessness, and by an increased libido that was present since puberty and that was only partially relieved by having sex repeatedly with her husband. Nightly opiate therapy for 19 years has controlled the insomnia, motor restlessness, and excessive libido without affecting her normal libido. The insomnia had not responded to treatment with >25 agents covering >10 pharmacologic categories. During her first (unmedicated) polysomnographic (PSG) study in 1981, she slept 0 min while spending 436 min in bed. In 1984, four consecutive PSG studies were conducted in a design that confirmed the efficacy of propoxyphene therapy of her insomnia. In 1990, an ambulatory PSG revealed two runs of EEG rhythmic paroxysmal activity arising from sleep and wakefulness, without clinical correlate. Neurologic history was negative for seizures, but positive for complete right carotid artery occlusion and three transient ischemic attacks. At age 55 years, typical RLS emerged that was controlled with levodopa therapy, and a concurrent relapse of insomnia was controlled with oxycodone replacing propoxyphene. Nightly opiate therapy of

  9. Insomnia and the risk of incident heart failure: a population study.

    Science.gov (United States)

    Laugsand, Lars E; Strand, Linn B; Platou, Carl; Vatten, Lars J; Janszky, Imre

    2014-06-01

    Insomnia is highly prevalent among heart failure patients, but only a few small studies have investigated insomnia symptoms and risk of heart failure. We aimed to assess the prospective association between self-reported insomnia symptoms and the risk of incident heart failure in a large Norwegian cohort. Baseline data on insomnia symptoms, including difficulty initiating sleep, difficulty maintaining sleep and having non-restorative sleep, socio-demographic variables, and health status, including established cardiovascular risk factors, were collected from 54 279 men and women 20-89 years of age who participated in the Nord-Trøndelag Health study (HUNT) between 1995 and 1997 and were free from known heart failure at baseline. The cohort was followed for incident heart failure from baseline through 2008. We used Cox proportional hazard models to assess the association of baseline insomnia symptoms with the risk of heart failure. A total of 1412 cases of heart failure occurred during a mean follow-up of 11.3 years (SD = 2.9 years), either identified at hospitals or by the National Cause of Death Registry. There was a dose-dependent association between the number of insomnia symptoms and risk of heart failure. The multi-adjusted hazard ratios were 0.96 (0.57-1.61), 1.35 (0.72-2.50), and 4.53 (1.99-10.31) for people with one, two, and three insomnia symptoms, compared with people with none of the symptoms (P for trend 0.021). Insomnia is associated with an increased risk of incident heart failure. If our results are confirmed by others and causation is proved, evaluation of insomnia symptoms might have consequences for cardiovascular prevention. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.

  10. Sleep Disorders: Insomnia.

    Science.gov (United States)

    Burman, Deepa

    2017-09-01

    Insomnia is the most common type of sleep disorder in the family medicine population. It is defined as a persistent difficulty initiating or maintaining sleep, or a report of nonrestorative sleep, accompanied by related daytime impairment. Insomnia is a significant public health problem because of its high prevalence and management challenges. There is increasing evidence of a strong association between insomnia and various medical and psychiatric comorbidities. Diagnosis of insomnia and treatment planning rely on a thorough sleep history to address contributing and precipitating factors as well as maladaptive behaviors resulting in poor sleep. Using a sleep diary or sleep log is more accurate than patient recall to determine sleep patterns. A sleep study is not routinely indicated for evaluation of insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the mainstay of treatment and is a safe and effective approach. The key challenge of CBT-I is the lack of clinicians to implement it. The newer generation nonbenzodiazepines (eg, zolpidem, zaleplon) are used as first-line pharmacotherapy for chronic insomnia. Newer drugs active on targets other than the gamma-aminobutyric acid receptor are now available, but clear treatment guidelines are needed. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  11. Possible Insomnia Predicts Some Risky Behaviors among Adolescents when Controlling for Depressive Symptoms

    Science.gov (United States)

    Catrett, Christina D.; Gaultney, Jane F.

    2009-01-01

    This study investigated whether previously reported links between sleep and risk taking among adolescents (E. M. O'Brien & J. A. Mindell, 2005) are associated--concurrently, longitudinally, or both--with sleep or underlying depression. The present study analyzed data from a nationally representative sample of 4,353 adolescents in the United…

  12. How do I best manage insomnia and other sleep disorders in older adults with cancer?

    Science.gov (United States)

    Loh, Kah Poh; Burhenn, Peggy; Hurria, Arti; Zachariah, Finly; Mohile, Supriya Gupta

    2016-11-01

    Insomnia is common in older adults with cancer, with a reported prevalence of 19-60% in prior studies. Cancer treatments are associated with increased risk of insomnia or aggravation of pre-existing insomnia symptoms, and patients who are receiving active cancer treatments are more likely to report insomnia. Insomnia can lead to significant physical and psychological consequences with increased mortality. We discuss physiological sleep changes in older adults, and illustrated the various sleep disorders. We present a literature review on the prevalence and the effects of insomnia on the quality of life in older adults with cancer. We discuss the risk factors and presented a theoretical framework of insomnia in older adults with cancer. We present a case study to illustrate the assessment and management of insomnia in older adults with cancer, comparing and contrasting a number of tools for sleep assessment. There are currently no guidelines on the treatment of sleep disorders in older adults with cancer. We present an algorithm developed at the City of Hope Comprehensive Cancer Center by a multidisciplinary team for managing insomnia, using evidence-based pharmacologic and non-pharmacologic interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Correlates of self-report chronic insomnia disorders with 1-6 month and 6-month durations in home-dwelling urban older adults - the Shih-Pai Sleep Study in Taiwan: a cross-sectional community study.

    Science.gov (United States)

    Chiou, Jing-Hui; Chen, Hsi-Chung; Chen, Kuang-Hung; Chou, Pesus

    2016-06-03

    To examine the correlates of insomnia disorder with different durations in home-dwelling older adults. A cross-sectional survey in the Shih-Pai area of Taipei City, Taiwan (The Shih-Pai Sleep Study). A total 4047 subjects over the age of 65 years completed the study (2259 men and 1788 women). The Pittsburgh Sleep Quality Index and the duration of insomnia symptoms were used to identify DSM-IV 1-6 month and 6-month insomnia disorders. The prevalence of DSM-IV defined insomnia disorder was 5.8 %; two-thirds of these case lasted for ≥6 months. The shared correlates for both 1-6 and 6-month insomnia disorders were gender (women), depression and moderate pain. Pulmonary diseases were exclusively associated with 1-6 month insomnia disorder (OR: 2.57, 95 % CI: 1.46-4.52). In contrast, heart disease (OR: 1.73, 95 % CI: 1.21-2.49) and severe pain (OR: 2.34, 95 % CI: 1.14-4.40) were associated with 6-month insomnia disorder. The prevalence of persistent insomnia disorder is higher than short-term insomnia disorder. Correlates for less persistent and more persistent insomnia disorder appears to be partially different. Duration quantifiers may be important in the identification of the etiology of insomnia and further studies with follow-ups are needed to examine the order of developing insomnia disorder and associated conditions.

  14. Sleep, insomnia, and hypertension: current findings and future directions.

    Science.gov (United States)

    Thomas, S Justin; Calhoun, David

    2017-02-01

    Blood pressure (BP) varies over 24 hours. During normal sleep, BP typically decreases by 10% or more. Research suggests that disordered sleep, particularly sleep deprivation and obstructive sleep apnea, is associated with increased BP and risk of hypertension. Less is known about the relationship between insomnia and hypertension. Population-based studies have reported an association between insomnia symptoms and both prevalent and incident hypertension, particularly in the context of short sleep duration. Furthermore, a number of mechanisms have been proposed to explain the relationship between insomnia and hypertension. However, few studies have examined these proposed mechanisms, and even fewer clinical trials have been conducted to determine if improved sleep improves BP and/or reverses a nondipping BP pattern. Methodological concerns, particularly with respect to the diagnosis of insomnia, no doubt impact the strength of any observed association. Additionally, a large majority of studies have only examined the association between insomnia symptoms and clinic BP. Therefore, future research needs to focus on careful consideration of the diagnostic criteria for insomnia, as well as inclusion of either home BP or ambulatory BP monitoring. Finally, clinical trials aimed at improving the quality of sleep should be conducted to determine if improved sleep impacts 24-hour BP. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  15. 失眠及其相关精神因素对女性肠易激综合征患者的影响%Influence of insomnia and insomnia-related psychological factors on symptoms of female patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    杨微微; 汤玉蓉; 徐新寓; 王一琳; 林琳

    2012-01-01

    AIM: To investigate the influence of insomnia and insomnia-related psychological factors on the symptoms of female patients with irritable bowel syndrome (IBS). METHODS: Two hundred and forty-five adult female outpatients with IBS who were treated at the Department of Gastroenterology of the First Affiliated Hospital of Nanjing Medical University were included in this study. A questionnaire survey was conducted using a demographic information questionnaire, a symptom questionnaire, athens insomnia scale (AIS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS). According to AIS scores, female patients with IBS were divided into insomnia group and non-insomnia group. The influence of insomnia on typical symptoms, somatic symptoms and psychological symptoms of IBS, and the relationship between psychological factors and IBS were analyzed. RESULTS: The insomnia and non-insomnia groups differed significantly in their rating of abdominal pain/discomfort in terms of severity and duration (P < 0.05), but there was no difference in attack frequency between the two groups. The incidence of somatic symptoms, scores of SAS and SDS, and scores of SAS' and SDS' (sleep-related entries were removed) were all significantly higher in the insomnia group than in the non-insomnia group (all P < 0.01). Severity, attack frequency and duration of abdominal pain/discomfort were all positively correlated with SAS and SDS scores (all P< 0.05). CONCLUSION: Insomnia and insomnia-related psychological factors (anxiety, depression) can aggravate the symptoms of female patients with IBS.%目的:探讨失眠和失眠相关精神因素对女性肠易激综合征(irritable bowel syndrome,IBS)患者症状的影响.方法:收集2009-01/10就诊于南京医科大学第一附属医院消化科门诊的成年女性IBS患者245例,对其进行问卷调查:一般人口学资料、症状问卷、阿森斯失眠量表(athens insomnia scale,AIS)、焦虑自评量表(selfrating anxiety

  16. Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population-based study.

    Science.gov (United States)

    Goldman-Mellor, Sidra; Caspi, Avshalom; Gregory, Alice M; Harrington, HonaLee; Poulton, Richie; Moffitt, Terrie E

    2015-04-01

    People with insomnia complain of cognitive deficits in daily life. Results from empirical studies examining associations between insomnia and cognitive impairment, however, are mixed. Research is needed that compares treatment-seeking and community-based insomnia study samples, measures subjective as well as objective cognitive functioning, and considers participants' pre-insomnia cognitive function. We used data from the Dunedin Study, a representative birth cohort of 1,037 individuals, to examine whether insomnia in early midlife was associated with subjective and objective cognitive functioning. We also tested whether individuals with insomnia who reported seeking treatment for their sleep problems (treatment-seekers) showed greater impairment than other individuals with insomnia (non-treatment-seekers). The role of key confounders, including childhood cognitive ability and comorbid health conditions, was evaluated. Insomnia was diagnosed at age 38 according to DSM-IV criteria. Objective neuropsychological assessments at age 38 included the WAIS-IV IQ test, the Wechsler Memory Scale, and the Trail-Making Test. Childhood cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R). A total of 949 cohort members were assessed for insomnia symptoms and other study measures at age 38. Although cohort members with insomnia (n = 186, 19.6%) had greater subjective cognitive impairment than their peers at age 38, they did not exhibit greater objective impairment on formal testing. Treatment-seekers, however, exhibited significant objective impairment compared to non-treatment-seekers. Controlling for comorbidity, daytime impairment, and medications slightly decreased this association. Childhood cognitive deficits antedated the adult cognitive deficits of treatment-seekers. Links between insomnia and cognitive impairment may be strongest among individuals who seek clinical treatment. Clinicians should take into account the

  17. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

    Science.gov (United States)

    Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

    2010-10-01

    To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration 5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (pimprovements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

  18. Drugs for insomnia.

    Science.gov (United States)

    Zisapel, Nava

    2012-09-01

    Sleep is a vital neurochemical process involving sleep-promoting and arousal centers in the brain. Insomnia is a pervasive disorder characterized by difficulties in initiating or maintaining or non-refreshing (poor quality) sleep and clinically significant daytime distress. Insomnia is more prevalent in women and old age and puts sufferers at significant physical and mental health risks. This review summarizes published data on the current and emerging insomnia drug classes, rationale for development and associated risks/benefits. (Summary of Product Characteristics and Medline search on "hypnotic" or specific drug names and "Insomnia"). GABA(A) receptor modulators facilitate sleep onset and some improve maintenance but increase risk of dependence, memory, cognitive and psychomotor impairments, falls, accidents and mortality. Melatonin receptor agonists improve quality of sleep and/or sleep onset but response may develop over several days. They have more benign safety profiles and are indicated for milder insomnia, longer usage and (prolonged release melatonin) older patients. Histamine H-1 receptor antagonists improve sleep maintenance but their effects on cognition, memory and falls remain to be demonstrated. Late-stage pipeline orexin OX1/OX2 and serotonin 5HT2A receptor antagonists may hold the potential to address several unmet needs in insomnia pharmacotherapy but safety issues cast some doubts over their future. Current and new insomnia drugs in the pipeline target different sleep regulating mechanisms and symptoms and have different tolerability profiles. Drug selection would ideally be based on improvement in the quality of patients' sleep, overall quality of life and functional status weighed against risk to the individual and public health.

  19. Subjective-objective sleep discrepancy among older adults: Associations with insomnia diagnosis and insomnia treatment

    OpenAIRE

    Kay, Daniel B.; Buysse, Daniel J.; Germain, Anne; Hall, Martica; Monk, Timothy H.

    2014-01-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioral therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioral therapy for insomnia correlates with the magnitude of symptom improvement rep...

  20. Reports by caregivers of behavioral and psychological symptoms of dementia

    Directory of Open Access Journals (Sweden)

    Francisco de Assis Carvalho do Vale

    Full Text Available Abstract Behavioral and Psychological Symptoms of Dementia (BPSD are relevant since they are frequent and cause distress to caregivers. However, they may not be reported by physicians due to the priority usually attributed to cognitive symptoms. Objectives: To verify whether BPSD is being systematically investigated by physicians even in specialized settings and whether their records on medical files are accurate. Methods: Assessment of records on medical files of BPSD reported by caregivers to 182 patients (57.1% men, mean age 67.6±13.5 years assisted in a tertiary-care behavioral neurology outpatient clinic (BNOC who also had appointments in other clinics of the same hospital. Alzheimer's disease (37.9% and vascular disease (19.2% were the most frequent causes of dementia. Results: Report/appointment ratios were 0.58 in BNOC, 0.43 in other neurological, 0.93 in psychiatric and 0.20 in non-neurological, non-psychiatric clinics. BPSD most frequently recorded in BNOC were insomnia, aggressiveness, agitation/hyperactivity, visual hallucinations, apathy, inadequate behavior and ease of crying. Sorted by psychiatrists, categories associated to more BPSD were affect/mood, thought and personality/behavior. affect/mood and sensoperception symptoms were the most frequently reported. Sorted according to Neuropsychiatric Inventory (NPI, categories associated to more BPSD were depression/dysphoria, delusion and apathy/indifference. depression/dysphoria and agitation/ aggression symptoms were the most frequently reported. Conclusions: BPSD reported by caregivers were very diverse and were not systematically investigated by physicians. Notes in medical files often contained non-technical terms.

  1. A combined group treatment for nightmares and insomnia in combat veterans: a pilot study.

    Science.gov (United States)

    Swanson, Leslie M; Favorite, Todd K; Horin, Elizabeth; Arnedt, J Todd

    2009-12-01

    Insomnia and nightmares are hallmarks of posttraumatic stress disorder (PTSD). Sleep disturbances in PTSD negatively impact clinical course and functioning. In this open clinical trial, the preliminary effects of a combined treatment for insomnia and nightmares in combat veterans with PTSD were assessed. Ten combat veterans participated in a 10-session group treatment combining cognitive-behavioral therapy for insomnia with exposure, rescripting, and relaxation therapy. Participants maintained daily sleep and dream diaries and completed self-report measures of sleep quality and PTSD symptoms pre- and posttreatment. Participants reported improvements in sleep and nightmares following treatment. Future research using controlled designs to evaluate this treatment is warranted.

  2. Insomnia in patients with COPD.

    Science.gov (United States)

    Budhiraja, Rohit; Parthasarathy, Sairam; Budhiraja, Pooja; Habib, Michael P; Wendel, Christopher; Quan, Stuart F

    2012-03-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be associated with sleep disturbances. However, the correlates of insomnia in COPD patients have not been well characterized. The aim of the current study was to describe the prevalence of insomnia disorder in COPD and to elucidate the demographic and clinical characteristics of COPD patients that are associated with insomnia. Cross-sectional study. Clinic-based sample from an academic hospital. Patients with stable COPD. An interviewer-conducted survey was administered to 183 participants with COPD. Seventy-two of these participants (30 with and 42 without insomnia) maintained a sleep diary and underwent actigraphy for 7 days. Insomnia (chronic sleep disturbance associated with impaired daytime functioning) was present in 27.3% of participants. Current tobacco users (odds ratio (OR), 2.13) and those with frequent sadness/anxiety (OR, 3.57) had higher odds, but oxygen use was associated with lower odds (OR, 0.35) of insomnia. Patients with insomnia had worse quality of life and a higher prevalence of daytime sleepiness. Actigraphy revealed shorter sleep duration and lower sleep efficiency, and a sleep diary revealed worse self-reported sleep quality in participants with insomnia. Insomnia disorder is highly prevalent in patients with COPD; current tobacco use and sadness/anxiety are associated with a higher prevalence, and oxygen use with a lower prevalence of insomnia; patients with insomnia have poorer quality of life and increased daytime sleepiness; and insomnia is associated with worse objective sleep quality.

  3. Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment

    Directory of Open Access Journals (Sweden)

    Hong F

    2016-09-01

    Full Text Available Fangxin Hong,1,2 Traci M Blonquist,1 Barbara Halpenny,3 Donna L Berry,3,4 1Department of Biostatistics and Computational Biology, Dana‑Farber Cancer Institute, Boston, MA, USA;2Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA; 3Department of Nursing and Patient Care Services, The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA; 4Department of Medicine, Harvard Medical School, Boston, MA, USA Introduction: Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods: Participants completed the Symptom Distress Scale-15 before treatment (T1 and during cancer treatment (T2 and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results: Significantly, (P≤0.0002 more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2 and 38% with the change score (T2–T1. When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2 and 70% with the change score (T2–T1. Conclusion: More

  4. Are Patients with Childhood Onset of Insomnia and Depression More Difficult to Treat Than Are Those with Adult Onsets of These Disorders? A Report from the TRIAD Study

    Science.gov (United States)

    Edinger, Jack D.; Manber, Rachel; Buysse, Daniel J.; Krystal, Andrew D.; Thase, Michael E.; Gehrman, Phillip; Fairholme, Christopher P.; Luther, James; Wisniewski, Stephen

    2017-01-01

    . Conclusions: Patients with comorbid depression and insomnia who experienced the first onset of both disorders in childhood are less responsive to the treatments offered herein than are those with adult onsets of these comorbid disorders. Further research is needed to identify therapies that enhance the depression and insomnia treatment responses of those with childhood onsets of these two conditions. Citation: Edinger JD, Manber R, Buysse DJ, Krystal AD, Thase ME, Gehrman P, Fairholme CP, Luther J, Wisniewski S. Are patients with childhood onset of insomnia and depression more difficult to treat than are those with adult onsets of these disorders? A report from the TRIAD study. J Clin Sleep Med. 2017;13(2):205–213. PMID:27784414

  5. Insomnia, dreams, and suicide: Connecting links

    Directory of Open Access Journals (Sweden)

    Sagar B Karia

    2016-01-01

    Full Text Available Introduction: A growing empirical literature has examined insomnia symptoms as a possible risk factor for a range of suicidal behavior. Not much literature is available in normal adolescent population. Aims: The aim is to find insomnia prevalence, studying various dream factors, and suicidality prevalence among students of various courses. To check if there is a relation between insomnia and suicidal behavior and dreams, particularly nightmares and suicide. Materials and Methods: A total of 400 students of various courses were assessed using Insomnia Severity Index and The Mannheim Dream Questionnaire and Suicide Behaviour Questionnaire. Results: Insomnia was present in 11%, 23%, 19%, and 19% and suicide behavior in 16%, 17%, 12%, and 22%, respectively, in medical, commerce, engineering, and arts students. Statistically significant correlation was found between suicide and insomnia severity and various dream factors. Conclusions: Insomnia and dreams had relation with suicidality in normal adolescent population.

  6. The Nature of Stable Insomnia Phenotypes

    Science.gov (United States)

    Pillai, Vivek; Roth, Thomas; Drake, Christopher L.

    2015-01-01

    Study Objectives: We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither criterion (i.e., insomnia cases that do not meet quantitative thresholds for onset or maintenance problems). Insomnia cases that exhibited the same symptom profile over a 1-y period were considered to be phenotypes, and were compared in terms of clinical and demographic characteristics. Design: Longitudinal. Setting: Urban, community-based. Participants: Nine hundred fifty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based current insomnia (46.6 ± 12.6 y; 69.4% female). Interventions: None. Measurements and results: At baseline, participants were divided into four symptom profile groups based on quantitative criteria. Follow-up assessment 1 y later revealed that approximately 60% of participants retained the same symptom profile, and were hence judged to be phenotypes. Stability varied significantly by phenotype, such that sleep onset insomnia (SOI) was the least stable (42%), whereas combined insomnia (CI) was the most stable (69%). Baseline symptom groups (cross-sectionally defined) differed significantly across various clinical indices, including daytime impairment, depression, and anxiety. Importantly, however, a comparison of stable phenotypes (longitudinally defined) did not reveal any differences in impairment or comorbid psychopathology. Another interesting finding was that whereas all other insomnia phenotypes showed evidence of an elevated wake drive both at night and during the day, the “neither criterion” phenotype did not; this latter phenotype exhibited significantly higher daytime sleepiness despite subthreshold onset and maintenance difficulties. Conclusions: By adopting a stringent, stability-based definition, this study offers timely and important data on the longitudinal trajectory of specific insomnia phenotypes. With

  7. Insomnia in school-age children with Asperger syndrome or high-functioning autism

    Directory of Open Access Journals (Sweden)

    Smedje Hans

    2006-04-01

    Full Text Available Abstract Background Asperger syndrome (AS and high-functioning autism (HFA are pervasive developmental disorders (PDD in individuals of normal intelligence. Childhood AS/HFA is considered to be often associated with disturbed sleep, in particular with difficulties initiating and/or maintaining sleep (insomnia. However, studies about the topic are still scarce. The present study investigated childhood AS/HFA regarding a wide range of parent reported sleep-wake behaviour, with a particular focus on insomnia. Methods Thirty-two 8–12 yr old children with AS/HFA were compared with 32 age and gender matched typically developing children regarding sleep and associated behavioural characteristics. Several aspects of sleep-wake behaviour including insomnia were surveyed using a structured paediatric sleep questionnaire in which parents reported their children's sleep patterns for the previous six months. Recent sleep patterns were monitored by use of a one-week sleep diary and actigraphy. Behavioural characteristics were surveyed by use of information gleaned from parent and teacher-ratings in the High-Functioning Autism Spectrum Screening Questionnaire, and in the Strengths and Difficulties Questionnaire. Results Parent-reported difficulties initiating sleep and daytime sleepiness were more common in children with AS/HFA than in controls, and 10/32 children with AS/HFA (31.2% but none of the controls fulfilled our definition of paediatric insomnia. The parent-reported insomnia corresponded to the findings obtained by actigraphy. Children with insomnia had also more parent-reported autistic and emotional symptoms, and more teacher-reported emotional and hyperactivity symptoms than those children without insomnia. Conclusion Parental reports indicate that in childhood AS/HFA insomnia is a common and distressing symptom which is frequently associated with coexistent behaviour problems. Identification and treatment of sleep problems need to be a routine

  8. Cognitive behavioral therapy vs. Tai Chi for late life insomnia and inflammatory risk: a randomized controlled comparative efficacy trial.

    Science.gov (United States)

    Irwin, Michael R; Olmstead, Richard; Carrillo, Carmen; Sadeghi, Nina; Breen, Elizabeth C; Witarama, Tuff; Yokomizo, Megumi; Lavretsky, Helen; Carroll, Judith E; Motivala, Sarosh J; Bootzin, Richard; Nicassio, Perry

    2014-09-01

    To investigate the comparative efficacy of cognitive behavioral therapy (CBT), Tai Chi Chih (TCC), and sleep seminar education control (SS) on the primary outcome of insomnia diagnosis, and secondary outcomes of sleep quality, fatigue, depressive symptoms, and inflammation in older adults with insomnia. Randomized controlled, comparative efficacy trial. Los Angeles community. 123 older adults with chronic and primary insomnia. Random assignment to CBT, TCC, or SS for 2-hour group sessions weekly over 4 months with follow-up at 7 and 16 months. Insomnia diagnosis, patient-reported outcomes, polysomnography (PSG), and high-sensitivity C-reactive protein (CRP) levels. CBT performed better than TCC and SS in remission of clinical insomnia as ascertained by a clinician (P 3.0 mg/L) at 16 months (odds ratio [OR], 0.26 [95% CI, 0.07-0.97] P insomnia was associated with lower levels of CRP (P insomnia remission. PSG measures did not change. Treatment of late-life insomnia is better achieved and sustained by cognitive behavioral therapies. Insomnia treatment and remission reduces a marker of inflammatory risk, which has implications for cardiovascular morbidity and diabetes observed with sleep disturbance in epidemiologic surveys. © 2014 Associated Professional Sleep Societies, LLC.

  9. Insomnia, dreams, and suicide: Connecting links

    OpenAIRE

    Sagar B Karia; Nirali Mehta; Devavrat Harshe; Avinash De Sousa; Nilesh Shah

    2016-01-01

    Introduction: A growing empirical literature has examined insomnia symptoms as a possible risk factor for a range of suicidal behavior. Not much literature is available in normal adolescent population. Aims: The aim is to find insomnia prevalence, studying various dream factors, and suicidality prevalence among students of various courses. To check if there is a relation between insomnia and suicidal behavior and dreams, particularly nightmares and suicide. Materials and Methods: A total of 4...

  10. The nature of stable insomnia phenotypes.

    Science.gov (United States)

    Pillai, Vivek; Roth, Thomas; Drake, Christopher L

    2015-01-01

    We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither criterion (i.e., insomnia cases that do not meet quantitative thresholds for onset or maintenance problems). Insomnia cases that exhibited the same symptom profile over a 1-y period were considered to be phenotypes, and were compared in terms of clinical and demographic characteristics. Longitudinal. Urban, community-based. Nine hundred fifty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based current insomnia (46.6 ± 12.6 y; 69.4% female). None. At baseline, participants were divided into four symptom profile groups based on quantitative criteria. Follow-up assessment 1 y later revealed that approximately 60% of participants retained the same symptom profile, and were hence judged to be phenotypes. Stability varied significantly by phenotype, such that sleep onset insomnia (SOI) was the least stable (42%), whereas combined insomnia (CI) was the most stable (69%). Baseline symptom groups (cross-sectionally defined) differed significantly across various clinical indices, including daytime impairment, depression, and anxiety. Importantly, however, a comparison of stable phenotypes (longitudinally defined) did not reveal any differences in impairment or comorbid psychopathology. Another interesting finding was that whereas all other insomnia phenotypes showed evidence of an elevated wake drive both at night and during the day, the 'neither criterion' phenotype did not; this latter phenotype exhibited significantly higher daytime sleepiness despite subthreshold onset and maintenance difficulties. By adopting a stringent, stability-based definition, this study offers timely and important data on the longitudinal trajectory of specific insomnia phenotypes. With the exception of daytime sleepiness, few clinical differences are apparent across stable phenotypes.

  11. Association between mental health screening by self-report questionnaire and insomnia in medical students

    OpenAIRE

    Loayza H.,Maria Paz; Ponte,Talles S.; Carvalho,Clarissa G.; Pedrotti,Michell R.; Nunes,Paula V.; Souza,Camila M.; Zanette,Camila B.; Voltolini,Sara; Chaves,Marcia L. F.

    2001-01-01

    Epidemiological research points to the high prevalence of psychiatric disorders among insomniacs. We carried out a cross-sectional study with medical students with the aim of evaluating the association between insomnia and suspicion of psychiatric disorder; 302 medical students were included (184 males and 118 females; mean age = 20.47±1.89 years). The main association was tested by logistic regression analysis. The overall prevalence of positivity in a screening test for psychiatric disorder...

  12. The burden of insomnia in Japan

    Directory of Open Access Journals (Sweden)

    Mishima K

    2015-01-01

    Full Text Available Kazuo Mishima,1 Marco daCosta DiBonaventura,2 Hillary Gross2 1Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 2Kantar Health, New York, NY, USA Objectives: Several studies have suggested that patients who experience insomnia report a number of significant impairments. However, despite this literature, fewer studies have focused on the burden of insomnia among patients in Japan. The objective of the current study is to extend this work in Japan to further understand the effect of insomnia on health-related quality of life (hrQOL. Further, another objective is to understand general predictors of hrQOL among patients with insomnia. Methods: Data from the 2012 Japan National Health and Wellness Survey, an annual, cross-sectional study of adults aged 18 years or older, were used (N=30,000. All National Health and Wellness Survey respondents were categorized based on the incidence of self-reported insomnia diagnosis and prescription medication usage (clinical insomniacs under treatment versus [vs] good sleepers without insomnia or insomnia symptoms. Comparisons among different groups were made using multiple regression models controlling for demographics and health history. Results: Clinical insomniacs (n=1,018; 3.4% reported significantly worse hrQOL compared with good sleepers (n=20,542 (mental component summary: 34.2 vs 48.0; physical component summary: 48.0 vs 52.8; health utilities: 0.61 vs 0.76; all P<0.05. Health behaviors (smoking, exercise, alcohol use and comorbidities were the strongest predictors of health utilities for clinical insomniacs. For all three clinical insomniac subgroups of interest, those with a physical comorbidity but not a psychiatric one, those with a psychiatric comorbidity but not a physical one, and those without either a physical or psychiatric comorbidity, large decrements in health utilities were observed for respondents who did

  13. Clinical practice guidelines for insomnia disorder | Malan | South ...

    African Journals Online (AJOL)

    Insomnia disorder is defined as difficulty in falling asleep, maintaining sleep, and early morning awakenings. Common daytime consequences experienced are fatigue, mood instability and impaired concentration. In chronic insomnia these symptoms persist over a period of at least three months. Chronic insomnia can also ...

  14. Music for insomnia in adults.

    Science.gov (United States)

    Jespersen, Kira V; Koenig, Julian; Jennum, Poul; Vuust, Peter

    2015-08-13

    design or being the only published study. As regards risk of bias, most studies were at high risk of bias on at least one domain: one study was at high risk of selection bias and one was judged to be at unclear risk; six studies were at high risk of performance bias; three studies were at high risk of detection bias; one study was at high risk of attrition bias and was study was judged to be at unclear risk; two studies were judged to be at unclear risk of reporting bias; and four studies were at high risk of other bias.Five studies (N = 264) reporting on sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) were included in the meta-analysis. The results of a random-effects meta-analysis revealed an effect in favour of music listening (mean difference (MD) -2.80; 95% confidence interval (CI) -3.42 to -2.17; Z = 8.77, P music may be effective for improving subjective sleep quality in adults with insomnia symptoms. The intervention is safe and easy to administer. More research is needed to establish the effect of listening to music on other aspects of sleep as well as the daytime consequences of insomnia.

  15. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort.

    Science.gov (United States)

    Chien, Kuo-Liong; Chen, Pei-Chung; Hsu, Hsiu-Ching; Su, Ta-Chen; Sung, Fung-Chang; Chen, Ming-Fong; Lee, Yuan-Teh

    2010-02-01

    To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events. Prospective cohort study. Community-based. A total of 3,430 adults aged 35 years or older. None. During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting or = 9 h were 1.15 (0.91-1.45), 1.02 (0.85-1.25), 1.05 (0.88-1.27), and 1.43 (1.16-1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86-1.20) for occasional insomnia, 1.15 (0.92-1.42) for frequent insomnia, and 1.70 (1.16-2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71-3.76) for all-cause death and 2.07 (1.11-3.85) for CVD rate in participants sleeping > or = 9 h and for those with frequent insomnia. Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths.

  16. Persistent insomnia is associated with mortality risk.

    Science.gov (United States)

    Parthasarathy, Sairam; Vasquez, Monica M; Halonen, Marilyn; Bootzin, Richard; Quan, Stuart F; Martinez, Fernando D; Guerra, Stefano

    2015-03-01

    Insomnia has been associated with mortality risk, but whether this association is different in subjects with persistent vs intermittent insomnia is unclear. Additionally, the role of systemic inflammation in such an association is unknown. We used data from a community-based cohort to determine whether persistent or intermittent insomnia, defined based on persistence of symptoms over a 6-year period, was associated with death during the following 20 years of follow-up. We also determined whether changes in serum C-reactive protein (CRP) levels measured over 2 decades between study initiation and insomnia determination were different for the persistent, intermittent, and never insomnia groups. The results were adjusted for confounders such as age, sex, body mass index, smoking, physical activity, alcohol, and sedatives. Of the 1409 adult participants, 249 (18%) had intermittent and 128 (9%) had persistent insomnia. During a 20-year follow-up period, 318 participants died (118 due to cardiopulmonary disease). In adjusted Cox proportional-hazards models, participants with persistent insomnia (adjusted hazards ratio [HR] 1.58; 95% confidence interval [CI], 1.02-2.45) but not intermittent insomnia (HR 1.22; 95% CI, 0.86-1.74) were more likely to die than participants without insomnia. Serum CRP levels were higher and increased at a steeper rate in subjects with persistent insomnia as compared with intermittent (P = .04) or never (P = .004) insomnia. Although CRP levels were themselves associated with increased mortality (adjusted HR 1.36; 95% CI, 1.01-1.82; P = .04), adjustment for CRP levels did not notably change the association between persistent insomnia and mortality. In a population-based cohort, persistent, and not intermittent, insomnia was associated with increased risk for all-cause and cardiopulmonary mortality and was associated with a steeper increase in inflammation. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Insomnia, Sleep Quality, and Quality of Life in Mild to Moderate Parkinson's Disease.

    Science.gov (United States)

    Shafazand, Shirin; Wallace, Douglas M; Arheart, Kristopher L; Vargas, Silvia; Luca, Corneliu C; Moore, Henry; Katzen, Heather; Levin, Bonnie; Singer, Carlos

    2017-03-01

    Sleep disorders are prevalent in Parkinson's disease but underreported in clinical settings. The contribution of sleep disorders to health-related quality of life (HRQOL) for patients with this degenerative neurological disease are not well known. To evaluate the impact of insomnia symptoms, obstructive sleep apnea (OSA), and poor sleep quality on HRQOL in a cohort of patients with idiopathic Parkinson's disease. We enrolled a convenience sample of 66 adults seen in the University of Miami Movement Disorders Clinic between July 2011 and June 2013. Participants completed validated questionnaires to determine insomnia symptoms, OSA risk, depression, anxiety, and HRQOL. All patients underwent unattended polysomnography to confirm OSA. Results were compared for those with and without insomnia symptoms. Principal component and regression analyses were performed to evaluate determinants of HRQOL. Participants were predominately Hispanic males with mild to moderate Parkinson's disease. Insomnia symptoms were reported for 46% of the study subjects. OSA (apnea-hypopnea index, ≥5) was noted in 47%, with a mean apnea-hypopnea index of 8.3 ± 11.0. Fairly bad to very bad sleep quality was reported by 21% of the participants. Insomnia (r = 0.71; P Insomnia symptoms, OSA, and subsequent poor sleep quality are prevalent in Parkinson's disease. In this single-center, exploratory study, we found that insomnia and poor sleep quality, but not OSA, play important roles in determining overall quality of life for patients with this disease. Clinical trial registered with www.clinicaltrials.gov (NCT02034357).

  18. Prevalence of insomnia in the adult Norwegian population.

    Science.gov (United States)

    Pallesen, S; Nordhus, I H; Nielsen, G H; Havik, O E; Kvale, G; Johnsen, B H; Skjøtskift, S

    2001-11-01

    A representative adult sample (18 years and above) of the Norwegian population, comprising 2001 subjects, participated in telephone interviews, focusing on the one-month point prevalence of insomnia and use of prescribed hypnotics. Employment of DSM-IV inclusion criteria of insomnia yielded a prevalence rate of 11.7%. Logistic regression analysis performed on the different insomnia symptoms revealed that somatic and psychiatric health were the strongest predictors of insomnia, whereas gender, age, and socioeconomic status showed a more inconsistent relationship. Use of prescribed hypnotic drugs was reported by 6.9% and was related to being female, elderly, and having somatic and emotional problems. Sleep onset problems and daytime impairment were more common during winter compared to summer. Use of hypnotics was more common in the southern (rather than the northern) regions of Norway. For sleep onset problems a Season x Region interaction was found, indicating that the prevalence of sleep onset problems increased in southern Norway from summer to winter, while the opposite pattern was found in the northern regions. The importance of clinically adequate criteria and seasonal variation in the evaluation of insomnia is briefly discussed.

  19. Sleep problems in bipolar disorders: more than just insomnia.

    Science.gov (United States)

    Steinan, M K; Scott, J; Lagerberg, T V; Melle, I; Andreassen, O A; Vaaler, A E; Morken, G

    2016-05-01

    Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management of potential confounding factors. This multicenter study seeks to address these issues and also compares BD cases with Hypersomnia as well as the more commonly investigated Insomnia and No Sleep Problem groups. A cross-sectional comparison of sleep profiles in 563 BD I and II individuals who participated in a structured assessment of demographic, clinical, illness history and treatment variables. Over 40% cases met criteria for Insomnia and 29% for Hypersomnia. In univariate analysis, Insomnia was associated with BD II depression whilst Hypersomnia was associated with BD I depression or euthymia. After controlling for confounders and covariates, it was demonstrated that Hypersomnia cases were significantly more likely to be younger, have BD I and be prescribed antidepressants whilst Insomnia cases had longer illness durations and were more likely to be prescribed benzodiazepines and hypnotics. Whilst Insomnia symptoms are common in BD, Hypersomnia is a significant, frequently underexplored problem. Detailed analyses of large representative clinical samples are critical to extending our knowledge of differences between subgroups defined by sleep profile. © 2015 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  20. Insomnia and sleep misperception.

    Science.gov (United States)

    Bastien, C H; Ceklic, T; St-Hilaire, P; Desmarais, F; Pérusse, A D; Lefrançois, J; Pedneault-Drolet, M

    2014-10-01

    Sleep misperception is often observed in insomnia individuals (INS). The extent of misperception varies between different types of INS. The following paper comprised sections which will be aimed at studying the sleep EEG and compares it to subjective reports of sleep in individuals suffering from either psychophysiological insomnia or paradoxical insomnia and good sleeper controls. The EEG can be studied without any intervention (thus using the raw data) via either PSG or fine quantitative EEG analyses (power spectral analysis [PSA]), identifying EEG patterns as in the case of cyclic alternating patterns (CAPs) or by decorticating the EEG while scoring the different transient or phasic events (K-Complexes or sleep spindles). One can also act on the on-going EEG by delivering stimuli so to study their impact on cortical measures as in the case of event-related potential studies (ERPs). From the paucity of studies available using these different techniques, a general conclusion can be reached: sleep misperception is not an easy phenomenon to quantify and its clinical value is not well recognized. Still, while none of the techniques or EEG measures defined in the paper is available and/or recommended to diagnose insomnia, ERPs might be the most indicated technique to study hyperarousal and sleep quality in different types of INS. More research shall also be dedicated to EEG patterns and transient phasic events as these EEG scoring techniques can offer a unique insight of sleep misperception. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Professional correlates of insomnia.

    Science.gov (United States)

    Léger, Damien; Massuel, Marie-Anne; Metlaine, Arnaud

    2006-02-01

    Insomnia is a highly prevalent disorder that affects daytime functioning, behavior, and quality of life. Several reports have shown that insomnia impacts on the workforce and is associated with an increased risk of absenteeism. However, few workplace studies have been performed. Our study attempted to evaluate the professional correlates of insomnia by comparing a group of workers with insomnia to a matched group of good sleepers. The main objective measure was absenteeism. Accidents, self-esteem at work, job satisfaction, and efficiency at work were also investigated. Pairs of workers with insomnia (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition definition) and good sleepers, matched by age, sex, and occupational status, were interviewed by their occupational physician and also answered a self-administered questionnaire on work-related criteria. Objective data on absenteeism (number of days absent from work) were provided by the employers' health resource databases. Paris and the Ile de France region (France). Seven hundred eighty-five subjects completed the questionnaire. We retained 369 pair (ie, 738 subjects) for analysis. Insomniacs missed work twice as often as good sleepers. The difference between insomniacs and good sleepers in terms of absenteeism was particularly high for blue-collar workers (odds ratio = 3.0) and men (odds ratio = 2.31). Insomniacs had also a higher accident rate while driving and, strikingly, a 3-fold greater risk of having 2 or 3 serious road accidents. They also reported poor self-esteem at work, less job satisfaction, and less efficiency at work, compared with good sleepers. Our study found an objective increase in absenteeism in insomniacs compared with good sleepers.

  2. Association between mental health screening by self-report questionnaire and insomnia in medical students

    Directory of Open Access Journals (Sweden)

    Loayza H. Maria Paz

    2001-01-01

    Full Text Available Epidemiological research points to the high prevalence of psychiatric disorders among insomniacs. We carried out a cross-sectional study with medical students with the aim of evaluating the association between insomnia and suspicion of psychiatric disorder; 302 medical students were included (184 males and 118 females; mean age = 20.47±1.89 years. The main association was tested by logistic regression analysis. The overall prevalence of positivity in a screening test for psychiatric disorder was 22.19%; and of insomnia, 28.15%. Difficulty initiating sleep (OR=3.45, difficulty maintaining sleep (OR=7.61, falling asleep later (OR=1.99 and waking up earlier (OR=1.91 were associated with suspicion of psychiatric disorder. As a group, the variables difficulty initiating sleep, difficulty maintaining sleep, falling asleep after 11 pm, and waking up before 6 am presented an odds ratio of 5.96 for positivity in the screening for psychiatric disorder. Furthermore, difficulty maintaining sleep (OR=2.24 was associated with "being female," and falling asleep later (OR=0.43 was associated with "being male". These results underscore the importance of determining in what cases difficulty sleeping may have severe clinical repercussions or affect performance.

  3. Insomnia Self-Management in Heart Failure

    Science.gov (United States)

    2018-01-05

    Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

  4. Midlife insomnia and subsequent mortality: the Hordaland health study.

    Science.gov (United States)

    Sivertsen, Børge; Pallesen, Ståle; Glozier, Nick; Bjorvatn, Bjørn; Salo, Paula; Tell, Grethe S; Ursin, Reidun; Øverland, Simon

    2014-07-15

    Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study was to examine the effect of insomnia in middle age on all-cause mortality. Using a cohort design with 13-15 years follow-up, mortality registry data were linked to health information obtained during 1997-99, as part of the community-based Hordaland Health Study (HUSK), in Western Norway. 6,236 participants aged 40-45 provided baseline information on self- reported insomnia using the Karolinska Sleep Questionnaire Scale (defined according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), sociodemographic factors, health behaviors, shift/night-work, obstructive sleep apnea symptoms, sleep duration, sleep medication use, anxiety, depression, as well as a range of somatic diagnoses and symptoms. Height, weight and blood pressure were measured. Information on mortality was obtained from the Norwegian Cause of Death Registry. Insomnia was reported by 5.6% (349/6236) at baseline and a significant predictor of all-cause-mortality (hazard ratio [HR] = 2.74 [95% CI:1.75-4.30]). Adjusting for all confounders did not attenuate the effect (HR = 3.34 [95% CI:1.67-6.69]). Stratifying by gender, the effect was especially strong in men (HR = 4.72 [95% CI:2.48-9.03]); but also significant in women (adjusted HR = 1.96 [95% CI:1.04-3.67]). The mortality risk among participants with both insomnia and short sleep duration (insomnia in combination with normal/greater sleep duration was not associated with mortality. Insomnia was associated with a three-fold risk of mortality over 13-15 years follow-up. The risk appeared even higher in males or when insomnia was combined with short sleep duration, although such unadjusted subgroup analyses should be interpreted with caution. Establishing prevention strategies and low-threshold interventions should consequently be a prioritized task

  5. Midlife insomnia and subsequent mortality: the Hordaland health study

    Science.gov (United States)

    2014-01-01

    Background Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study was to examine the effect of insomnia in middle age on all-cause mortality. Methods Using a cohort design with 13-15 years follow-up, mortality registry data were linked to health information obtained during 1997-99, as part of the community-based Hordaland Health Study (HUSK), in Western Norway. 6,236 participants aged 40–45 provided baseline information on self- reported insomnia using the Karolinska Sleep Questionnaire Scale (defined according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), sociodemographic factors, health behaviors, shift/night-work, obstructive sleep apnea symptoms, sleep duration, sleep medication use, anxiety, depression, as well as a range of somatic diagnoses and symptoms. Height, weight and blood pressure were measured. Information on mortality was obtained from the Norwegian Cause of Death Registry. Results Insomnia was reported by 5.6% (349/6236) at baseline and a significant predictor of all-cause-mortality (hazard ratio [HR] = 2.74 [95% CI:1.75-4.30]). Adjusting for all confounders did not attenuate the effect (HR = 3.34 [95% CI:1.67-6.69]). Stratifying by gender, the effect was especially strong in men (HR = 4.72 [95% CI:2.48-9.03]); but also significant in women (adjusted HR = 1.96 [95% CI:1.04-3.67]). The mortality risk among participants with both insomnia and short sleep duration (insomnia in combination with normal/greater sleep duration was not associated with mortality. Conclusions Insomnia was associated with a three-fold risk of mortality over 13-15 years follow-up. The risk appeared even higher in males or when insomnia was combined with short sleep duration, although such unadjusted subgroup analyses should be interpreted with caution. Establishing prevention strategies and low

  6. Validation of the Athens Insomnia Scale for screening insomnia in South Korean firefighters and rescue workers.

    Science.gov (United States)

    Jeong, Hyeonseok S; Jeon, Yujin; Ma, Jiyoung; Choi, Yera; Ban, Soonhyun; Lee, Sooyeon; Lee, Bora; Im, Jooyeon Jamie; Yoon, Sujung; Kim, Jieun E; Lim, Jae-Ho; Lyoo, In Kyoon

    2015-10-01

    Sleep problems are a major cause of occupational stress in firefighters and rescue workers. We evaluated the psychometric properties of the Athens Insomnia Scale (AIS) among South Korean firefighters and rescue workers. Structured clinical interviews and self-report questionnaires were administered to 221 firefighters and rescue workers. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Short-Form 36-item Health Survey (SF36), and Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were used to examine convergent and divergent validity. Test-retest reliability was calculated from a subsample (n = 24). Analysis of internal consistency, factor analysis, and receiver operator characteristic curve analysis were conducted. Cronbach's alpha was 0.88. The mean item-total correlation coefficient was 0.73. The test-retest reliability was excellent (ICC = 0.94). Significant correlations of the AIS with the PSQI, ISI, ESS, and SF36 confirmed convergent validity. Nonsignificant associations of the AIS with the AUDIT-C and socioeconomic status showed divergent validity. Factor analysis revealed a one-factor structure. For groups with different symptom severity, group-specific cutoff scores which may improve positive predictive values were suggested. The AIS may be a useful tool with good reliability and validity for screening insomnia symptoms in firefighters and rescue workers.

  7. Hazards of insomnia and the effects of acupuncture treatment on insomnia.

    Science.gov (United States)

    Lin, Yu-fang; Liu, Zhi-dan; Ma, Wen; Shen, Wei-dong

    2016-05-01

    Insomnia is a common disease in modern society; it is made worse by increasingly fierce competition in the workplace and elsewhere, along with rapid economic and social development. Sleep disorders can result in changes in serum biomarkers and decreased immunity, and may cause maladies such as depression and cardiac diseases, as well as many other somatic symptoms. Western medications for treating insomnia can easily lead to addiction and other adverse effects. Fortunately, acupuncture can ease the symptoms of insomnia. This review summarizes the hazards associated with insomnia and the use of acupuncture in its treatment. Furthermore, the authors introduce an effective and low-cost method of treating insomnia with acupuncture. This review indicates that insomnia poses a major threat to mental health through its effects on serum components, heart function and the immune system of patients, which may lead to other physiological disorders. Anxiety and depression are the two main negative emotions affected by insomnia. Acupuncture, which has showed effectiveness against insomnia and its complications, may be an effective and complementary method for the treatment of insomnia and associated maladies.

  8. Pain-related insomnia versus primary insomnia: a comparison study of sleep pattern, psychological characteristics, and cognitive-behavioral processes.

    Science.gov (United States)

    Tang, Nicole K Y; Goodchild, Claire E; Hester, Joan; Salkovskis, Paul M

    2012-06-01

    Recent applications of cognitive-behavior therapy for primary insomnia in the management of pain-related insomnia are based on the implicit assumption that the 2 types of insomnia share the same presentation and maintaining mechanisms. The objectives of this study were to compare the characteristics of patients who have pain-related insomnia with those reporting primary insomnia and to identify psychological factors that predict pain-related insomnia. Chronic pain patients with concomitant insomnia (n=137; Pain-related Insomnia Group) completed a selection of questionnaires that measure sleep patterns, psychological attributes, and cognitive-behavioral processes associated with the persistence of insomnia. Their responses were compared with those of primary insomnia patients (n=33; Primary Insomnia Group), using 3 sets of multivariate analyses of covariance that took account of demographic differences. Hierarchical regression analyses were performed to identify predictors of insomnia severity among the chronic pain patients. The Pain-related Insomnia Group did not differ from the Primary Insomnia Group in their pattern and severity of sleep disturbance. The 2 groups were largely comparable in terms of their psychological characteristics, except that the Primary Insomnia Group was distinguishable from the Pain-related Insomnia Group by their greater tendency to worry. Patients in the Pain-related Insomnia Group reported levels of sleep-related anxiety and presleep somatic arousal that matched with those reported by patients in the Primary Insomnia Group. However, relative to patients in the Pain-related Insomnia Group, those in the Primary Insomnia Group reported more dysfunctional sleep beliefs and presleep cognitive arousal. In addition to pain intensity, depression, and presleep cognitive arousal were significant predictors of insomnia severity within the Pain-related Insomnia Group. There are more similarities than differences between the 2 types of insomnia

  9. Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index.

    Science.gov (United States)

    Chung, Ka-Fai; Kan, Katherine Ka-Ki; Yeung, Wing-Fai

    2011-05-01

    To compare the psychometric properties of the Chinese versions of Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS) and Sleep Quality Index (SQI) for assessment and screening of insomnia in adolescents. This is a school-based survey of 1516 adolescents aged 12-19 years. Sleep-wake habit questionnaire, ISI, AIS, SQI, Epworth Sleepiness Scale (ESS) and 12-item General Health Questionnaire (GHQ-12) were administered. Insomnia Interview Schedule was used to assess the severity of insomnia symptoms and DSM-IV-TR diagnosis of insomnia. The Cronbach's alpha of ISI, AIS and SQI were 0.83, 0.81 and 0.65, respectively, and the 2-week test-retest reliability were 0.79, 0.80 and 0.72. All three scales had a 2-factor structure, and their scores were significantly correlated with sleep-wake variables, ESS and GHQ-12 scores, smoking and drinking habits, and academic performance. The areas under curve of ISI, AIS and SQI for detecting clinical insomnia were 0.85, 0.80 and 0.85, respectively. The optimal cut-offs for ISI, AIS and SQI were a total score of nine (sensitivity/specificity: 0.87/0.75), seven (sensitivity/specificity: 0.78/0.74) and five (sensitivity/specificity: 0.83/0.79), respectively. The Chinese versions of ISI, AIS and SQI are reliable and valid instruments. The ISI and AIS appear to have better psychometric properties than the SQI. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Prospective study of predictors and consequences of insomnia: personality, lifestyle, mental health, and work-related stressors.

    Science.gov (United States)

    Vedaa, Øystein; Krossbakken, Elfrid; Grimsrud, Ingse Dagny; Bjorvatn, Bjørn; Sivertsen, Børge; Magerøy, Nils; Einarsen, Ståle; Pallesen, Ståle

    2016-04-01

    To prospectively investigate the reciprocal relationships between personality traits, lifestyle factors, mental health, sleepiness, and work-related stressors against insomnia. A total of 799 Norwegian shift-working nurses (mean age 33.2 years, 90% female) participated in this prospective cohort study. They were assessed on self-report instruments (Bergen Insomnia Scale, Diurnal Type Scale, Hospital Anxiety and Depression Scale, Negative Acts Questionnaire-Revised, Work-Family Interface Scale, among others) in 2008/2009 (wave 1) and 2011 (wave 3). Structural equation modeling was employed to investigate the bidirectional relationship between a wide range of individual and work-related variables and insomnia. Languidity (β = 0.18***), anxiety (β = 0.11**), depression (β = 0.14***), exposure to bullying behavior (β = 0.08*), and negative spillover between work and family life (work to family, β = 0.08*; family to work, β = 0.07*) predicted increased symptoms of insomnia over time. Morningness (β = -0.09*) and positive spillover from work to family (β = -0.11**) predicted less symptoms of insomnia over time. No support was found for night work as a predictor of increased insomnia. Insomnia was a precursor for anxiety (β = 0.11**), but not for depression (*p work-related factors than as a precursor to them. The scope of factors causing insomnia, and factors protecting against it, should be further investigated. Insomnia should be considered in prediction models for mental illnesses and as an outcome of adverse work-related experiences. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Sleep diaries of Vietnam War veterans with chronic PTSD: the relationships among insomnia symptoms, psychosocial stress, and nightmares.

    Science.gov (United States)

    Gehrman, Philip R; Harb, Gerlinde C; Cook, Joan M; Barilla, Holly; Ross, Richard J

    2015-01-01

    Impaired sleep and nightmares are known symptoms of posttraumatic stress disorder (PTSD) in the veteran population. In order to assess prospectively the sleep disturbances in this population, sleep diaries are an effective way to obtain information over an extended period of time. In this investigation, a sample of veterans (N = 105) completed daily sleep diaries for a 6-week period. Greater PTSD severity and nightmare-related distress were correlated with more awakenings, shorter duration of sleep, longer sleep latency, and greater frequency of nightmares. Perceived frequency of daytime stressors was associated with an increased number of nightmares, nightmare-related distress, and longer sleep latency. The use of sleep diaries in future investigations may allow targeted treatments for veteran populations with PTSD and sleep disturbances.

  12. DSM-5 Insomnia and Short Sleep: Comorbidity Landscape and Racial Disparities

    Science.gov (United States)

    Kalmbach, David A.; Pillai, Vivek; Arnedt, J. Todd; Drake, Christopher L.

    2016-01-01

    Study Objectives: We estimated rates of cardiometabolic disease, pain conditions, and psychiatric illness associated with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia disorder (current and in remission) and habitual short sleep (fewer than 6 h), and examined the roles of insomnia and short sleep in racial disparities in disease burden between black and non-Hispanic white Americans. Methods: This epidemiological survey study was cross-sectional. The community-based sample consisted of 3,911 subjects (46.0 y ± 13.3; 65.4% female; 25.0% black) across six sleep groups based on DSM-5 insomnia classification (never vs. remitted vs. current) and self-reported habitual sleep duration (normal vs. short). Vascular events, cardiometabolic disease, pain conditions, and psychiatric symptoms were self-reported. Results: Short sleeping insomniacs were at elevated risk for myocardial infarction, stroke, treated hypertension, diabetes, chronic pain, back pain, depression, and anxiety, independent of sex, age, and obesity. Morbidity profiles for insomniacs with normal sleep duration and former insomniacs, irrespective of sleep duration, were similar with elevations in treated hypertension, chronic pain, depression, and anxiety. Regarding racial disparities, cardiometabolic and psychiatric illness burden was greater for blacks, who were more likely to have short sleep and the short sleep insomnia phenotype. Evidence suggested that health disparities may be attributable in part to race-related differences in sleep. Conclusions: Insomnia disorder with short sleep is the most severe phenotype of insomnia and comorbid with many cardiometabolic and psychiatric illnesses, whereas morbidity profiles are highly similar between insomniacs with normal sleep duration and former insomniacs. Short sleep endemic to black Americans increases risk for the short sleep insomnia phenotype and likely contributes to racial disparities in cardiometabolic disease

  13. Binge drinking and insomnia in middle-aged and older adults: the Health and Retirement Study.

    Science.gov (United States)

    Canham, Sarah L; Kaufmann, Christopher N; Mauro, Pia M; Mojtabai, Ramin; Spira, Adam P

    2015-03-01

    Alcohol use in later life has been linked to poor sleep. However, the association between binge drinking, which is common among middle-aged and older adults, and insomnia has not been previously assessed. We studied participants aged 50 years and older (n = 6027) from the 2004 Health and Retirement Study who reported the number of days they had ≥4 drinks on one occasion in the prior 3 months. Participants also reported the frequency of four insomnia symptoms. Logistic regression analyses assessed the association between binge drinking frequency and insomnia. Overall, 32.5% of participants had >0 to ≤2 binge drinking days/week; and 3.6% had >2 binge drinking days/week. After adjusting for demographic variables, medical conditions, body mass index, and elevated depressive symptoms, participants who binged >2 days/week had a 64% greater odds of insomnia than non-binge drinkers (adjusted odds ratio [aOR] = 1.64, 95% confidence interval [CI] = 1.09-2.47, p = 0.017). Participants reporting >0 to ≤2 binge days/week also had a 35% greater odds of insomnia than non-binge drinkers (aOR = 1.35, 95% CI = 1.15-1.59, p = 0.001). When smoking was added to the regression model, these associations fell just below the level of significance. Results suggest that binge drinking is associated with a greater risk of insomnia among adults aged 50 years and older, although this relationship may be driven in part by current smoking behavior. The relatively high prevalence of both binge drinking and sleep complaints among middle-aged and older populations warrants further investigation into binge drinking as a potential cause of late-life insomnia. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Association between stress-related sleep reactivity and cognitive processes in insomnia disorder and insomnia subgroups: preliminary results.

    Science.gov (United States)

    Palagini, Laura; Faraguna, Ugo; Mauri, Mauro; Gronchi, Alessia; Morin, Charles M; Riemann, Dieter

    2016-03-01

    Stress-related sleep reactivity, sleep-related cognitions, and psychological factors play an important role in insomnia. The aim was to investigate their possible association in Insomnia Disorder, insomnia subgroups, and healthy subjects. The cross-sectional study consisted of 93 subjects who met diagnostic criteria for Insomnia Disorder according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and of 30 healthy subjects. Survey instruments included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Ford Insomnia Response to Stress Test (FIRST), Dysfunctional Beliefs about Sleep scale (DBAS), Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS). Descriptive statistics, Pearson correlations, χ(2)-test, and multiple linear regression were performed. FIRST and SAS best determined the insomnia subjects vs good sleepers (FIRST χ(2) = 109.6, p insomnia, stress-related sleep reactivity, and psychological factors, such as anxiety symptoms, may distinguish insomnia subjects from good sleepers; (2) sleep reactivity and sleep-related cognitions seem interrelated, unhelpful beliefs may affect the stress reactivity; (3) psychological factors may influence sleep quality and the severity of insomnia; (4) these important sleep-related variables may have similar associations in insomnia subgroups; they may constitute the core factors for insomnia development and maintenance. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Assertiveness in Women Reporting Symptoms of Bulimia.

    Science.gov (United States)

    Ruhl, Berenice; McCanne, Thomas R.

    It has been suggested that a lack of assertiveness may be an important component of the psychological make-up of bulimic women, and that bulimic women may experience particular difficulties in asserting themselves in interactions with men. In this study, 23 women reporting the symptoms of bulimia by high scores on the Bulimia Test (BULIT) and 21…

  16. Developing a successful treatment for co-morbid insomnia and sleep apnoea.

    Science.gov (United States)

    Sweetman, Alexander M; Lack, Leon C; Catcheside, Peter G; Antic, Nick A; Chai-Coetzer, Ching Li; Smith, Simon S; Douglas, James A; McEvoy, R Doug

    2017-06-01

    Insomnia and sleep apnoea are the two most common sleep disorders, found in 6% and 23-50% of the general population respectively. These disorders also frequently co-occur, with 39-58% of sleep apnoea patients reporting symptoms indicative of co-morbid insomnia. When these disorders co-occur, clinicians are faced with difficult treatment decisions, patients experience the additive detrimental impacts of both disorders, and the effectiveness of discrete treatments for each disorder may be impaired. A common finding is that co-morbid insomnia and sleep apnoea (COMISA) is more difficult to treat than either disorder presenting alone. Co-morbid insomnia reduces the initial acceptance of, and later adherence to, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea. This has resulted in recent recommendations that treatment approaches should initially target COMISA patients' insomnia to remove this barrier to CPAP treatment, and improve patient outcomes. However, no randomised controlled trial outcomes investigating this treatment approach currently exist. The current article aims to review and integrate recent research examining the prevalence, characteristics, and theoretical mechanistic relationships between co-occurring insomnia and OSA, and discuss previous treatment attempts. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Predictors of improvement in subjective sleep quality reported by older adults following group-based cognitive behavior therapy for sleep maintenance and early morning awakening insomnia.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2013-09-01

    Cognitive behavior therapy is an effective nonpharmacologic treatment for insomnia. However, individualized administration is costly and often results in substantial variability in treatment response across individual patients, particularly so for older adults. Group-based administration has demonstrated impressive potential for a brief and inexpensive answer to the effective treatment of insomnia in the older population. It is important to identify potential predictors of response to such a treatment format to guide clinicians when selecting the most suitable treatment for their patients. The aim of our study was to identify factors that predict subjective sleep quality of older adults following group-based administration of cognitive behavior therapy for insomnia (CBT-I). Eighty-six adults (41 men; mean age, 64.10 y; standard deviation [SD], 6.80) with sleep maintenance or early morning awakening insomnia were selected from a community-based sample to participate in a 4-week group-based treatment program of CBT-I. Participants were required to complete 7-day sleep diaries and a comprehensive battery of questionnaires related to sleep quality and daytime functioning. Hierarchical multiple regression analyses were used to identify factors predicting subjective sleep quality immediately following treatment and at 3-month follow-up. Sleep diaries reported average nightly sleep efficiency (SE), which was used as the outcome measure of sleep quality. Participants with the greatest SE following treatment while controlling for pretreatment SE were relatively younger and had more confidence in their ability to sleep at pretreatment. These characteristics may be useful to guide clinicians when considering the use of a group-based CBT-I for sleep maintenance or early morning awakening insomnia in older adults. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Insomnia in adult attention-deficit/hyperactivity disorder: A comparison with borderline personality disorder population in a clinical setting and control participants.

    Science.gov (United States)

    Weibel, Sébastien; Jermann, Françoise; Weiner, Luisa; Nicastro, Rosetta; Ardu, Stefano; Pham, Eleonore; Hasler, Roland; Dayer, Alexandre; Prada, Paco; Perroud, Nader

    2017-07-01

    Many adults with attention-deficit/hyperactivity disorder (ADHD) report sleeping difficulties. The relationship between sleep and ADHD is poorly understood, and shows discrepancies between subjective and objective measures. In order to determine the specificity of sleep-associated symptoms in ADHD, subjective sleep assessments among ADHD adult patients were compared with control subjects and with individuals suffering from borderline personality disorder (BPD). 129 outpatients with ADHD, 70 with BPD (including 17 patients with BPD and ADHD comorbidity), and 65 control participants were assessed for sleep quality, insomnia, and sleepiness, using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). ADHD- and BPD-sufferers achieved higher insomnia and lower sleep quality scores than control subjects. Clinical groups did not differ in terms of sleep quality, although insomnia was more severe among BPD patients. Depression scores explained most of sleep symptoms, but even when controlling for depression, ADHD sufferers showed higher sleep latency. Inattentive symptoms were associated with somnolence, while hyperactive/impulsive symptoms were associated with insomnia and lower sleep efficiency. Sleep-related symptoms associated with ADHD were partly explained by non-specific factors, especially depression symptoms. In a dimensional perspective, hyperactive and inattentive symptoms were associated with specific sleep symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Daytime consequences of insomnia complaints in the French general population].

    Science.gov (United States)

    Ohayon, M M; Lemoine, P

    2004-01-01

    Insomnia is a frequent symptom in the general population; numerous studies have proven this. In the past years, classifications have gradually given more emphasis to daytime repercussions of insomnia and to their consequences on social and cognitive functioning. They are now integrated in the definition of insomnia and are used to quantify its severity. If the daytime consequences of insomnia are well known at the clinical level, there are few epidemiological data on this matter. The aim of this study was to assess the daytime repercussions of insomnia complaints in the general population of France. A representative sample (n=5,622) aged 15 or older was surveyed by telephone with the help of the sleep-EVAL expert system, a computer program specially designed to evaluate sleep disorders and to manage epidemiological investigations. Interviews have been completed for 80.8% of the solicited subjects (n=5,622). The variables considered comprised insomnia and its daytime repercussions on cognitive functioning, affective tone, daytime sleepiness and diurnal fatigue. Insomnia was found in 18.6% of the sample. The prevalence was higher in women (22.4%) than in men (14.5%, psleep. Nearly 75% of insomnia complainers reported having a disrupted sleep or waking up too early in the morning and about 40% said they had a non-restorative sleep. Repercussions on daytime functioning were reported by most insomnia subjects (67%). Repercussions on cognitive functioning changed according age, number of insomnia symptoms and the use of a psychotropic medication. A decreased efficiency was more likely to be reported by subjects between 15 and 44 years of age (OR: 2.9), those using a psychotropic (OR: 1.5), those reporting at least three insomnia symptoms (OR: 1.4) and women (OR: 1.4). The highest probability of the appearance of concentration difficulties was found in subjects younger than 65 Years, having a depressive disorder and using a psychotropic (15-44 years: OR 19.1; 45-64 years

  20. Cognitive Behavioral Therapy for Insomnia in the Context of Cardiovascular Conditions

    OpenAIRE

    Conley, Samantha; Redeker, Nancy S.

    2015-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide and is associated with high levels of morbidity, disability and poor quality of life. The prevalence of insomnia symptoms and diagnosis of insomnia are high among those with CVD. Although insomnia appears to be important to CVD, less is known about the effects of insomnia treatment on important biological, sleep, symptom, quality of life, functional and morbidity or mortality outcomes in people with or at-risk for CVD. The p...

  1. The Natural History of Insomnia: Acute Insomnia and First-onset Depression

    Science.gov (United States)

    Ellis, Jason G.; Perlis, Michael L.; Bastien, Célyne H.; Gardani, Maria; Espie, Colin A.

    2014-01-01

    Study Objectives: While many studies have examined the association between insomnia and depression, no studies have evaluated these associations (1) within a narrow time frame, (2) with specific reference to acute and chronic insomnia, and (3) using polysomnography. In the present study, the association between insomnia and first-onset depression was evaluated taking into account these considerations. Design: A mixed-model inception design. Setting: Academic research laboratory. Participants: Fifty-four individuals (acute insomnia [n = 33], normal sleepers [n = 21]) with no reported history of a sleep disorder, chronic medical condition, or psychiatric illness. Interventions: N/A. Measurements and Results: Participants were assessed at baseline (2 nights of polysomnography and psychometric measures of stress and mood) and insomnia and depression status were reassessed at 3 months. Individuals with acute insomnia exhibited more stress, poorer mood, worse subjective sleep continuity, increased N2 sleep, and decreased N3 sleep. Individuals who transitioned to chronic insomnia exhibited (at baseline) shorter REM latencies and reduced N3 sleep. Individuals who exhibited this pattern in the transition from acute to chronic insomnia were also more likely to develop first-onset depression (9.26%) as compared to those who remitted from insomnia (1.85%) or were normal sleepers (1.85%). Conclusion: The transition from acute to chronic insomnia is presaged by baseline differences in sleep architecture that have, in the past, been ascribed to Major Depression, either as heritable traits or as acquired traits from prior episodes of depression. The present findings suggest that the “sleep architecture stigmata” of depression may actually develop over the course transitioning from acute to chronic insomnia. Citation: Ellis JG; Perlis ML; Bastien CH; Gardani M; Espie CA. The natural history of insomnia: acute insomnia and first-onset depression. SLEEP 2014;37(1):97-106. PMID

  2. Prospective assessment of nocturnal awakenings in a case series of treatment-seeking chronic insomnia patients: a pilot study of subjective and objective causes.

    Science.gov (United States)

    Krakow, Barry; Romero, Edward; Ulibarri, Victor A; Kikta, Shara

    2012-12-01

    The cause of nocturnal awakenings in patients with chronic insomnia is rarely researched. This study prospectively assessed the etiology of nocturnal awakenings (subjectively and objectively) among patients with insomnia at a private, community-based sleep medical center. Twenty adult patients with chronic insomnia enrolled between April 2008 and February 2010 met diagnostic criteria for an insomnia disorder, never previously visited a sleep specialist or underwent sleep testing, and reported no classic sleep disordered breathing symptoms. Patients completed validated scales for insomnia, sleepiness, impairment, anxiety, depression, and quality of life, a qualitative interview to assess subjective reasons for awakenings, and a diagnostic sleep study to objectively assess awakenings and their precipitants. Subjective and objective data showed clinically meaningful insomnia, primarily sleep maintenance insomnia. The most common self-reported reasons for awakenings were: uncertain cause (50%), nightmares (45%), nocturia (35%), bedroom distractions (20%), or pain (15%). No patient identified breathing symptoms as a cause. Objectively, 531 awakenings were observed in the total sample, and 478 (90%) were preceded by sleep breathing events (apnea, hypopnea, or respiratory effort-related event). Fifty-three awakenings were caused by other factors (independent leg jerks [7], spontaneous [14], and sleep that was laboratory-induced [32]). Thirty awakenings ≥ 5 min-a duration sufficient to predispose toward an insomnia episode-were each preceded by a breathing event. Among patients with insomnia with no classic sleep breathing symptoms and therefore low probability of a sleep breathing disorder, most of their awakenings were precipitated by a medical condition (sleep disordered breathing), which contrasted sharply with their perceptions about their awakenings

  3. Insomnia, Nightmares, and Chronotype as Markers of Risk for Severe Mental Illness: Results from a Student Population.

    Science.gov (United States)

    Sheaves, Bryony; Porcheret, Kate; Tsanas, Athanasios; Espie, Colin A; Foster, Russell G; Freeman, Daniel; Harrison, Paul J; Wulff, Katharina; Goodwin, Guy M

    2016-01-01

    To group participants according to markers of risk for severe mental illness based on subsyndromal symptoms reported in early adulthood and evaluate attributes of sleep across these risk categories. An online survey of sleep and psychiatric symptomatology (The Oxford Sleep Survey) was administered to students at one United Kingdom university. 1403 students (undergraduate and postgraduate) completed the survey. The median age was 21 (interquartile range = 20-23) and 55.60% were female. The cross-sectional data were used to cluster participants based on dimensional measures of psychiatric symptoms (hallucinations, paranoia, depression, anxiety, and (hypo)mania). High, medium, and low symptom groups were compared across sleep parameters: insomnia symptoms, nightmares, chronotype, and social jet lag. Insomnia symptoms, nightmares frequency, and nightmare-related distress increased in a dose-response manner with higher reported subsyndromal psychiatric symptoms (low, medium, and high). The high-risk group exhibited a later chronotype (mid sleep point for free days) than the medium- or low-risk group. The majority of participants (71.7%) in the high-risk group screened positive for insomnia and the median nightmare frequency was two per 14 days (moderately severe pathology). Insomnia, nightmares, and circadian phase delay are associated with increased subsyndromal psychiatric symptoms in young people. Each is a treatable sleep disorder and might be a target for early intervention to modify the subsequent progression of psychiatric disorder. © 2016 Associated Professional Sleep Societies, LLC.

  4. Constipation and other common symptoms reported by women and men in methadone and buprenorphine maintenance treatment.

    Science.gov (United States)

    Haber, Paul S; Elsayed, Mahmoud; Espinoza, David; Lintzeris, Nicholas; Veillard, Anne-Sophie; Hallinan, Richard

    2017-12-01

    Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist. Multivariate analysis included other potential moderators of opioid-associated symptoms. Opioid users reported a higher frequency and severity of symptoms than non-opioid users. Constipation, dry mouth, decreased appetite, sweating and fatigue were highly prevalent in the previous 30days (51-80%). Nausea, itchy skin, trouble urinating, menstrual problems, lightheadedness, blurred vision, heart racing were also common (30-50%). Non-OST opioid users had significantly higher frequency and severity than OST recipients of nausea, vomiting, diarrhoea, decreased appetite, sweating and itchy skin. Sweating was significantly more common in MMT than BMT. Constipation scores were higher in women, otherwise most sex differences were small. Higher PAC-SYM scores were associated with vomiting (OR=1.04) and sweating (OR=1.06). Cannabis use was associated with vomiting (OR=2.19). Constipation (OR=1.07), insomnia (OR=2.5) and depression (OR=2.82) were associated with fatigue. Men and women receiving OST report similarly high rates of somatic symptoms, though less than opioid users not receiving OST. There were few differences between BMT and MMT. Buprenorphine might be preferred where sweating is problematic. Several modifiable factors were identified. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Insomnia Patients With Objective Short Sleep Duration Have a Blunted Response to Cognitive Behavioral Therapy for Insomnia.

    Science.gov (United States)

    Bathgate, Christina J; Edinger, Jack D; Krystal, Andrew D

    2017-01-01

    This study examined whether individuals with insomnia and objective short sleep duration insomnia (CBT-I) when compared to individuals with insomnia and normal sleep duration ≥6 h. Secondary analyses of a randomized, clinical trial with 60 adult participants (n = 31 women) from a single academic medical center. Outpatient treatment lasted 8 weeks, with a final follow-up conducted at 6 months. Mixed-effects models controlling for age, sex, CBT-I treatment group assignment, and treatment provider examined sleep parameters gathered via actigraphy, sleep diaries, and an Insomnia Symptom Questionnaire (ISQ) across the treatment and follow-up period. Six months post-CBT-I treatment, individuals with insomnia and normal sleep duration ≥6 h fared significantly better on clinical improvement milestones than did those with insomnia and short sleep duration insomnia and normal sleep duration had significantly higher insomnia remission (ISQ 80%; χ2[1, N = 60] = 21, p 50% decline in MWASO (χ2[1, N = 60] = 60, p insomnia and short sleep duration. Additionally, those with insomnia and normal sleep duration had more success decreasing their total wake time (TWT) at the 6-month follow-up compared to those with insomnia and short sleep duration (χ2[2, N = 60] = 44.1, p insomnia remission, with the area under the curve = 0.986. Findings suggest that individuals with insomnia and objective short sleep duration insomnia and normal sleep duration ≥6 h. Using an actigraphy TST cutoff of 6 hours to classify sleep duration groups was highly accurate and provided good discriminant value for determining insomnia remission. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  6. Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia: A Randomised Controlled Study

    Directory of Open Access Journals (Sweden)

    L. Bergdahl

    2016-01-01

    Full Text Available Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i. However CBT-i may not suit everyone. Auricular acupuncture (AA is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4, with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI, Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16, Epworth Sleepiness Scale (ESS, and Hospital Anxiety and Depression scale (HAD, were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder. The trial is registered with ClinicalTrials.gov NCT01765959.

  7. Going direct to the consumer: Examining treatment preferences for veterans with insomnia, PTSD, and depression.

    Science.gov (United States)

    Gutner, Cassidy A; Pedersen, Eric R; Drummond, Sean P A

    2018-05-01

    Inclusion of consumer preferences to disseminate evidence-based psychosocial treatment (EBPT) is crucial to effectively bridge the science-to-practice quality chasm. We examined this treatment gap for insomnia, posttraumatic stress disorder (PTSD), depression, and comorbid symptoms in a sample of 622 young adult veterans through preference in symptom focus, treatment modality, and related gender differences among those screening positive for each problem. Data were collected from veteran drinkers recruited through targeted Facebook advertisements as part of a brief online alcohol intervention. Analyses demonstrated that veterans reported greater willingness to seek insomnia-focused treatment over PTSD- or depression-focused care. Notably, even when participants screened negative for insomnia, they preferred sleep-focused care to PTSD- or depression-focused care. Although one in five veterans with a positive screen would not consider care, veterans screening for both insomnia and PTSD who would consider care had a preference for in-person counseling, and those screening for both insomnia and depression had similar preferences for in-person and mobile app-based/computer self-help treatment. Marginal gender differences were found. Incorporating direct-to-consumer methods into research can help educate stakeholders about methods to expand EBPT access. Though traditional in-person counseling was often preferred, openness to app-based/computer interventions offers alternative methods to provide veterans with EBPTs. Published by Elsevier B.V.

  8. Insomnia in the elderly: cause, approach, and treatment.

    Science.gov (United States)

    Kamel, Nabil S; Gammack, Julie K

    2006-06-01

    Insomnia is a prevalent problem in late life. Sleep problems in the elderly are often mistakenly considered a normal part of aging. Insomnia, the most common sleep disorder, is a subjective report of insufficient or nonrestorative sleep despite adequate opportunity to sleep. Despite the fact that more than 50% of elderly people have insomnia, it is typically undertreated, and nonpharmacologic interventions are underused by health care practitioners. This article will review the causes of insomnia in the elderly, the approach to patient evaluation, and the nonpharmacologic and pharmacologic treatment of insomnia.

  9. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  10. Insomnia as an expression of obstructive sleep apnea syndrome--the effect of treatment with nocturnal ventilatory support.

    Science.gov (United States)

    Mendes, M Saldanha; dos Santos, J Moutinho

    2015-01-01

    Obstructive sleep apnea syndrome (OSAS) and insomnia often coexist, and it is estimated that nearly half of those who suffer from the former report symptoms of the latter. The fact that these patients have no other causes of insomnia indicates that it is a sign of OSAS. The aim of the study is to evaluate the effectiveness of nocturnal ventilatory support (NVS) in the treatment of insomnia secondary to OSAS. In order to conduct the retrospective study, the authors reviewed the medical records of patients with insomnia and OSAS that had received NVS. Patients with psychiatric disorders, sleep movement disorders, psycho-physiological insomnia, circadian rhythm sleep disorders, inadequate sleep hygiene, use and abuse of hypnotic agents, stimulants, antidepressants, anxiolytics and alcohol, were excluded. For the selected patients, the effects of NVS in terms of clinical signs and symptoms of insomnia, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS) score, and number of sleep hours were analyzed, before and after treatment with NVS. After reviewing 1241 medical records, 56 patients were selected, with a mean age of 60.9±10.0 years. Twenty-two (39.3%) suffered from intermediate insomnia, 19 (33.9%) had initial insomnia, eight (14.3%) had the mixed type, and seven patients (12.5%) had terminal insomnia. The majority of patients (n=48; 85.7%) were treated with auto-titrating continuous positive airway pressure (APAP). Forty-four patients (78.6%) overcame insomnia; insomnia symptoms persisted in nine (16.1%), and three (5.4%) patients abandoned during the medical follow-up. There was an association between the type of insomnia and its resolution and, in percentage terms patients with the mixed type did not manage to overcome insomnia symptoms (75%). There was a statistically significant difference between patients that overcame insomnia and those who did not in terms of the average time which elapsed between the initiation of treatment with NVS and compliance

  11. CHoosing Options for Insomnia in Cancer Effectively (CHOICE): Design of a patient centered comparative effectiveness trial of acupuncture and cognitive behavior therapy for insomnia.

    Science.gov (United States)

    Garland, Sheila N; Gehrman, Philip; Barg, Frances K; Xie, Sharon X; Mao, Jun J

    2016-03-01

    Insomnia is a prevalent and persistent side effect of cancer, which if left unaddressed, can be unremitting and negatively influence physical and mental well-being. Acupuncture and Cognitive Behavioral Therapy (CBT) are commonly used non-pharmacological treatments that are efficacious for treating insomnia in cancer patients; however, little is known about the comparative effectiveness of these options. The goal of personalized medicine is to determine which treatments are most effective for which individuals, and patient preference for treatment is a particularly important contributor to adherence and outcomes. Here we describe the design of a clinical trial that begins to determine how best to personalize the treatment of insomnia for cancer survivors. This project is a randomized controlled comparative effectiveness trial with a nested qualitative study comparing acupuncture and CBT for insomnia and co-morbid symptoms in a heterogeneous sample of 160 cancer survivors. The primary aim is to determine which treatment is associated with the largest reduction in insomnia severity. The secondary aim is to examine the demographic, clinical, and psychological characteristics that predict and/or moderate treatment effect. Patients will receive ten treatments of acupuncture or 7 sessions of CBT over eight weeks and complete validated patient-reported outcome measures of sleep and co-morbid symptoms at baseline, mid-treatment, post-treatment, and at three-months to assess durability of effect. The results of the proposed study have the potential to improve healthcare outcomes by helping cancer survivors and their caregivers make informed and evidence-based decisions, leading to patient-centered and personalized care for cancer survivors with insomnia. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. DSM-5 Insomnia and Short Sleep: Comorbidity Landscape and Racial Disparities.

    Science.gov (United States)

    Kalmbach, David A; Pillai, Vivek; Arnedt, J Todd; Drake, Christopher L

    2016-12-01

    We estimated rates of cardiometabolic disease, pain conditions, and psychiatric illness associated with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia disorder (current and in remission) and habitual short sleep (fewer than 6 h), and examined the roles of insomnia and short sleep in racial disparities in disease burden between black and non-Hispanic white Americans. This epidemiological survey study was cross-sectional. The community-based sample consisted of 3,911 subjects (46.0 y ± 13.3; 65.4% female; 25.0% black) across six sleep groups based on DSM-5 insomnia classification ( never vs. remitted vs. current ) and self-reported habitual sleep duration ( normal vs. short ). Vascular events, cardiometabolic disease, pain conditions, and psychiatric symptoms were self-reported. Short sleeping insomniacs were at elevated risk for myocardial infarction, stroke, treated hypertension, diabetes, chronic pain, back pain, depression, and anxiety, independent of sex, age, and obesity. Morbidity profiles for insomniacs with normal sleep duration and former insomniacs, irrespective of sleep duration, were similar with elevations in treated hypertension, chronic pain, depression, and anxiety. Regarding racial disparities, cardiometabolic and psychiatric illness burden was greater for blacks, who were more likely to have short sleep and the short sleep insomnia phenotype. Evidence suggested that health disparities may be attributable in part to race-related differences in sleep. Insomnia disorder with short sleep is the most severe phenotype of insomnia and comorbid with many cardiometabolic and psychiatric illnesses, whereas morbidity profiles are highly similar between insomniacs with normal sleep duration and former insomniacs. Short sleep endemic to black Americans increases risk for the short sleep insomnia phenotype and likely contributes to racial disparities in cardiometabolic disease and psychiatric illness. © 2016 Associated

  13. Parents' Reports of Children's Internalizing Symptoms: Associations with Parents' Mental Health Symptoms and Substance Use Disorder.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Hamrick, Hannah C; Braitman, Abby L; White, Tyler D; Jenkins, Jennika

    2017-06-01

    This brief report examined the unique associations between parents' ratings of child internalizing symptoms and their own depression and anxiety in families with parental substance use disorder (SUD). Further, we examined whether parental SUD (father only, mother only, both parents) was related to discrepancy in mothers' and fathers' reports of children's internalizing symptoms. Participants were 97 triads (fathers, mothers) in which one or both parents met criteria for SUD. Polynomial regression analyses were conducted to examine whether father-mother reports of child internalizing symptoms had unique associations with parents' own symptoms of depression and anxiety while controlling for child gender, child age, and SUD diagnoses. Controlling for fathers' symptoms and other covariates, mothers experiencing more depression and anxiety symptoms reported more symptoms of child internalizing symptoms than did fathers. Mothers' and fathers' SUD was associated with higher anxiety symptoms among mothers after controlling for other variables. A second set of polynomial regressions examined whether father-mother reports of child internalizing symptoms had unique associations with parents' SUD diagnoses while controlling for child gender and child age. After controlling for mothers' symptoms and other covariates, parents' reports of children's internalizing symptoms were not significantly associated with either parent's SUD or parental SUD interactions (i.e., both parents have SUD diagnoses). Taken together, mothers' ratings of children's internalizing symptoms may be accounted for, in part, by her reports of depression and anxiety symptoms.

  14. Eszopiclone for late-life insomnia

    Directory of Open Access Journals (Sweden)

    Christina S McCrae

    2007-10-01

    Full Text Available Christina S McCrae1, Amanda Ross1, Ashley Stripling2, Natalie D Dautovich21Department of Clinical and Health Psychology, 2Department of Psychology, University of Florida, Gainesville, Florida, USAAbstract: Insomnia, the most common sleep disturbance in later life, affects 20%–50% of older adults. Eszopiclone, a short-acting nonbenzodiazepine hypnotic agent developed for the treatment of insomnia, has been available in Europe since 1992 and in the US since 2005. Although not yet evaluated for transient insomnia in older adults, eszopiclone has been shown to be safe and efficacious for short-term treatment (2 weeks of chronic, primary insomnia in older adults (64–91 years. Clinical studies in younger adults (mean = 44 years have shown eszopiclone can be used for 6–12 months without evidence of problems. Because the oldest participant in these longer-term trials was 69, it not known whether eszopiclone is effective for older adults [particularly the old old (75–84 years and oldest old (85+] when used over longer periods. This is unfortunate, because older individuals frequently suffer from chronic insomnia. Cognitive-behavioral therapy for insomnia, which effectively targets the behavioral factors that maintain chronic insomnia, represents an attractive treatment alternative or adjuvant to eszopiclone for older adults. To date, no studies have compared eszopiclone to other hypnotic medications or to nonpharmacological interventions, such as cognitive-behavioral therapy for insomnia, in older adults. All of the clinical trials reported herein were funded by Sepracor. This paper provides an overview of the literature on eszopiclone with special emphasis on its use for the treatment of late-life insomnia. Specific topics covered include pharmacology, pharmacodynamics, pharmacokinetics, clinical trial data, adverse events, drug interactions, tolerance/dependence, and economics/cost considerations for older adults. Keywords: aging, eszopiclone

  15. Insomnia and limb pain in hemodialysis patients: What is the share of restless leg syndrome?

    OpenAIRE

    Majid Malaki; Fakhr Sadat Mortazavi; Sussan Moazemi; Maryam Shoaran

    2012-01-01

    Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS) as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, ...

  16. Restless Legs Syndrome -- Causes and Symptoms

    Science.gov (United States)

    ... miles): 10 25 50 Share: Essentials in Sleep Insomnia Overview & Facts Symptoms & Causes Diagnosis & Self Tests Treatment Sleep Apnea Overview & Facts ... Self Test & Diagnosis Treatment Snoring Overview and Facts Causes and Symptoms Self Tests & ... Insomnia Short Sleeper Hypersomnias Narcolepsy Insufficient ...

  17. The cognitive treatment components and therapies of cognitive behavioral therapy for insomnia: A systematic review.

    Science.gov (United States)

    Jansson-Fröjmark, Markus; Norell-Clarke, Annika

    2018-06-07

    Since the beginning of the twenty-first century, there has been an increased focus on developing and testing cognitive components and therapies for insomnia disorder. The aim of the current review was thus to describe and review the efficacy of cognitive components and therapies for insomnia. A systematic review was conducted on 32 studies (N = 1455 subjects) identified through database searches. Criteria for inclusion required that each study constituted a report of outcome from a cognitive component or therapy, that the study had a group protocol, adult participants with diagnosed insomnia or undiagnosed insomnia symptoms or reported poor sleep, and that the study was published until and including 2016 in English. Each study was systematically reviewed with a standard coding sheet. Several cognitive components, a multi-component cognitive program, and cognitive therapy were identified. It is concluded that there is support for paradoxical intention and cognitive therapy. There are also other cognitive interventions that appears promising, such as cognitive refocusing and behavioral experiments. For most interventions, the study quality was rated as low to moderate. We conclude that several cognitive treatment components and therapies can be viewed as efficacious or promising interventions for patients with insomnia disorder. Methodologically stronger studies are, however, warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea.

    Science.gov (United States)

    Lack, Leon; Sweetman, Alexander

    2016-09-01

    Insomnia is often comorbid with obstructive sleep apnea. It reduces positive airway pressure (PAP) therapy acceptance and adherence. Comorbid patients show greater daytime impairments and poorer health outcomes. The insomnia often goes undiagnosed, undertreated, or untreated. Pharmacotherapy is not recommended for long-term treatment. Although care should be taken administering behavioral therapies to patients with elevated sleepiness, cognitive behavior therapy for insomnia (CBTi) is an effective and durable nondrug therapy that reduces symptoms and may increase the effectiveness of PAP therapy. Sleep clinics should be alert to comorbid insomnia and provide adequate diagnostic tools and clinicians with CBTi expertise. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Psychosocial Correlates of Insomnia in an Adolescent Population

    Science.gov (United States)

    Siomos, Konstantinos E.; Avagianou, Penelope-Alexia; Floros, Georgios D.; Skenteris, Nikolaos; Mouzas, Odysseas D.; Theodorou, Kyriaki; Angelopoulos, Nikiforos V.

    2010-01-01

    This study examines the nature of the relationship between psychosocial factors and insomnia complaints in an adolescent non-clinical population. It is a cross-sectional study of a stratified sample of 2,195 Greek adolescent high-school students. Subjects were given the Athens insomnia scale, the Symptom Checklist scale (SCL-90-R) and a…

  20. Self-reported symptoms associated with exposure to electromagnetic fields: a questionnaire study.

    Science.gov (United States)

    Küçer, Nermin; Pamukçu, Tuğba

    2014-01-01

    Abstract In the last years, it has been discussed frequently whether there are any harmful effects of electromagnetic fields on human health. Electromagnetic fields are generated by several natural and man-made sources. Part of the electromagnetic spectrum called Radiofrequency is used in communication systems such as mobile (cellular) phone and computer. The aim of our study was to explore different self-reported symptoms that may be associated with exposure to electromagnetic fields. This survey study was conducted, using a questionnaire, on 350 people aged +9 years in Turkey. The chi-square test was used for data analysis. Self-reported symptoms were headache, vertigo/dizziness, fatigue, forgetfulness, sleep disturbance-insomnia, tension-anxiety, joint and bone pain, lacrimation of the eyes, hearing loss and tinnitus. As a result of the survey, the study has shown that users of mobile phone and computer more often complained of headache, joint and bone pain, hearing loss, vertigo/dizziness, tension-anxiety symptoms according to time of daily usage (p < 0.05). In users of mobile phone and computer, women significantly (p < 0.05) complained more often of headache, vertigo/dizziness, fatigue, forgetfulness and tension-anxiety than men.

  1. Insomnia as an expression of obstructive sleep apnea syndrome – the effect of treatment with nocturnal ventilatory support

    Directory of Open Access Journals (Sweden)

    M. Saldanha Mendes

    2015-07-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS and insomnia often coexist, and it is estimated that nearly half of those who suffer from the former report symptoms of the latter. The fact that these patients have no other causes of insomnia indicates that it is a sign of OSAS. Objective: The aim of the study is to evaluate the effectiveness of nocturnal ventilatory support (NVS in the treatment of insomnia secondary to OSAS. Materials and methods: In order to conduct the retrospective study, the authors reviewed the medical records of patients with insomnia and OSAS that had received NVS. Patients with psychiatric disorders, sleep movement disorders, psycho-physiological insomnia, circadian rhythm sleep disorders, inadequate sleep hygiene, use and abuse of hypnotic agents, stimulants, antidepressants, anxiolytics and alcohol, were excluded. For the selected patients, the effects of NVS in terms of clinical signs and symptoms of insomnia, apnea–hypopnea index (AHI, Epworth Sleepiness Scale (ESS score, and number of sleep hours were analyzed, before and after treatment with NVS. Results: After reviewing 1241 medical records, 56 patients were selected, with a mean age of 60.9 ± 10.0 years. Twenty-two (39.3% suffered from intermediate insomnia, 19 (33.9% had initial insomnia, eight (14.3% had the mixed type, and seven patients (12.5% had terminal insomnia. The majority of patients (n = 48; 85.7% were treated with auto-titrating continuous positive airway pressure (APAP. Forty-four patients (78.6% overcame insomnia; insomnia symptoms persisted in nine (16.1%, and three (5.4% patients abandoned during the medical follow-up. There was an association between the type of insomnia and its resolution and, in percentage terms patients with the mixed type did not manage to overcome insomnia symptoms (75%.There was a statistically significant difference between patients that overcame insomnia and those who did not in terms of the

  2. Insomnia patients' help-seeking experiences.

    Science.gov (United States)

    Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Glozier, Nicholas; Saini, Bandana

    2014-03-04

    Timely access to appropriate treatment is important for optimizing insomnia management. To date, little is known about insomnia patients' treatment experiences or how they access and engage with the available health care resources. This study sought to capture the help-seeking experiences and behavioral patterns of patients with insomnia who are seeking or receiving specialist care. A purposive sample of 26 insomnia patients from specialist sleep and mental health clinics located in metropolitan New South Wales, Australia was recruited. Participants completed a brief questionnaire, followed by an in-depth, semi-structured interview. Interviews were digitally recorded, transcribed verbatim, and analyzed using framework analysis. Three key themes emerged from the data: patients' sleep beliefs, treatment beliefs, and accessing specialized care. The findings show that daytime symptoms arising from insomnia serve as important illness cues for patients to seek medical help. In addition, participants' treatment pathways highlight factors that prevent the widespread use of cognitive behavioral therapy for insomnia (CBT-I), including limited awareness about CBT-I, tentative referral mechanisms, limited service providers, and the high cost of CBT-I.

  3. Genetic Pathways to Insomnia

    OpenAIRE

    Mackenzie J. Lind; Philip R. Gehrman

    2016-01-01

    This review summarizes current research on the genetics of insomnia, as genetic contributions are thought to be important for insomnia etiology. We begin by providing an overview of genetic methods (both quantitative and measured gene), followed by a discussion of the insomnia genetics literature with regard to each of the following common methodologies: twin and family studies, candidate gene studies, and genome-wide association studies (GWAS). Next, we summarize the most recent gene identif...

  4. Familial Aggregation of Insomnia.

    Science.gov (United States)

    Jarrin, Denise C; Morin, Charles M; Rochefort, Amélie; Ivers, Hans; Dauvilliers, Yves A; Savard, Josée; LeBlanc, Mélanie; Merette, Chantal

    2017-02-01

    There is little information about familial aggregation of insomnia; however, this type of information is important to (1) improve our understanding of insomnia risk factors and (2) to design more effective treatment and prevention programs. This study aimed to investigate evidence of familial aggregation of insomnia among first-degree relatives of probands with and without insomnia. Cases (n = 134) and controls (n = 145) enrolled in a larger epidemiological study were solicited to invite their first-degree relatives and spouses to complete a standardized sleep/insomnia survey. In total, 371 first-degree relatives (Mage = 51.9 years, SD = 18.0; 34.3% male) and 138 spouses (Mage = 55.5 years, SD = 12.2; 68.1% male) completed the survey assessing the nature, severity, and frequency of sleep disturbances. The dependent variable was insomnia in first-degree relatives and spouses. Familial aggregation was claimed if the risk of insomnia was significantly higher in the exposed (relatives of cases) compared to the unexposed cohort (relatives of controls). The risk of insomnia was also compared between spouses in the exposed (spouses of cases) and unexposed cohort (spouses of controls). The risk of insomnia in exposed and unexposed biological relatives was 18.6% and 10.4%, respectively, yielding a relative risk (RR) of 1.80 (p = .04) after controlling for age and sex. The risk of insomnia in exposed and unexposed spouses was 9.1% and 4.2%, respectively; however, corresponding RR of 2.13 (p = .28) did not differ significantly. Results demonstrate evidence of strong familial aggregation of insomnia. Additional research is warranted to further clarify and disentangle the relative contribution of genetic and environmental factors in insomnia. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  5. On counterbalancing of symptom-reporting in trauma surveys.

    Science.gov (United States)

    Reddy, Madhavi K; Polusny, Melissa A; Murdoch, Maureen

    2009-12-01

    Some traumatic stress research surveys are potentially subject to context effects, such as priming, because they include questions about traumatic experiences and trauma-related symptoms within the same survey. In this study, asking about traumatic experiences before or after asking about PTSD influenced symptom reporting was investigated in a sample of 424 National Guard soldiers. Results indicate ordering of symptom measures immediately before or after reports of combat experiences did not influence reports of PTSD symptoms. Implications of results are discussed.

  6. The Association Between Insomnia and Sleep Duration in Adults With Attention-Deficit Hyperactivity Disorder: Results From a General Population Study

    Science.gov (United States)

    Wynchank, Dora; ten Have, Margreet; Bijlenga, Denise; Penninx, Brenda W.; Beekman, Aartjan T.; Lamers, Femke; de Graaf, Ron; Kooij, J.J. Sandra

    2018-01-01

    Study Objectives: Insomnia and short or long sleep duration are important comorbid conditions in adults with attention-deficit hyperactivity disorder (ADHD), but reports of the association vary. In a general population study, we evaluated the relationship between ADHD symptom severity, insomnia symptoms, and sleep duration in adults. Methods: Data were from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 4,618). ADHD symptom severity and symptom dimensions (hyperactivity and inattention) were assessed using the Adult ADHD Self-Report Scale screener. Self-reported insomnia symptoms (Insomnia Rating Scale; IRS) were defined as clinically relevant if IRS ≥ 9. Self-reported short sleep duration was defined as ≤ 6 hours, and long sleep duration as ≥ 10 hours. Results: Within the group with clinically relevant ADHD symptoms, 43% reported significant insomnia symptoms (odds ratio [OR] = 2.66, 95% confidence interval [CI] 1.74–4.07); 41% short sleep duration (relative risk ratio [RRR] = 1.94, 95% CI 1.31–2.85) and 6% long sleep (RRR = 5.87, 95% CI 1.97–17.45). Increased inattention symptoms were associated with IRS ≥ 9, short and long sleep duration in fully adjusted models (OR = 1.10, 95% CI 1.06–1.14; RRR = 1.06, 95% CI 1.02–1.09; RRR = 1.16, 95% CI 1.05–1.28, respectively). Increased hyperactivity symptoms were associated with IRS ≥ 9 (OR = 1.17, 95% CI 1.11–1.23) and short sleep duration (RRR = 1.12, 95% CI 1.05–1.19). Conclusions: Both clinically significant ADHD symptoms and inattention and hyperactivity symptom dimensions were consistently associated with insomnia symptoms and altered sleep duration. These associations confirm that sleep disturbances should be assessed and given appropriate clinical attention in adults with ADHD. Citation: Wynchank D, ten Have M, Bijlenga D, Penninx BW, Beekman AT, Lamers F, de Graaf R, Kooij JJ. The association between insomnia and sleep duration in adults with

  7. Neurobiology of insomnia as measured with FMRI

    OpenAIRE

    Orff, Henry John

    2010-01-01

    Insomnia, the most common sleep disorder afflicting adults, is diagnostically characterized by a chronic complaint of difficulty sleeping at night and a report of consequent impairment in daytime functioning. Despite this diagnostic requirement and the relative prevalence of daytime distress in patients with insomnia, studies to date have shown only limited evidence of objective daytime impairment in this population. This investigation tested a neurobiological compensation model which attempt...

  8. [The newest epidemiology trend of insomnia].

    Science.gov (United States)

    Ikeda, Maki; Kaneita, Yoshitaka

    2014-03-01

    Sleep disturbance such as insomnia is one of common complaint among adults in developed countries. Insomnia induces sleepiness and drowsiness, resulting in a reduction of working efficiency in the daytime. Drivers in the transportation system and machine operators could cause serious industrial accidents if they have sleep disturbances. Recent studies reported that approximately 20% of Japanese population had sleep disturbances. Here we provide a general account of sleep disturbance about Japanese population.

  9. Adolescent insomnia, suicide risk, and the interpersonal theory of suicide.

    Science.gov (United States)

    Zullo, Lucas; Horton, Sarah; Eaddy, Michael; King, Jessica; Hughes, Jennifer; Diederich, Andrew; Kennard, Betsy; Emslie, Graham; Stewart, Sunita

    2017-11-01

    Although insomnia has been repeatedly linked with suicide ideation, the reason for the linkage is not clear. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that three core variables (thwarted belongingness, perceived burdensomeness, and acquired capability) are the final common pathway for all risk factors for suicide ideation and behavior. Recent research has suggested that insomnia may be associated with suicide ideation independently of the IPTS. We examined cross-sectional data from 151 psychiatric inpatients (ages 12-17) to determine if the association between insomnia symptoms and a continuous measure of suicide risk (measured as increasingly severe ideation and plan) was explained by the framework of the IPTS. When all IPTS variables and depressive symptoms were included in the model, insomnia symptoms did not contribute unique variance to suicide risk. Perceived burdensomeness and depressive symptoms were found to explain the relationship between insomnia symptoms and suicide risk. Our findings suggest that improved sleep might reduce suicide risk, that management of interpersonal need cognitions might reduce risk in the presence of insomnia symptoms, and reinforce the independent role of depressive symptoms in suicide risk in clinical samples of adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Exposure-response relationship of wind turbine noise with self-reported symptoms of sleep and health problems: A nationwide socioacoustic survey in Japan

    Directory of Open Access Journals (Sweden)

    Takayuki Kageyama

    2016-01-01

    Full Text Available The association of wind turbine noise (WTN with sleep and physical/mental health has not been fully investigated. To investigate the relationship of WTN with the prevalence of self-reported symptoms of sleep and health problems, a socioacoustic survey of 1079 adult residents was conducted throughout Japan (2010-2012: 747 in 34 areas surrounding wind turbine plants and 332 in 16 control areas. During face-to-face interviews, the respondents were not informed of the purpose of the survey. Questions on symptoms such as sleeplessness and physical/mental complaints were asked without specifying reasons. Insomnia was defined as having one or any combination of the following that occurs three or more times a week and bothers a respondent: Difficulty initiating sleep, difficulty maintaining sleep, premature morning awakening, and feeling of light overnight sleep. Poor health was defined as having high scores for health complaints, as determined using the Total Health Index, exceeding the criteria proposed by the authors of the index. The noise descriptor for WTN was LAeq,n outdoor, estimated from the results of actual measurement at some locations in each site. Multiple logistic analysis was applied to the LAeq,n and insomnia or poor health. The odds ratio (OR of insomnia was significantly higher when the noise exposure level exceeded 40 dB, whereas the self-reported sensitivity to noise and visual annoyance with wind turbines were also independently associated with insomnia. OR of poor health was not significant for noise exposure, but significant for noise sensitivity and visual annoyance. The above two moderators appear to indicate the features of respondents who are sensitive to stimuli or changes in their homeostasis.

  11. Exposure-response relationship of wind turbine noise with self-reported symptoms of sleep and health problems: A nationwide socioacoustic survey in Japan.

    Science.gov (United States)

    Kageyama, Takayuki; Yano, Takashi; Kuwano, Sonoko; Sueoka, Shinichi; Tachibana, Hideki

    2016-01-01

    The association of wind turbine noise (WTN) with sleep and physical/mental health has not been fully investigated. To investigate the relationship of WTN with the prevalence of self-reported symptoms of sleep and health problems, a socioacoustic survey of 1079 adult residents was conducted throughout Japan (2010-2012): 747 in 34 areas surrounding wind turbine plants and 332 in 16 control areas. During face-to-face interviews, the respondents were not informed of the purpose of the survey. Questions on symptoms such as sleeplessness and physical/mental complaints were asked without specifying reasons. Insomnia was defined as having one or any combination of the following that occurs three or more times a week and bothers a respondent: Difficulty initiating sleep, difficulty maintaining sleep, premature morning awakening, and feeling of light overnight sleep. Poor health was defined as having high scores for health complaints, as determined using the Total Health Index, exceeding the criteria proposed by the authors of the index. The noise descriptor for WTN was LAeq,n outdoor, estimated from the results of actual measurement at some locations in each site. Multiple logistic analysis was applied to the LAeq,n and insomnia or poor health. The odds ratio (OR) of insomnia was significantly higher when the noise exposure level exceeded 40 dB, whereas the self-reported sensitivity to noise and visual annoyance with wind turbines were also independently associated with insomnia. OR of poor health was not significant for noise exposure, but significant for noise sensitivity and visual annoyance. The above two moderators appear to indicate the features of respondents who are sensitive to stimuli or changes in their homeostasis.

  12. Self-reported symptoms and healthcare seeking in the general population-exploring "The Symptom Iceberg"

    DEFF Research Database (Denmark)

    Elnegaard, Sandra; Andersen, Rikke Sand; Pedersen, Anette Fischer

    2015-01-01

    leading to GP contacts. CONCLUSION: Prevalence of symptoms and GP contacts are common in this overview of 44 different self-reported symptoms. For almost 2/3 of the reported symptoms no gender differences were found concerning the proportion leading to GP contacts. An enhanced understanding of healthcare...... population may increase our knowledge of this complex field. The primary objective of this study was to estimate the prevalence of self-reported symptoms and the proportion of individuals reporting GP contact, in a large Danish nationwide cohort. A secondary objective was to explore gender differences in GP...

  13. Stress Reactivity in Insomnia.

    Science.gov (United States)

    Gehrman, Philip R; Hall, Martica; Barilla, Holly; Buysse, Daniel; Perlis, Michael; Gooneratne, Nalaka; Ross, Richard J

    2016-01-01

    This study examined whether individuals with primary insomnia (PI) are more reactive to stress than good sleepers (GS). PI and GS (n = 20 per group), matched on gender and age, completed three nights of polysomnography. On the stress night, participants received a mild electric shock and were told they could receive additional shocks during the night. Saliva samples were obtained for analysis of cortisol and alpha amylase along with self-report and visual analog scales (VAS). There was very little evidence of increased stress on the stress night, compared to the baseline night. There was also no evidence of greater stress reactivity in the PI group for any sleep or for salivary measures. In the GS group, stress reactivity measured by VAS scales was positively associated with an increase in sleep latency in the experimental night on exploratory analyses. Individuals with PI did not show greater stress reactivity compared to GS.

  14. Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS).

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M; Brinton, Eliot A; Budoff, Mathew J; Cedars, Marcelle I; Hodis, Howard N; Lobo, Rogerio A; Manson, Joann E; Merriam, George R; Miller, Virginia M; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S Mitchell; Taylor, Hugh S

    2013-04-01

    To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Cross-sectional analysis. Multicenter, randomized controlled trial. Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). None. Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E2 levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E2, CAC, and CIMT were assessed. In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E2. Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. NCT00154180. Published by Elsevier Inc.

  15. Self-Reported Menopausal Symptoms, Coronary Artery Calcification and Carotid Intima-Media Thickness in Recently Menopausal Women Screened for the Kronos Early Estrogen Prevention Study (KEEPS)

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M.; Brinton, Eliot A.; Budoff, Mathew J.; Cedars, Marcelle I.; Hodis, Howard N.; Lobo, Rogerio A.; Manson, JoAnn E.; Merriam, George R.; Miller, Virginia M.; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S. Mitchell; Taylor, Hugh S.

    2012-01-01

    Objective To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Setting Multi-center, randomized controlled trial. Patients Recently menopausal women (n=868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). Design Cross sectional analysis. Interventions None Main Outcome Measures Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum estradiol (E2) levels and measures of atherosclerosis were assessed. Atherosclerosis was quantified using Coronary Artery Calcium (CAC) Agatston scores (n=771) and Carotid Intima-Media Thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, estradiol (E2), CAC, and CIMT were assessed. Results In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations (p=0.09) and depression (p=0.07) approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness and E2. Conclusions Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine if baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. PMID:23312232

  16. Pharmacotherapy of Pediatric Insomnia

    Science.gov (United States)

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  17. Insomnia and the performance of US workers: results from the America insomnia survey.

    Science.gov (United States)

    Kessler, Ronald C; Berglund, Patricia A; Coulouvrat, Catherine; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C; Stephenson, Judith J; Walsh, James K

    2011-09-01

    To estimate the prevalence and associations of broadly defined (i.e., meeting full ICD-10, DSM-IV, or RDC/ICSD-2 inclusion criteria) insomnia with work performance net of comorbid conditions in the America Insomnia Survey (AIS). Cross-sectional telephone survey. National sample of 7,428 employed health plan subscribers (ages 18+). None. Broadly defined insomnia was assessed with the Brief Insomnia Questionnaire (BIQ). Work absenteeism and presenteeism (low on-the-job work performance defined in the metric of lost workday equivalents) were assessed with the WHO Health and Work Performance Questionnaire (HPQ). Regression analysis examined associations between insomnia and HPQ scores controlling 26 comorbid conditions based on self-report and medical/pharmacy claims records. The estimated prevalence of insomnia was 23.2%. Insomnia was significantly associated with lost work performance due to presenteeism (χ² (1) = 39.5, P absenteeism (χ² (1) = 3.2, P = 0.07), with an annualized individual-level association of insomnia with presenteeism equivalent to 11.3 days of lost work performance. This estimate decreased to 7.8 days when controls were introduced for comorbid conditions. The individual-level human capital value of this net estimate was $2,280. If we provisionally assume these estimates generalize to the total US workforce, they are equivalent to annualized population-level estimates of 252.7 days and $63.2 billion. Insomnia is associated with substantial workplace costs. Although experimental studies suggest some of these costs could be recovered with insomnia disease management programs, effectiveness trials are needed to obtain precise estimates of return-on-investment of such interventions from the employer perspective.

  18. Stress and Sleep Reactivity: A Prospective Investigation of the Stress-Diathesis Model of Insomnia

    Science.gov (United States)

    Drake, Christopher L.; Pillai, Vivek; Roth, Thomas

    2014-01-01

    Study Objectives: To prospectively assess sleep reactivity as a diathesis of insomnia, and to delineate the interaction between this diathesis and naturalistic stress in the development of insomnia among normal sleepers. Design: Longitudinal. Setting: Community-based. Participants: 2,316 adults from the Evolution of Pathways to Insomnia Cohort (EPIC) with no history of insomnia or depression (46.8 ± 13.2 y; 60% female). Interventions: None. Measurements and Results: Participants reported the number of stressful events they encountered at baseline (Time 1), as well as the level of cognitive intrusion they experienced in response to each stressor. Stressful events (OR = 1.13; P insomnia one year hence (Time 2). Intrusion mediated the effects of stressful events on risk for insomnia (P insomnia (OR = 1.78; P insomnia as a function of intrusion was significantly higher in individuals with high sleep reactivity. Trait sleep reactivity also constituted a significant risk for depression (OR = 1.67; P Insomnia at Time 2 significantly mediated this effect (P insomnia, and that it triggers insomnia by exacerbating the effects of stress-induced intrusion. Sleep reactivity is also a precipitant of depression, as mediated by insomnia. These findings support the stress-diathesis model of insomnia, while highlighting sleep reactivity as an important diathesis. Citation: Drake CL, Pillai V, Roth T. Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia. SLEEP 2014;37(8):1295-1304. PMID:25083009

  19. FORTY CASES OF INSOMNIA TREATED WITH ACUPUNCTURE, MASSAGE AND MUSIC THERAPY

    Institute of Scientific and Technical Information of China (English)

    WANG Lin-yu

    2005-01-01

    @@ Insomnia is a commonly encountered sleep disorder in clinical practice. The author of the present paper treated 40 cases of insomnia with acupuncture and massage combined with music therapy and achieved satisfied outcomes. Following is the report.

  20. Insomnia in Iranian Traditional Medicine

    OpenAIRE

    Feyzabadi, Zohre; Jafari, Farhad; Feizabadi, Parvin Sadat; Ashayeri, Hassan; Esfahani, Mohammad Mahdi; Badiee Aval, Shapour

    2014-01-01

    Context: Insomnia is one of the most prevalent sleep disorders characterized by sleep difficulty that impairs daily functioning and reduces quality of life. The burden of medical, psychiatric, interpersonal, and societal consequences of insomnia expresses the importance of diagnosing and treatment of insomnia. The aim of study was to investigate causes of insomnia from the viewpoint of Iranian traditional medicine. Evidence Acquisition: In this review study, we searched insomnia in a few of t...

  1. Insomnia (primary) in older people

    OpenAIRE

    Alessi, Cathy; Vitiello, Michael V

    2011-01-01

    Up to 40% of older adults have insomnia, with difficulty getting to sleep, early waking, or feeling unrefreshed on waking. The prevalence of insomnia increases with age. Other risk factors include medical and psychiatric illnesses, psychological factors, stress, daytime napping, and hyperarousal.Primary insomnia is a chronic and relapsing condition that may increase the risks of accidents.Primary insomnia is chronic insomnia without specific underlying medical, psychiatric, or other sleep ...

  2. MANAGEMENT OF INSOMNIA USING PHARMOCOLOGY OR NON- PHARMACOLOGY

    Directory of Open Access Journals (Sweden)

    Muammar Ghaddafi

    2013-11-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Insomnia is a symptom rather than a diagnosis that may lead to irritability, dissatisfaction and decrease individual productivity. Insomnia can be divided into primary and secondary symptom which cause by other condition, but the mechanism on how this happened still unclear. In addition, relation between insomnia and other clinical problem is always undefined because it is impossible to find out the relation between causes and consequences of this symptom. Practitioner can choose either pharmacotherapy or non-pharmacotherapy in management of insomnia patient. Side effects and efficacy of pharmacotherapy must be considered before we prescribe a medicine to de patient. We also can Choose non-pharmacotherapy which is without side effects, but can be same effective as pharmacotherapy and even more.

  3. Treating Acute Insomnia: A Randomized Controlled Trial of a "Single-Shot" of Cognitive Behavioral Therapy for Insomnia.

    Science.gov (United States)

    Ellis, Jason G; Cushing, Toby; Germain, Anne

    2015-06-01

    Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia. A pragmatic parallel group randomized controlled trial. Community. Forty adults (mean age 32.9 ± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep. A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects were offered a full individual course of CBT-I on completion of the study, regardless of group allocation. Subjects completed sleep diaries and the Insomnia Severity Index (ISI) pretreatment and 1 mo following treatment. There were no between-group differences on baseline ISI scores or subjective sleep continuity. The intervention group reported significantly lower ISI scores than controls (t(38) 2.24, P insomnia caseness (i.e., ≥ 10), 60% of those in the CBT-I group had remitted by 1 mo compared to 15% of those in the control group. This single session of cognitive behavioral therapy for insomnia (CBT-I) is sufficiently efficacious for a significant proportion of those with acute insomnia. The results are discussed in terms of integrating this brief form of CBT-I into the "stepped care" model of insomnia. Testing the efficacy of an early intervention for acute insomnia (SRCTN05891695) http://www.controlled-trials.com/ISRCTN05891695. © 2015 Associated Professional Sleep Societies, LLC.

  4. [Etiology of adult insomnia].

    Science.gov (United States)

    Dollander, M

    2002-01-01

    In the article, the author develops an analysis of external and intrapsychic factors related to adults' insomnia. First she undertakes a literature review to describe semiological, evolutive and etiological levels of insomnia. From a semiological point of view, it is usual to differenciate initial insomnia (associated to the first phase of sleeping), intermittent insomnia (related to frequent awakenings) and final insomnia (related to early morning awakenings). From an evolutive point of view, we can identify transitory insomnia (characterized by frequent awakenings) and chronic insomnia. On the other hand, we are allowed to distinguish organic insomnia (disorder where an organic cerebral injury is demonstrated or suspected) from insomnias related to psychiatric or somatic disease or idiopathic one. Then, the author makes a literary review to identify various insomnia causes and points out. Social factors: insomnia rates are higher by divorced, separated or widowed people. Percentages are higher when scholastic level is weak, domestic income is less then 915 O a month, or by unemployed people. Besides, sleep quality is deteriorated by ageing. Sleeping and waking rhythm is able to loose its synchronization. Complaints about insomnia occur far frequently from women than men. Environmental factors: working constraints increase sleep disorders. It is possible to make the same conclusion when we have to face overcharge of external events, deep intrapsychic conflicts (related to grief, unemployment, damage or hospitalization) or interpersonal conflicts' situations where we are confronted to stress related to socio-affective environment, lack of social support or conjugal difficulties. Medical and physiologic causes: legs impatience syndrome, recurrent limbs shakings syndrome, breathe stop during sleep, narcolepsy, excessive medicine or hypnotic drugs use, some central nervous system injuries, every nocturnal awakening (related to aches.), surgical operation

  5. The value of mindfulness meditation in the treatment of insomnia.

    Science.gov (United States)

    Martires, Joanne; Zeidler, Michelle

    2015-11-01

    Insomnia is the most common reported sleep disorder with limited treatment options including pharmacotherapy and cognitive behavioral therapy for insomnia. Pharmacotherapy can be complicated by tolerance and significant side-effects and cognitive behavioral therapy for insomnia providers are limited in number. This article reviews mindfulness meditation as an additional therapy for insomnia. Both mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI) have been studied in the treatment of insomnia. Randomized controlled studies of MBSR and MBTI have shown overall reduction in sleep latency and total wake time and increase in total sleep time after mindfulness therapy using both patient reported outcome and quantitative measures of sleep. Mindfulness techniques have been shown to be well accepted by patients with long-lasting effects. A three-arm randomized study with MBSR, MBTI, and self-monitoring showed similar improvement in insomnia between the MBSR and MBTI groups, with possibly longer duration of efficacy in the MBTI group. Recent data show that MBTI is also an effective and accepted treatment for insomnia in older patients. Increasing evidence shows that mindfulness meditation, delivered either via MBSR or MBTI, can be successfully used for the treatment of insomnia with good patient acceptance and durable results.

  6. Subjective daytime functioning assessment in people with insomnia.

    Science.gov (United States)

    Grabowski, Karol; Nowicka-Sauer, Katarzyna; Zdrojewski, Tomasz; Rutkowski, Marcin; Bandosz, Piotr; Nowicki, Zbigniew

    2017-10-29

    The aim of this study was to assess the prevalence and severity of subjective daytime functioning impairment among people with insomnia complaints. Another goal was to establish its relationships with age, gender, type and duration of subjective insomnia. Study group consisted of NATPOL study participants - 2,413 people (1,245 women and 1,168 men) aged 18-79. We extracted group with declared insomnia complaints, consisting of 1,221 people (736 women and 485 men) aged 18-79. Data on insomnia symptoms characteristics, their duration and subjective functioning impairment were further analyzed. Functioning impairment was declared by 825 people (67.7% of those who declared subjective insomnia) and it was more common in women. It was most common among people with insomnia complaints lasting over two weeks - 72.4%. In people with symptoms lasting less than two weeks or for a few days it was 70.7% and 64.9% respectively. People with insomnia symptoms lasting over two weeks accounted for 20% of group with severe functioning impairment. For shorter duration of symptoms it was 8.6% and 6.9% respectively. Among people with mild functioning impairment, persons with symptoms lasting for a few days and less than two weeks were predominant - 32.5% and 35.3% respectively. In people aged 18-24 years mild functioning impairment was predominant (66.66%). Subjective daytime functioning impairment is common in people declaring insomnia symptoms. It is more common in women and its prevalence and intensity are greater in people with longer duration of sleep problems. Its prevalence is not correlated with age and it is the mildest in people aged 18-24.

  7. Sleep Reactivity and Insomnia: Genetic and Environmental Influences

    Science.gov (United States)

    Drake, Christopher L.; Friedman, Naomi P.; Wright, Kenneth P.; Roth, Thomas

    2011-01-01

    Study Objectives: Determine the genetic and environmental contributions to sleep reactivity and insomnia. Design: Population-based twin cohort. Participants: 1782 individual twins (988 monozygotic or MZ; 1,086 dizygotic or DZ), including 744 complete twin pairs (377 MZ and 367 DZ). Mean age was 22.5 ± 2.8 years; gender distribution was 59% women. Measurements: Sleep reactivity was measured using the Ford Insomnia Response to Stress Test (FIRST). The criterion for insomnia was having difficulty falling asleep, staying asleep, or nonrefreshing sleep “usually or always” for ≥ 1 month, with at least “somewhat” interference with daily functioning. Results: The prevalence of insomnia was 21%. Heritability estimates for sleep reactivity were 29% for females and 43% for males. The environmental variance for sleep reactivity was greater for females and entirely due to nonshared effects. Insomnia was 43% to 55% heritable for males and females, respectively; the sex difference was not significant. The genetic variances in insomnia and FIRST scores were correlated (r = 0.54 in females, r = 0.64 in males), as were the environmental variances (r = 0.32 in females, r = 0.37 in males). In terms of individual insomnia symptoms, difficulty staying asleep (25% to 35%) and nonrefreshing sleep (34% to 35%) showed relatively more genetic influences than difficulty falling asleep (0%). Conclusions: Sleep reactivity to stress has a substantial genetic component, as well as an environmental component. The finding that FIRST scores and insomnia symptoms share genetic influences is consistent with the hypothesis that sleep reactivity may be a genetic vulnerability for developing insomnia. Citation: Drake CL; Friedman NP; Wright KP; Roth T. Sleep reactivity and insomnia: genetic and environmental influences. SLEEP 2011;34(9):1179-1188. PMID:21886355

  8. Insomnia of childhood.

    Science.gov (United States)

    Lipton, Jonathan; Becker, Ronald E; Kothare, Sanjeev V

    2008-12-01

    Insomnia is a major public health problem and is the most common sleep disturbance in both adults and children. The causes of sleeplessness are age-dependent and have potentially enormous effects on cognitive development, behavior, family dynamics, and the metabolic health of children. Here we review the epidemiology, cause, pathophysiology, and clinical approach to pediatric insomnia. Normal sleep is crucial for brain function, behavior, and normal metabolism. Consistently, sleep loss has been linked to behavioral and attention problems, impaired learning and memory, obesity, and psychiatric disorders. The neurological mechanisms that govern sleep initiation and maintenance are poorly understood. The types of insomnia are age-dependent and can occur as primary disorders, or in the context of another primary sleep disorder such as restless legs syndrome, or secondary to another underlying medical condition. Children with chronic diseases and especially children with neurodevelopmental disorders are at particular risk of insomnia. Pediatric insomnia is common and is a source of potential psychophysiological stress to both children and their caregivers. The causes of insomnia are various. Pediatricians should have a working knowledge of the causes of sleeplessness in order to promptly curtail the chronic effects of sleep loss and effectively screen for underlying, potentially treatable disorders.

  9. The influence of PTSD, sleep fears, and neighborhood stress on insomnia and short sleep duration in urban, young adult, African Americans.

    Science.gov (United States)

    Hall Brown, Tyish; Mellman, Thomas A

    2014-01-01

    African Americans residing in stressful urban environments have high rates of insomnia and short sleep duration, both of which are associated with adverse health outcomes. However, limited data exist that explore factors influencing inadequate sleep in this high-risk population. This study sought to evaluate the contributions of demographics, trauma, posttraumatic stress disorder (PTSD) symptoms, sleep fears, and neighborhood stress to both insomnia and short sleep in urban African American young adults. Data were analyzed from self-report measures completed by 378 participants 18-35 years of age. PTSD symptom severity and sleep fears were independently associated with insomnia severity, and sleep fears was associated with sleep duration. Results have implications for preventative health intervention strategies for urban African American young adults.

  10. Insomnia and the Performance of US Workers: Results from the America Insomnia Survey

    Science.gov (United States)

    Kessler, Ronald C.; Berglund, Patricia A.; Coulouvrat, Catherine; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C.; Stephenson, Judith J.; Walsh, James K.

    2011-01-01

    Study Objectives: To estimate the prevalence and associations of broadly defined (i.e., meeting full ICD-10, DSM-IV, or RDC/ICSD-2 inclusion criteria) insomnia with work performance net of comorbid conditions in the America Insomnia Survey (AIS). Design/Setting: Cross-sectional telephone survey. Participants: National sample of 7,428 employed health plan subscribers (ages 18+). Interventions: None. Measurements and Results: Broadly defined insomnia was assessed with the Brief Insomnia Questionnaire (BIQ). Work absenteeism and presenteeism (low on-the-job work performance defined in the metric of lost workday equivalents) were assessed with the WHO Health and Work Performance Questionnaire (HPQ). Regression analysis examined associations between insomnia and HPQ scores controlling 26 comorbid conditions based on self-report and medical/pharmacy claims records. The estimated prevalence of insomnia was 23.2%. Insomnia was significantly associated with lost work performance due to presenteeism (χ21 = 39.5, P absenteeism (χ21 = 3.2, P = 0.07), with an annualized individual-level association of insomnia with presenteeism equivalent to 11.3 days of lost work performance. This estimate decreased to 7.8 days when controls were introduced for comorbid conditions. The individual-level human capital value of this net estimate was $2,280. If we provisionally assume these estimates generalize to the total US workforce, they are equivalent to annualized population-level estimates of 252.7 days and $63.2 billion. Conclusions: Insomnia is associated with substantial workplace costs. Although experimental studies suggest some of these costs could be recovered with insomnia disease management programs, effectiveness trials are needed to obtain precise estimates of return-on-investment of such interventions from the employer perspective. Citation: Kessler RC; Berglund PA; Coulouvrat C; Hajak G; Roth T; Shahly V; Shillington AC; Stephenson JJ; Walsh JK. Insomnia and the performance

  11. Insomnia and limb pain in hemodialysis patients: What is the share of restless leg syndrome?

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2012-01-01

    Full Text Available Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, serum phosphorous, ionized calcium, iron and ferritin levels. These variables between patients with insomnia and those with normal sleep were evaluated by independent "t" test. Without considering the etiology or pathogenesis of insomnia, we evaluated the occurrence of insomnia and limb pain in these patients, and specifically, restless leg syndrome. Insomnia and limb pain were common in dialytic patients. 46% of patients had insomnia. 91% of sleepless group had limb pain as a persistent, annoying complaint. Limb pain was not seen in groups with a normal sleep pattern. Restless leg syndrome was found in 8% of total cases (2 out of 26 and 17% among the insomnia group (2 out of 12. In spite of high incidence of insomnia among patients undergoing regular hemodialysis, role of RLS is trivial. There is a strong relationship between hemoglobin levels and duration of renal replacement therapy to insomnia occurrence.

  12. Insomnia and limb pain in hemodialysis patients: what is the share of restless leg syndrome?

    Science.gov (United States)

    Malaki, Majid; Mortazavi, Fakhr Sadat; Moazemi, Sussan; Shoaran, Maryam

    2012-01-01

    Insomnia and limb pain are common problems in dialysis patients. In addition, restless leg syndrome (RLS) as a specific cause of insomnia and limb pain has been reported in many studies. The purpose of this study was to estimate incidence of insomnia and RLS as a cause of insomnia in these patients. Twenty-six patients undergoing hemodialysis were investigated for insomnia, limb pain and RLS as per the defined criteria. They were evaluated for dialysis quality, dialysis duration, hemoglobin, serum phosphorous, ionized calcium, iron and ferritin levels. These variables between patients with insomnia and those with normal sleep were evaluated by independent "t" test. Without considering the etiology or pathogenesis of insomnia, we evaluated the occurrence of insomnia and limb pain in these patients, and specifically, restless leg syndrome. Insomnia and limb pain were common in dialytic patients. 46% of patients had insomnia. 91% of sleepless group had limb pain as a persistent, annoying complaint. Limb pain was not seen in groups with a normal sleep pattern. Restless leg syndrome was found in 8% of total cases (2 out of 26) and 17% among the insomnia group (2 out of 12). In spite of high incidence of insomnia among patients undergoing regular hemodialysis, role of RLS is trivial. There is a strong relationship between hemoglobin levels and duration of renal replacement therapy to insomnia occurrence.

  13. Phenotypes of sleeplessness: stressing the need for psychodiagnostics in the assessment of insomnia.

    Science.gov (United States)

    van de Laar, Merijn; Leufkens, Tim; Bakker, Bart; Pevernagie, Dirk; Overeem, Sebastiaan

    2017-09-01

    Insomnia is a too general term for various subtypes that might have different etiologies and therefore require different types of treatment. In this explorative study we used cluster analysis to distinguish different phenotypes in 218 patients with insomnia, taking into account several factors including sleep variables and characteristics related to personality and psychiatric comorbidity. Three clusters emerged from the analysis. The 'moderate insomnia with low psychopathology'-cluster was characterized by relatively normal personality traits, as well as normal levels of anxiety and depressive symptoms in the presence of moderate insomnia severity. The 'severe insomnia with moderate psychopathology'-cluster showed relatively high scores on the Insomnia Severity Index and scores on the sleep log that were indicative for severe insomnia. Anxiety and depressive symptoms were slightly above the cut-off and they were characterized by below average self-sufficiency and less goal-directed behavior. The 'early onset insomnia with high psychopathology'-cluster showed a much younger age and earlier insomnia onset than the other two groups. Anxiety and depressive symptoms were well above the cut-off score and the group consisted of a higher percentage of subjects with comorbid psychiatric disorders. This cluster showed a 'typical psychiatric' personality profile. Our findings stress the need for psychodiagnostic procedures next to a sleep-related diagnostic approach, especially in the younger insomnia patients. Specific treatment suggestions are given based on the three phenotypes.

  14. On insomnia analysis using methods of artificial intelligence

    Science.gov (United States)

    Wasiewicz, P.; Skalski, M.

    2011-10-01

    Insomnia generally is defined as a subjective report of difficulty falling sleep, difficulty staying asleep, early awakening, or nonrestorative sleep. It is one of the most common health complaints among the general population. in this paper we try to find relationships between different insomnia cases and predisposing, precipitating, and perpetuating factors following by pharmacological treatment.

  15. Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial.

    Science.gov (United States)

    Talbot, Lisa S; Maguen, Shira; Metzler, Thomas J; Schmitz, Martha; McCaslin, Shannon E; Richards, Anne; Perlis, Michael L; Posner, Donn A; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C

    2014-02-01

    Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. RANDOMIZED CONTROLLED TRIAL WITH TWO ARMS: CBT-I and monitor-only waitlist control. Department of Veterans Affairs (VA) Medical Center. Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress disorder should include behavioral sleep medicine. TRIAL NAME: Cognitive Behavioral Treatment Of Insomnia

  16. Clinical Update on Epidemiology, Pathogenesis, and Nonpharmacological Treatment of Insomnia

    Directory of Open Access Journals (Sweden)

    Mustafa Kahriman

    2006-04-01

    Full Text Available Scientific background: Insomnia is by far the most common form of sleep disturbance. Most typically, insomnia has been defined as the symptom of difficulty initiating or maintaining sleep and more rarely as an inability to obtain restorative sleep. Insomnia disorders are most often classified as either primary or secondary to other sleep, psychiatric, or medical conditions, although it is often difficult in practice to determine true causality of insomnia or there may be more than one cause (comorbid conditions. Increasing age, female sex, and psychiatric and medical disorders are consistent risk factors for insomnia. Insomnia is associated with significant social, medical, and financial consequences including impaired social functioning and quality of life, increased risk for psychiatric disorders, and increased health care costs. The clinical assessment of insomnia is based on a careful clinical interview, often supplemented by sleep questionnaires, sleep logs, and psychological testing. Polysomnography is indicated only in selected cases when specific sleep pathologies are suspected. Assessment: A large proportion of insomnia sufferers go undiagnosed, and therefore untreated, by their doctors, and many of these patients incur considerable personal, vocational, and health-related consequences as a result. Insomnia can be triggered by a variety of precipitating events, but when it becomes a chronic problem, psychological and behavioral factors are almost always involved in perpetuating or exacerbating sleep disturbances over time. Psychological and behavioral therapies for primary insomnia include sleep restriction, stimulus control therapy, relaxation training, cognitive strategies, and a combination of those methods, referred to as cognitive behavior therapy of insomnia. Results of the controlled clinical trials indicate that 70% to 80% of patients with primary insomnia partially benefit from cognitive behavior therapy. Although only 20% to

  17. Severity of self-reported diseases and symptoms in Denmark

    DEFF Research Database (Denmark)

    Iburg, Kim Moesgaard; Rasmussen, Niels Kristian; Avlund, Kirsten

    2006-01-01

    , more frequently than males, reported on all symptoms and all disease groups except injuries. People with relatively low levels of education reported most diseases, especially musculoskeletal and cardiovascular diseases, more frequently than people with higher education. Age-adjusted mean SF-36 scores...... for all dimensions combined showed that the symptoms of melancholy/depression and breathing difficulties, psychiatric disorders and respiratory diseases scored lowest (i.e. were most often associated with worse health). Females had lower SF-36 combined scores (worse health) than males on all symptoms. We......OBJECTIVE: To estimate and rank the relative severity of self-reported diseases and symptoms in Denmark. METHOD: The 1994 Danish Health and Morbidity Survey collected data from 5,472 Danes older than 16 years of age. Interviews (response frequency: 79%) gave information on diseases and symptoms...

  18. A Cross-Cultural Comparison of Symptom Reporting and Symptom Clusters in Heart Failure.

    Science.gov (United States)

    Park, Jumin; Johantgen, Mary E

    2017-07-01

    An understanding of symptoms in heart failure (HF) among different cultural groups has become increasingly important. The purpose of this study was to compare symptom reporting and symptom clusters in HF patients between a Western (the United States) and an Eastern Asian sample (China and Taiwan). A secondary analysis of a cross-sectional observational study was conducted. The data were obtained from a matched HF patient sample from the United States and China/Taiwan ( N = 240 in each). Eight selective items related to HF symptoms from the Minnesota Living with Heart Failure Questionnaire were analyzed. Compared with the U.S. sample, HF patients from China/Taiwan reported a lower level of symptom distress. Analysis of two different regional groups did not result in the same number of clusters using latent class approach: the United States (four classes) and China/Taiwan (three classes). The study demonstrated that symptom reporting and identification of symptom clusters might be influenced by cultural factors.

  19. Prevalence and Polysomnographic Correlates of Insomnia Comorbid with Medical Disorders

    Science.gov (United States)

    Budhiraja, Rohit; Roth, Thomas; Hudgel, David W.; Budhiraja, Pooja; Drake, Christopher L.

    2011-01-01

    Study Objectives: To determine the prevalence and polysomnographic correlates of insomnia in subjects with self-reported medical disorders. Design: Prospective cross-sectional study. Participants: Community-based sample of 3282 men and women aged 18 to 65 years old, with a subset who underwent polysomnography. Measurements: Self-reported measures of sleep habits and current health, and polysomnographic sleep variables. Results: The prevalence of insomnia was 21.4%. The adjusted odds of insomnia were 2.2 times as high in persons with any medical disorders as in those without medical disorders. Specifically, odds of insomnia were higher in people with heart disease (OR = 1.6 [95% CI: 1.2-23], P = 0.004), hypertension (1.5 [12-18], P insomnia increased with increasing number of medical disorders. However, polysomnographic sleep was not significantly different in persons with or without medical disorders for most disorders assessed. Conclusion: This large population-based study suggests that insomnia is highly prevalent in diverse chronic medical disorders. However, polysomnographic evidence of disturbed sleep is present in only a subset of comorbid insomnia populations. Citation: Budhiraja R; Roth T; Hudgel DW; Budhiraja P; Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. SLEEP 2011;34(7):859-867. PMID:21731135

  20. Insomnia and Well-Being

    Science.gov (United States)

    Hamilton, Nancy A.; Gallagher, Matthew W.; Preacher, Kristopher J.; Stevens, Natalie; Nelson, Christy A.; Karlson, Cynthia; McCurdy, Danyale

    2007-01-01

    Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological…

  1. Attention deficit hyperactivity disorder symptom self-report among ...

    African Journals Online (AJOL)

    Attention deficit hyperactivity disorder symptom self-report among medical students in Eldoret, Kenya. ... checklist to approximate a Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) ADHD diagnosis ...

  2. Attention deficit hyperactivity disorder symptom self-report among ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of self-reported attention deficit hyperactivity disorder (ADHD) symptoms among medical students in Eldoret ... divided into two parts. ... representatives prior to the start of whole-class activities and.

  3. Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory.

    Science.gov (United States)

    Fagundes, Christopher P; Shi, Qiuling; Vaporciyan, Ara A; Rice, David C; Popat, Keyuri U; Cleeland, Charles S; Wang, Xin Shelley

    2015-09-01

    Measuring patient-reported outcomes (PROs) has become increasingly important for assessing quality of care and guiding patient management. However, PROs have yet to be integrated with traditional clinical outcomes (such as length of hospital stay), to evaluate perioperative care. This study aimed to use longitudinal PRO assessments to define the postoperative symptom recovery trajectory in patients undergoing thoracic surgery for lung cancer. Newly diagnosed patients (N = 60) with stage I or II non-small cell lung cancer who underwent either standard open thoracotomy or video-assisted thoracoscopic surgery lobectomy reported multiple symptoms from before surgery to 3 months after surgery, using the MD Anderson Symptom Inventory. We conducted Kaplan-Meier analyses to determine when symptoms returned to presurgical levels and to mild-severity levels during recovery. The most-severe postoperative symptoms were fatigue, pain, shortness of breath, disturbed sleep, and drowsiness. The median time to return to mild symptom severity for these 5 symptoms was shorter than the time to return to baseline severity, with fatigue taking longer. Recovery from pain occurred more quickly for patients who underwent lobectomy versus thoracotomy (8 vs 18 days, respectively; P = .022). Patients who had poor preoperative performance status or comorbidities reported higher postoperative pain (all P < .05). Assessing symptoms from the patient's perspective throughout the postoperative recovery period is an effective strategy for evaluating perioperative care. This study demonstrates that the MD Anderson Symptom Inventory is a sensitive tool for detecting symptomatic recovery, with an expected relationship among surgery type, preoperative performance status, and comorbid conditions. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  4. Quality and readability of online information resources on insomnia

    Institute of Scientific and Technical Information of China (English)

    Yan Ma; Albert C.Yang; Ying Duan; Ming Dong; Albert S.Yeung

    2017-01-01

    The internet is a major source for health information.An increasing number of people,including patients with insomnia,search for remedies online;however,little is known about the quality of such information.This study aimed to evaluate the quality and readability of insomnia-related online information.Google was used as the search engine,and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability.The analyzed websites belonged to nonprofit,commercial,or academic organizations and institutions such as hospitais and universities.Insomnia-related websites typically included definitions (85%),causes and risk factors (100%),symptoms (95%),and treatment options (90%).Cognitive behavioral therapy for insomnia (CBT-Ⅰ) was the most commonly recommended approach for insomnia treatment,and sleep drugs are frequently mentioned.The overall quality of the websites on insomnia is moderate,but all the content exceeded the recommended reading ease levels.Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata,such as authorship,time of creation and last update,and conflicts of interest;providing evidence for reliability;and increasing the readability for a layman audience.

  5. Cognitive behaviour therapy for older adults experiencing insomnia and depression in a community mental health setting: Study protocol for a randomised controlled trial.

    Science.gov (United States)

    Sadler, Paul; McLaren, Suzanne; Klein, Britt; Jenkins, Megan; Harvey, Jack

    2015-11-27

    Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG

  6. Static magnetotherapy for the treatment of insomnia.

    Science.gov (United States)

    Shieh, Yao Y; Tsai, Fong Y

    2008-01-01

    Magnets have been used for centuries to treat a number of physical disorders. The vast majority of research, however, on static magnet therapy for insomnia has been confined to the auricular type of therapy, with publications limited to Chinese journals. Most of these studies have depended on the subjective self-assessment of participants rather than objective scientific measurements. In this study, the authors report the positive preliminary results of insomnia treatment using pillows with embedded magnets, magnetic insoles and TriPhase bracelets. The analysis is based on objective actigraphic and polysomnographic data. A theory of accelerated transition from wakefulness to sleep is proposed to explain the process of insomnia relief through low-strength static magnetic fields. Analysis by functional Magnetic Resonance Imaging (fMRI) is used to further investigate the theory.

  7. [Insomnia. A severe health care problem].

    Science.gov (United States)

    Sánchez-Cárdenas, Ana Gabriela; Navarro-Gerrard, Christian; Nellen-Hummel, Haiko; Halabe-Cherem, José

    2016-01-01

    The magnitude which sleep has on personal well-being is similar to the effects of diet and exercise. Sleep deprivation has severe negative effects on an individual's overall health, and this is usually overseen. From 30 to 40 % of the population has presented insomnia at a certain moment of life and from 9 to 15 % have evolved into a chronic and severe insomnia. Recent investigations have related sleep deprivation with obesity, metabolic disorders, heart disease, mental health problems and dementia. Recently, more investigations have focused on the multiple alterations suffered by the immune system in cases of sleep deprivation. In order to make an opportune diagnosis of insomnia, it is vital to obtain a detailed history of the patients' sleep habits. In the physical exam one must search for signs and symptoms which might suggest an organic cause that generates the patient's insomnia. One of the pillars in treatment of these patients consists in acquiring an adequate sleep hygiene based on the optimization of the environment and the behavior that are associated with sleep.

  8. Relationships between temperaments, occupational stress, and insomnia among Japanese workers.

    Directory of Open Access Journals (Sweden)

    Yasuhiko Deguchi

    Full Text Available Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A. Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ. Insomnia was assessed using the Athens Insomnia Scale (AIS. Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32 and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49 was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.

  9. Insomnia in chronic renal patients on dialysis in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Hejaili Fayez F

    2010-06-01

    Full Text Available Abstract Background Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD. This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis. Methods This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data. Results Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 ± 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (P-values: 0.05, 0.01, Conclusion Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.

  10. Relationships between temperaments, occupational stress, and insomnia among Japanese workers.

    Science.gov (United States)

    Deguchi, Yasuhiko; Iwasaki, Shinichi; Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Mitake, Tomoe; Nogi, Yukako; Inoue, Koki

    2017-01-01

    Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Insomnia was assessed using the Athens Insomnia Scale (AIS). Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32) and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49) was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.

  11. Treating Acute Insomnia: A Randomized Controlled Trial of a “Single-Shot” of Cognitive Behavioral Therapy for Insomnia

    Science.gov (United States)

    Ellis, Jason G.; Cushing, Toby; Germain, Anne

    2015-01-01

    Study Objectives: Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia. Design: A pragmatic parallel group randomized controlled trial. Setting: Community. Participants: Forty adults (mean age 32.9 ± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep. Interventions: A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects were offered a full individual course of CBT-I on completion of the study, regardless of group allocation. Measurements and Results: Subjects completed sleep diaries and the Insomnia Severity Index (ISI) pretreatment and 1 mo following treatment. There were no between-group differences on baseline ISI scores or subjective sleep continuity. The intervention group reported significantly lower ISI scores than controls (t(38) 2.24, P insomnia caseness (i.e., ≥ 10), 60% of those in the CBT-I group had remitted by 1 mo compared to 15% of those in the control group. Conclusions: This single session of cognitive behavioral therapy for insomnia (CBT-I) is sufficiently efficacious for a significant proportion of those with acute insomnia. The results are discussed in terms of integrating this brief form of CBT-I into the “stepped care” model of insomnia. Trial Registration: Testing the efficacy of an early intervention for acute insomnia (SRCTN05891695) http://www.controlled-trials.com/ISRCTN05891695. Citation: Ellis JG, Cushing T, Germain A. Treating acute insomnia: a randomized

  12. Case report

    African Journals Online (AJOL)

    abp

    2017-06-13

    Jun 13, 2017 ... Oxyuriasis's symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis. Here we report a curious case of oxyuriasis in the settings of a refugee camp in Greece. The patient was a. 10-year old Syrian ...

  13. Does comorbid obstructive sleep apnea impair the effectiveness of cognitive and behavioral therapy for insomnia?

    Science.gov (United States)

    Sweetman, Alexander; Lack, Leon; Lambert, Sky; Gradisar, Michael; Harris, Jodie

    2017-11-01

    Comorbid insomnia and obstructive sleep apnea (OSA) represents a highly prevalent and debilitating condition; however, physicians and researchers are still uncertain about the most effective treatment approach. Several research groups have suggested that these patients should initially receive treatment for their insomnia before the sleep apnea is targeted. The current study aims to determine whether Cognitive and Behavioral Therapy for Insomnia (CBT-i) can effectively treat insomnia in patients with comorbid OSA and whether its effectiveness is impaired by the presence of OSA. A retrospective chart review was conducted to examine 455 insomnia patients entering a CBT-i treatment program in a hospital out-patient setting. Three hundred and fourteen patients were diagnosed with insomnia alone and 141 with insomnia and comorbid OSA. Improvements in average sleep diary parameters, global insomnia severity, and several daytime functioning questionnaires from baseline, to post-treatment, to 3-month follow-up were compared between insomnia patients with and without comorbid OSA. Insomnia patients with comorbid OSA experienced significant improvements in insomnia symptoms, global insomnia severity, and other daytime functioning measures during and following treatment. Furthermore, improvements were no different between patients with or without comorbid OSA. Sleep apnea presence and severity were not related to rates of insomnia-remission or treatment-resistance following treatment. CBT-i is an effective treatment in the presence of comorbid OSA. This information offers support for the suggestion that patients with comorbid insomnia and OSA should be treated with CBT-i prior to the treatment of the OSA. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature.

    Science.gov (United States)

    Wynchank, Dora; Bijlenga, Denise; Beekman, Aartjan T; Kooij, J J Sandra; Penninx, Brenda W

    2017-10-30

    Insomnia is diagnosed when there is dissatisfaction with sleep quantity or quality. It has a prevalence in the general population ranging from 31 to 56%. Insomnia has previously been associated with adult attention-deficit/hyperactivity disorder (ADHD). In this review, we address three topics: (1) the cross-sectional relationship between ADHD and insomnia in adulthood, (2) the longitudinal relationship between ADHD and insomnia, and (3) insomnia as a side effect of pharmacological treatments for adult ADHD. Three cross-sectional, clinical, and population studies report a prevalence of insomnia in ADHD adults ranging from 43 to 80%. Longitudinal evidence for a link between childhood-onset ADHD and insomnia at later age is mixed, with one study confirming and another study not supporting such a longitudinal association. In randomized, placebo-controlled trials, insomnia is reported significantly more often in the treatment arm than in the placebo arm. In varying percentages of trial participants, insomnia is a treatment-emergent adverse effect in triple-bead mixed amphetamine salts (40-45%), dasotraline (35-45%), lisdexamfetamine (10-19%), and extended-release methylphenidate (11%). Ten to seventeen percent of subjects in placebo-controlled trials of atomoxetine report insomnia, possibly related to poor metabolizer status. The mechanisms explaining the relationship between ADHD and sleep problems are incompletely understood, but both genetic and non-shared environmental influences may be involved. Adults with ADHD should be assessed for insomnia, which is frequently comorbid, and both conditions should be treated.

  15. Differential sleep, sleepiness, and neurophysiology in the insomnia phenotypes of shift work disorder.

    Science.gov (United States)

    Gumenyuk, Valentina; Belcher, Ren; Drake, Christopher L; Roth, Thomas

    2015-01-01

    To characterize and compare insomnia symptoms within two common phenotypes of Shift Work Disorder. Observational laboratory and field study. Hospital sleep center. 34 permanent night workers. Subjects were classified by Epworth Sleepiness Scale and Insomnia Severity Index into 3 subgroups: asymptomatic controls, alert insomniacs (AI), and sleepy insomniacs (SI). Sleep parameters were assessed by sleep diary. Circadian phase was evaluated by dim-light salivary melatonin onset (DLMO). Objective sleepiness was measured using the multiple sleep latency test (MSLT). Brain activity was measured using the N1 event-related potential (ERP). A tandem repeat in PER3 was genotyped from saliva DNA. (1) AI group showed normal MSLT scores but elevated N1 amplitudes indicating cortical hyperarousal. (2) SI group showed pathologically low MSLT scores but normal N1 amplitudes. (3) AI and SI groups were not significantly different from one another in circadian phase, while controls were significantly phase-delayed relative to both SWD groups. (4) AI showed significantly longer sleep latencies and lower sleep efficiency than controls during both nocturnal and diurnal sleep. SI significantly differed from controls in nocturnal sleep parameters, but differences during diurnal sleep periods were smaller and not statistically significant. (5) Genotype × phenotype χ² analysis showed significant differences in the PER3 VNTR: 9 of 10 shift workers reporting sleepiness in a post hoc genetic substudy were found to carry the long tandem repeat on PER3, while 4 of 14 shift workers without excessive sleepiness carried the long allele. Our results suggest that the sleepy insomnia phenotype is comprehensively explained by circadian misalignment, while the alert insomnia phenotype resembles an insomnia disorder precipitated by shift work. © 2014 Associated Professional Sleep Societies, LLC.

  16. COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA IN BREAST CANCER SURVIVORS: A REVIEW OF THE LITERATURE

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    Debora Aricò

    2016-08-01

    Full Text Available Background: Insomnia is a common sleep disorder in patients with breast cancer and studies show a higher frequency than in the general population but it appears to be understudied and the treatment seems to be a neglected problem. There is a growing body of evidence about the efficacy of cognitive behavioral therapy for insomnia (CBT-I in breast cancer survivors. The aim of this review is to examine the best available scientific evidence related to CBT-I and insomnia in patients with breast cancer and to assess the effect of CBT-I on their psychosocial functioning, sleep, quality of life, and mood. Methods: Empirical articles published in peer-reviewed journals from the earliest reports available until August 2015 were considered. The research on PubMed generated 18 papers, three of which did not meet the inclusion criteria. Another paper was retrieved by screening the reference list of the previously selected papers. Results: A total of 16 studies were found that evaluated the effects of CBT-I in breast cancer patients. CBT-I appears to be an effective therapy for insomnia in breast cancer survivors, improving mood, general and physical fatigue and global and cognitive dimensions of quality of life. CBT-I may also reduce menopausal symptoms, such as hot flushes and night sweat problems, frequency of medicated nights, level of depression, and anxiety. Conclusions: CBT-I seems to be an eligible intervention for improving sleep in breast cancer survivors. Improvements concerning insomnia and sleep quality are durable (usually up to 12 months and statistically significant.

  17. Harm avoidance and depression, anxiety, insomnia, and migraine in fifth-year medical students in Taiwan

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    Chen CY

    2018-05-01

    Full Text Available Ching-Yen Chen,1–3 Nan-Wen Yu,2–4 Tien-Hao Huang,4 Wei-Shin Wang,4 Ji-Tseng Fang2,3,5 1Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Medical Education Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 4Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; 5Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan Purpose: During medical school training, increased stress, depression, and anxiety are common. Certain personality traits, particularly harm avoidance (HA, may increase the risk of psychopathological disorders, insomnia, and migraine among medical students. This study evaluated the role HA may play on levels of stress, depression, anxiety, and insomnia among Taiwanese medical students starting their fifth and final year of medical school.Patients and methods: A series of self-report questionnaires were used to measure the severity of anxiety, depression, and insomnia, as well as somatic symptoms, particularly migraine headache, among 143 Taiwanese fifth-year medical students (94 males and 49 females. Most had normal or mild levels of anxiety, depression, insomnia, and migraine.Results: HA personality trait was significantly associated with depression (all P ≤ 0.001 after adjusting for other factors. HA was not significantly associated with anxiety, insomnia, or migraine headache days.Conclusion: HA personality trait was significantly associated with depression among fifth-year medical students in Taiwan. Keywords: anxiety, depression, harm avoidance, psychological stress, sleep initiation and maintenance disorders, migraine, students, medical

  18. Insomnia in central neurologic diseases--occurrence and management

    DEFF Research Database (Denmark)

    Mayer, Geert; Jennum, Poul; Riemann, Dieter

    2011-01-01

    The objective of this review is to highlight the impact of insomnia in central neurological disorders by providing information on its prevalence and give recommendations for diagnosis and treatment. Insomnia in neurological disorders is a frequent, but underestimated symptom. Its occurrence may...... be a direct consequence of the disease itself or may be secondary to pain, depression, other sleep disorders or the effects of medications. Insomnia can have a significant impact on the patient's cognitive and physical function and may be associated with psychological distress and depression. Diagnosis...... of insomnia is primarily based on medical history and validated questionnaires. Actigraphy is a helpful diagnostic tool for assessing the circadian sleep-wake rhythm. For differential diagnosis and to measure the duration of sleep full polysomnography may be recommended. Prior to initiating treatment...

  19. Insomnia, platelet serotonin and platelet monoamine oxidase in chronic alcoholism.

    Science.gov (United States)

    Nenadic Sviglin, Korona; Nedic, Gordana; Nikolac, Matea; Mustapic, Maja; Muck-Seler, Dorotea; Borovecki, Fran; Pivac, Nela

    2011-08-18

    Insomnia is a common sleep disorder frequently occurring in chronic alcoholic patients. Neurobiological basis of insomnia, as well as of alcoholism, is associated with disrupted functions of the main neurotransmitter systems, including the serotonin (5-hydroxytryptamine, 5-HT) system. Blood platelets are considered a limited peripheral model for the central 5-HT neurons, since both platelets and central 5-HT synaptosomes have similar dynamics of 5-HT. Platelet 5-HT concentration and platelet monoamine oxidase type B (MAO-B) are assumed to represent biomarkers for particular symptoms and behaviors in psychiatric disorders. The hypothesis of this study was that platelet 5-HT concentration and platelet MAO-B activity will be altered in chronic alcoholic patients with insomnia compared to comparable values in patients without insomnia. The study included 498 subjects: 395 male and 103 female medication-free patients with alcohol dependence and 502 healthy control subjects: 325 men and 177 women. The effects of early, middle and late insomnia (evaluated using the Hamilton Depression Rating Scale), as well as sex, age and smoking on platelet 5-HT concentration and platelet MAO-B activity were evaluated using one-way ANOVA and multiple regression analysis by the stepwise method. Platelet 5-HT concentration, but not platelet MAO-B activity, was significantly reduced in alcoholic patients with insomnia compared to patients without insomnia. Multiple regression analysis revealed that platelet 5-HT concentration was affected by middle insomnia, smoking and sex, while platelet MAO activity was affected only by sex and age. The present and previous data suggest that platelet 5-HT concentration might be used, after controlling for sex and smoking, as a biomarker for insomnia in alcoholism, PTSD and in rotating shift workers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Implosive Therapy as a Treatment for Insomnia.

    Science.gov (United States)

    Carrera, Richard N.; Elenewski, Jeffrey J.

    1980-01-01

    The death implosion produced a decrease in insomnia beyond the strong expectancy effects that resulted from all experimental treatments. The failure to observe changes in reported fear of death was attributed to subjects' anxiety-based reluctance to acknowledge openly such fear. (Author)

  1. Changes in insomnia subtypes in early Parkinson disease.

    Science.gov (United States)

    Tholfsen, Lena K; Larsen, Jan P; Schulz, Jörn; Tysnes, Ole-Bjørn; Gjerstad, Michaela D

    2017-01-24

    To examine the development of factors associated with insomnia in a cohort of originally drug-naive patients with incident Parkinson disease (PD) during the first 5 years after diagnosis. One hundred eighty-two drug-naive patients with PD derived from a population-based incident cohort and 202 control participants were assessed for insomnia before treatment initiation and were repeatedly examined after 1, 3, and 5 years. Insomnia was diagnosed according to the Stavanger Sleepiness Questionnaire. The Parkinson's Disease Sleep Scale was used to differentiate sleep initiation problems from problems of sleep maintenance. Generalized estimating equation models were applied for statistical measures. The prevalence of insomnia in general was not higher in patients with PD compared to controls at the 5-year follow-up. There were changes in the prevalence of the different insomnia subtypes over the 5-year follow-up. The prevalence of solitary problems in sleep maintenance increased from 31% (n = 18) in the drug-naive patients at baseline to 49% (n = 29) after 1 year and were associated with the use of dopamine agonists and higher Montgomery-Åsberg Depression Rating Scale scores. The prevalence of solitary sleep initiation problems decreased continuously from 21% (n = 12) at baseline to 7.4% (n = 4) after 5 years; these were associated with less daytime sleepiness. The prevalence rates of the different insomnia subtypes changed notably in patients with early PD. The frequency of sleep maintenance problems increased, and these problems were associated with dopamine agonist use and depressive symptoms, while the total number of patients with insomnia remained stable. Our findings reflect the need for early individual assessments of insomnia subtypes and raise the possibility of intervention to reduce these symptoms in patients with early PD. © 2016 American Academy of Neurology.

  2. Insomnia in central neurologic diseases--occurrence and management.

    Science.gov (United States)

    Mayer, Geert; Jennum, Poul; Riemann, Dieter; Dauvilliers, Yves

    2011-12-01

    The objective of this review is to highlight the impact of insomnia in central neurological disorders by providing information on its prevalence and give recommendations for diagnosis and treatment. Insomnia in neurological disorders is a frequent, but underestimated symptom. Its occurrence may be a direct consequence of the disease itself or may be secondary to pain, depression, other sleep disorders or the effects of medications. Insomnia can have a significant impact on the patient's cognitive and physical function and may be associated with psychological distress and depression. Diagnosis of insomnia is primarily based on medical history and validated questionnaires. Actigraphy is a helpful diagnostic tool for assessing the circadian sleep-wake rhythm. For differential diagnosis and to measure the duration of sleep full polysomnography may be recommended. Prior to initiating treatment the cause of insomnia must be clearly identified. First line treatment aims at the underlying neurologic disease. The few high quality treatment studies show that short term treatment with hypnotics may be recommended in most disorders after having ruled out high risk for adverse effects. Sedating antidepressants may be an effective treatment for insomnia in stroke and Parkinson's disease (PD) patients. Melatonin and light treatment can stabilize the sleep-wake circadian rhythm and shorten sleep latency in dementias and PD. Cognitive behavioral therapy (CBT) can be effective in treating insomnia symptoms associated with most of the central neurological diseases. The prevalence and treatment of insomnia in neurological diseases still need to be studied in larger patient groups with randomized clinical trials to a) better understand their impact and causal relationship and b) to develop and improve specific evidence-based treatment strategies. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Insomnia in hemodialysis patients: A multicenter study from morocco

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    Mohamed Amine Hamzi

    2017-01-01

    Full Text Available Previous studies have shown that insomnia is a common sleep disorder in patients with end-stage renal disease. This study aims to determine the prevalence and risk factors of insomnia in our chronic hemodialysis (HD patients. This is a cross-sectional study conducted in three HD units in Morocco. To assess the prevalence of insomnia, we used a specific questionnaire. Patients complaining of difficulty in falling asleep and/or nocturnal awakenings occurring seven nights a week during the last month were included in the group “insomnia;” the other patients were used as controls. Clinical, biological, and dialysis data were recorded for each patient. Sleep disorders and their subjective causes were also identified. Eighty-nine percent of questioned patients admitted to having sleep disturbances of different degrees. Insomnia was significantly associated with female gender and time of dialysis. Age, body mass index, inter-dialytic weight gain, and blood pressure were similar between the two groups, as well as dialytic parameters and drug use. There was no significant difference in the values of plasma creatinine, urea, hemoglobin, parathyroid hormone, calcium, phosphorus, C-reactive protein, and albumin between the groups. Disorders most frequently encountered in patients with insomnia were waking up at night (90%, difficulty falling asleep (60%, and daytime sleepiness (60%. The restless legs syndrome was seen in half of these patients. The main reported causes of insomnia were anxiety and/or depression (70% and bone pain (67%. Insomnia is common in HD patients and is frequently associated with other disorders of sleep. Female sex and duration on dialysis are the two risk factors found in our study. Insomnia does not appear related to any biochemical or dialysis parameters. Increased attention should be given to the management of dialysis patients regarding the diagnosis and management of insomnia and associated sleep disorders.

  4. Enhancing CBT for Chronic Insomnia: A Randomised Clinical Trial of Additive Components of Mindfulness or Cognitive Therapy.

    Science.gov (United States)

    Wong, Mei Yin; Ree, Melissa J; Lee, Christopher W

    2016-09-01

    Although cognitive behavioural therapy (CBT) for insomnia has resulted in significant reductions in symptoms, most patients are not classified as good sleepers after treatment. The present study investigated whether additional sessions of cognitive therapy (CT) or mindfulness-based therapy (MBT) could enhance CBT in 64 participants with primary insomnia. All participants were given four sessions of standard CBT as previous research had identified this number of sessions as an optimal balance between therapist guidance and patient independence. Participants were then allocated to further active treatment (four sessions of CT or MBT) or a no further treatment control. The additional treatments resulted in significant improvements beyond CBT on self-report and objective measures of sleep and were well tolerated as evidenced by no dropouts from either treatment. The effect sizes for each of these additional treatments were large and clinically significant. The mean scores on the primary outcome measure, the Insomnia Severity Index, were 5.74 for CT and 6.69 for MBT, which are within the good-sleeper range. Treatment effects were maintained at follow-up. There were no significant differences between CT and MBT on any outcome measure. These results provide encouraging data on how to enhance CBT for treatment of insomnia. Copyright © 2015 John Wiley & Sons, Ltd. CBT treatments for insomnia can be enhanced using recent developments in cognitive therapy. CBT treatments for insomnia can be enhanced using mindfulness-based treatments. Both cognitive therapy and mindfulness produce additional clinically significant change. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Self reported symptoms of anxiety associated with coffee ...

    African Journals Online (AJOL)

    This study examined the psychophysiological effects of coffee consumption on anxiety as reported by University students. . It was hypothesized that heavy caffeine users would report significantly higher anxiety and more psychophysical symptoms of caffenism more than non-users. A sample size of 447-university students ...

  6. The evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis.

    Science.gov (United States)

    Tomaszek, Lucyna; Cepuch, Grazyna; Pawlik, Lidia

    2018-03-21

    The purpose of the study was to assess the incidence of insomnia in adolescents and young adults with cystic fibrosis and its impact on the quality of life, and to examine whether demographic and clinical factors and negative emotional states are predictors of insomnia in these patients. The study was conducted among 95 cystic fibrosis patients aged 14-25 years. The study used a personal questionnaire survey, the Athens Insomnia Scale, the Cystic Fibrosis Quality of Life Questionnaire, the Hospital Anxiety and Depression Scale, and the Numeric Rating Scale. Insomnia was diagnosed in 38% of cystic fibrosis patients. In patients with insomnia, the level of anxiety (Me: 10 vs. 4; P=0.000) and depression (Me: 6.5 vs. 2; P=0.000) was significantly higher than in the good sleep quality group. The risk of insomnia increases as anxiety (OR: 4.31; 95% CI: 2.20 to 8.41) and depressive symptoms exacerbate (OR: 4.98; 95% CI: 1.84 to 13.43). Insomnia significantly worsens the quality of life in cystic fibrosis patients (ß =-0.5, P=0.000). Insomnia affects a large percentage of cystic fibrosis patients, and anxiety and depression are factors that increase the risk of insomnia. Insomnia decreases the quality of life in cystic fibrosis patients.

  7. Prolonged-release melatonin for insomnia – an open-label long-term study of efficacy, safety, and withdrawal

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    Lemoine P

    2011-07-01

    Full Text Available Patrick Lemoine1, Doron Garfinkel2, Moshe Laudon3, Tali Nir3, Nava Zisapel3,41The Clinique Lyon-Lumière, Meyzieu, France; 2Geriatric-Palliative Department, Shoham Geriatric Medical Center, Pardes Hanna, Israel; 3Neurim Pharmaceuticals Ltd, Tel-Aviv, Israel; 4Department of Neurobiology Faculty of Life Sciences, Tel Aviv University, Tel Aviv, IsraelBackground: Prolonged-release melatonin (PRM 2 mg is indicated for insomnia in patients aged 55 years and older. A recent double-blind placebo-controlled study demonstrated 6-month efficacy and safety of PRM in insomnia patients aged 18–80 and lack of withdrawal and rebound symptoms upon discontinuation.Objective: To investigate the efficacy, safety, and withdrawal phenomena associated with 6–12 months PRM treatment.Methods: Data from a prospective 6–12-month open-label study of 244 community dwelling adults with primary insomnia, who had participated in a placebo-controlled, double-blind dose-ranging trial of PRM. Patients received PRM nightly, followed by a 2-week withdrawal period. Main outcome measures were patient-reported sleep quality ratings (diary, adverse events, vital signs, and laboratory tests recorded at each visit, and withdrawal symptoms (CHESS-84 [Check-list Evaluation of Somatic Symptoms]. Nocturnal urinary 6-sulfatoxymelatonin excretion, a measure of the endogenous melatonin production, was assessed upon discontinuing long-term PRM.Results: Of the 244 patients, 36 dropped out, 112 completed 6 months of treatment, and the other 96 completed 12 months of treatment. The mean number of nights by which patients reported sleep quality as "good" or "very good" was significantly higher during PRM than before treatment. There was no evidence of tolerance to PRM. Discontinuation of PRM was not associated with rebound insomnia or withdrawal symptoms; on the contrary, residual benefit was observed. PRM was well tolerated, and there was no suppression of endogenous melatonin production

  8. Case Studies of Chronic Insomnia Patients Participating in Group Cognitive Behavioral Therapy for Insomnia

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    Mi Jin Yi

    2012-10-01

    Full Text Available Background and Objective Pharmacotherapy currently widely used in the treatment of insomnia can be helpful in transient insomnia, but research regarding its effectiveness and safety of long-term use is not enough. Therefore, to complement the limitations of pharmacotherapy in the treatment of patients with insomnia, non-pharmacologic treatment methods (cognitive behavioral therapy, CBT are used. But CBT for insomnia appear to be costly and time-consuming compared to pharmacotherapy, clinical practice in the field can be difficult to be applied. We took the format of group therapy rather than individual therapy to complement the disadvantages of CBT and now we would like to have a thought into its meaning by reporting the effectiveness of group CBT for insomnia. Methods Patients were recruited at Sleep Center of St. Vincent’s Hospital, 2 men and 3 women led to a group of five patients. CBT is a treatment for correction factors that cause and maintain insomnia, it includes a variety of techniques such as sleep hygiene education, stimulus control, sleep restriction, relaxation and cognitive therapy. A series of treatment were performed five sessions once a week with a frequency from February to March 2012 and were proceeded for about 1 hour and 30 minutes per session. Results Results indicated that the subjective quality of sleep and sleep efficiency of all patients improved and Pittsburgh Sleep Quality Index and Beck Depression Inventory were decreased in spite of reducing dose of medication. Conclusions Like these cases, we can contribute to reduce the time and economic burden by performing group CBT for insomnia rather than individual therapy.

  9. Insomnia in Iranian Traditional Medicine

    Science.gov (United States)

    Feyzabadi, Zohre; Jafari, Farhad; Feizabadi, Parvin Sadat; Ashayeri, Hassan; Esfahani, Mohammad Mahdi; Badiee Aval, Shapour

    2014-01-01

    Context: Insomnia is one of the most prevalent sleep disorders characterized by sleep difficulty that impairs daily functioning and reduces quality of life. The burden of medical, psychiatric, interpersonal, and societal consequences of insomnia expresses the importance of diagnosing and treatment of insomnia. The aim of study was to investigate causes of insomnia from the viewpoint of Iranian traditional medicine. Evidence Acquisition: In this review study, we searched insomnia in a few of the most famous ancient textbooks of Iranian traditional medicine from different centuries. This books includeThe Canon of Medicine by Avicenna (the first version of Beirut), Zakhire Kharazmshahi by Jurjani (the scanned version of Bonyade Farhang-e Iran), Malfaregh by Razes (the first version of Iran University of Medical Sciences), and Aqili’s cure by Aqili (the first version of Iran University of Medical Sciences). Results: This study found that in Iranian traditional medicine manuscripts, insomnia was called sahar and even though many factors induce insomnia, most of them act through causing brain dystemperament. Conclusions: The brain dystemperament is considered one of the main causes of insomnia and insomnia can be well managed with an organized line of treatment, by correcting the brain dystemperament through elimination of causes. This study helps to find new solutions to treat insomnia. PMID:24829786

  10. Are we sleeping on the job? Insomnia among men with prostate cancer

    Directory of Open Access Journals (Sweden)

    Frances Josephine Drummond

    2016-06-01

    Full Text Available Prostate cancer is one of the most commonly diagnosed cancers in men and almost half of male cancer survivors in the US have had a prostate cancer diagnosis. Insomnia is common among cancer patients and survivors. There is evidence that cognitive behavioural therapy can be used to effectively manage insomnia among women with breast cancer. The aim of this review was to investigate the prevalence, risk factors and management of insomnia among men with prostate cancer. The effect of insomnia on the psychological health and health-related quality of life of these patients and/or survivors is also discussed. Increased awareness and knowledge of this symptom among men with prostate cancer may facilitate improved diagnosis, and management of insomnia in this large population. This in turn may improve the health-related quality of life of these men. Therefore, research into the effective management of insomnia among men with prostate cancer is essential.

  11. Manifestations of Insomnia in Sleep Apnea: Implications for Screening and Treatment.

    Science.gov (United States)

    Bailes, Sally; Rizzo, Dorrie; Baltzan, Marc; Grad, Roland; Pavilanis, Alan; Creti, Laura; Fichten, Catherine S; Libman, Eva

    2016-01-01

    The aims of this study were to examine the presence, type, and severity of insomnia complaints in obstructive sleep apnea (OSA) patients and to assess the utility of the Sleep Symptom Checklist (SSC) for case identification in primary care. Participants were 88 OSA patients, 57 cognitive-behavioral therapy for insomnia (CBT-I) patients, and 14 healthy controls (Ctrl). Each completed a sleep questionnaire as well as the SSC, which includes insomnia, daytime functioning, psychological, and sleep disorder subscales. Results showed that OSA patients could be grouped according to 3 insomnia patterns: no insomnia (OSA), n = 21; insomnia (OSA-I), n = 30, with a subjective complaint and disrupted sleep; and noncomplaining poor sleepers (OSA-I-NC), n = 37. Comparisons among the OSA, CBT-I, and Ctrl groups demonstrate distinct profiles on the SSC subscales, indicating its potential utility for both case identification and treatment planning.

  12. Sleeping Pills for Insomnia: Which Ones Work Best?

    Science.gov (United States)

    ... Treatment Is Not A Drug Consumer Reports Best Buy Drugs compares the effectiveness and safety of the most ... isn’t a drug at all. CR Best Buy Drugs pick: For chronic insomnia, CR Best Buy Drugs ...

  13. Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia.

    Science.gov (United States)

    Drake, Christopher L; Pillai, Vivek; Roth, Thomas

    2014-08-01

    To prospectively assess sleep reactivity as a diathesis of insomnia, and to delineate the interaction between this diathesis and naturalistic stress in the development of insomnia among normal sleepers. Longitudinal. Community-based. 2,316 adults from the Evolution of Pathways to Insomnia Cohort (EPIC) with no history of insomnia or depression (46.8 ± 13.2 y; 60% female). None. Participants reported the number of stressful events they encountered at baseline (Time 1), as well as the level of cognitive intrusion they experienced in response to each stressor. Stressful events (OR = 1.13; P stress-induced cognitive intrusion (OR = 1.61; P stressful events on risk for insomnia (P sleep reactivity significantly increased risk for insomnia (OR = 1.78; P sleep reactivity moderated the effects of stress-induced intrusion (P sleep reactivity. Trait sleep reactivity also constituted a significant risk for depression (OR = 1.67; P sleep reactivity is a significant risk factor for incident insomnia, and that it triggers insomnia by exacerbating the effects of stress-induced intrusion. Sleep reactivity is also a precipitant of depression, as mediated by insomnia. These findings support the stress-diathesis model of insomnia, while highlighting sleep reactivity as an important diathesis. Drake CL, Pillai V, Roth T. Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia.

  14. Internet treatment addressing either insomnia or depression, for patients with both diagnoses: a randomized trial.

    Science.gov (United States)

    Blom, Kerstin; Jernelöv, Susanna; Kraepelien, Martin; Bergdahl, Malin Olséni; Jungmarker, Kristina; Ankartjärn, Linda; Lindefors, Nils; Kaldo, Viktor

    2015-02-01

    To compare treatment effects when patients with insomnia and depression receive treatment for either insomnia or depression. A 9-w randomized controlled trial with 6- and 12-mo follow-up. Internet Psychiatry Clinic, Stockholm, Sweden. Forty-three adults in whom comorbid insomnia and depression were diagnosed, recruited via media and assessed by psychiatrists. Guided Internet-delivered cognitive behavior therapy (ICBT) for either insomnia or depression. Primary outcome measures were symptom self-rating scales (Insomnia Severity Index [ISI] and the Montgomery Åsberg Depression Rating Scale [MADRS-S]), assessed before and after treatment with follow-up after 6 and 12 mo. The participants' use of sleep medication and need for further treatment after completion of ICBT was also investigated. The insomnia treatment was more effective than the depression treatment in reducing insomnia severity during treatment (P = 0.05), and equally effective in reducing depression severity. Group differences in insomnia severity were maintained during the 12-mo follow-up period. Post treatment, participants receiving treatment for insomnia had significantly less self-rated need for further insomnia treatment (P treatment for depression. The need for depression treatment was similar in both groups. In this study, Internet-delivered treatment with cognitive behavior therapy (ICBT) for insomnia was more effective than ICBT for depression for patients with both diagnoses. This indicates, in line with previous research, that insomnia when comorbid with depression is not merely a symptom of depression, but needs specific treatment. The trial was registered at Clinicaltrials.gov, registration ID: NCT01256099. © 2015 Associated Professional Sleep Societies, LLC.

  15. Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people.

    Science.gov (United States)

    Yu, Doris S F

    2010-10-01

    This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0.81, with item-to-total correlations in the range of 0.34-0.67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. © 2010 The

  16. Overweight children report qualitatively distinct asthma symptoms: analysis of validated symptom measures.

    Science.gov (United States)

    Lang, Jason E; Hossain, Md Jobayer; Lima, John J

    2015-04-01

    Past studies of asthma in overweight/obese children have been inconsistent. The reason overweight/obese children commonly report worse asthma control remains unclear. To determine qualitative differences in symptoms between lean and overweight/obese children with early-onset, atopic asthma. We conducted a cross-sectional analytic study of lean (20% to 65% body mass index) and overweight/obese (≥85% body mass index) 10- to 17-year-old children with persistent, early-onset asthma. Participants completed 2 to 3 visits to provide a complete history, qualitative and quantitative asthma symptom characterization, and lung function testing. We determined associations between weight status and symptoms using multivariable linear and logistic regression methods. Overweight/obese and lean asthmatic children displayed similar lung function. Despite lower fraction of exhaled nitric oxide (30.0 vs 62.6 ppb; P = .037) and reduced methacholine responsiveness (PC20FEV1 1.87 vs 0.45 mg/mL; P overweight/obese children reported more than thrice frequent rescue treatments (3.7 vs 1.1 treatments/wk; P = .0002) than did lean children. Weight status affected the child's primary symptom reported with loss of asthma control (Fisher exact test; P = .003); overweight/obese children more often reported shortness of breath (odds ratio = 11.8; 95% CI, 1.41-98.7) and less often reported cough (odds ratio = 0.26; 95% CI, 0.08-0.82). Gastroesophageal reflux scores were higher in overweight/obese children (9.6 vs 23.2; P = .003) and appear to mediate overweight/obesity-related asthma symptoms. Overweight/obese children with early-onset asthma display poorer asthma control and a distinct pattern of symptoms. Greater shortness of breath and β-agonist use appears to be partially mediated via esophageal reflux symptoms. Overweight children with asthma may falsely attribute exertional dyspnea and esophageal reflux to asthma, leading to excess rescue medication use. Copyright © 2014 American

  17. Symptom report in detecting breast cancer-related lymphedema

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    Fu MR

    2015-10-01

    Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97

  18. Cognitive Behavioral Therapy for Insomnia in Posttraumatic Stress Disorder: A Randomized Controlled Trial

    Science.gov (United States)

    Talbot, Lisa S.; Maguen, Shira; Metzler, Thomas J.; Schmitz, Martha; McCaslin, Shannon E.; Richards, Anne; Perlis, Michael L.; Posner, Donn A.; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C.

    2014-01-01

    Study Objectives: Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. Design: Randomized controlled trial with two arms: CBT-I and monitor-only waitlist control. Setting: Department of Veterans Affairs (VA) Medical Center. Participants: Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Interventions: Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measurements and Results: Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Conclusions: Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress

  19. A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

    Science.gov (United States)

    Ong, Jason C.; Manber, Rachel; Segal, Zindel; Xia, Yinglin; Shapiro, Shauna; Wyatt, James K.

    2014-01-01

    Study Objectives: To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia. Design: Three-arm, single-site, randomized controlled trial. Setting: Academic medical center. Participants: Fifty-four adults with chronic insomnia. Interventions: Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or an eight-week self-monitoring (SM) condition. Measurements and Results: Patient-reported outcome measures were total wake time (TWT) from sleep diaries, the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia, and the Insomnia Severity Index (ISI) to determine remission and response as clinical endpoints. Objective sleep measures were derived from laboratory polysomnography and wrist actigraphy. Linear mixed models showed that those receiving a meditation-based intervention (MBSR or MBTI) had significantly greater reductions on TWT minutes (43.75 vs 1.09), PSAS (7.13 vs 0.16), and ISI (4.56 vs 0.06) from baseline-to-post compared to SM. Post hoc analyses revealed that each intervention was superior to SM on each of the patient-reported measures, but no significant differences were found when comparing MBSR to MBTI from baseline-to-post. From baseline to 6-month follow-up, MBTI had greater reductions in ISI scores than MBSR (P insomnia and could provide an alternative to traditional treatments for insomnia. Trial Registration: Mindfulness-Based Approaches to Insomnia: clinicaltrials.gov, identifier: NCT00768781 Citation: Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. A randomized controlled trial of mindfulness meditation for chronic insomnia. SLEEP 2014;37(9):1553-1563. PMID:25142566

  20. Insomnia: prevalence and associated factors

    OpenAIRE

    Lopes, Cátia; Lopes, Daniela; Ferreira, Sofia; Correia, Teresa; Pinto, Isabel C.

    2014-01-01

    Nowadays sleep disorders are very common and affect most of the population, the most common may be insomnia. Insomnia is defined as the difficulty of initiating or maintaining sleep it, may also be reflected in an early wake up and by the presence of a non-restful sleep and it is associated with impairment in social and occupational functioning of the individual. Knowing the prevalence and the associated factors of insomnia. This is a cross-sectional epidemiological study. The pop...

  1. SSRI and SNRI withdrawal symptoms reported on an internet forum.

    Science.gov (United States)

    Stockmann, Tom; Odegbaro, Dolapo; Timimi, Sami; Moncrieff, Joanna

    2018-05-09

    Antidepressant withdrawal symptoms are well-recognised, but their potential duration remains uncertain. We aimed to describe the characteristics of withdrawal associated with two popular classes of antidepressants, including duration. We analysed the content of a sample of posts on an antidepressant withdrawal website. We compared the characteristics of withdrawal associated with SSRIs and SNRIs, including time of onset, duration and nature of symptoms. 110 posts about SSRI withdrawal, and 63 concerning SNRI withdrawal, were analysed. The mean duration of withdrawal symptoms was significantly longer with SSRIs than SNRIs: 90.5 weeks (standard deviation, SD, 150.0) and 50.8 weeks (SD 76.0) respectively; p = 0.043). Neurological symptoms, such as 'brain zaps,' were more common among SNRI users (p = 0.023). Psychosexual/genitourinary symptoms may be more common among SSRI users (p = 0.054). The website aims to help people with antidepressant withdrawal, and is therefore likely to attract people who have difficulties. Length of prior use of antidepressants was long, with a mean of 252.2 weeks (SD 250.8). People accessing antidepressant withdrawal websites report experiencing protracted withdrawal symptoms. There are some differences in the characteristics of withdrawal associated with different classes of antidepressants.

  2. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    OpenAIRE

    Cokorda Istri Devi Larayanthi

    2013-01-01

    Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, gene...

  3. The beneficial effects of massage therapy for insomnia in postmenopausal women

    Directory of Open Access Journals (Sweden)

    H. Hachul

    2014-06-01

    Full Text Available With increases life expectancy, the incidence of undesirable manifestations of menopause has increased as well. The effects of lost ovarian function include progressive decrease in estradiol secretion, trophic changes in the breast, vasomotor symptoms, anxiety, depression, and sleep disorders. Insomnia, which has physiological consequences and can result in a loss of quality of life, is prevalent in women after menopause. Hormone therapy has been widely used to reduce menopausal symptoms, but its use in recent years has been questioned because of the reported risks of cardiovascular events and increased incidence of tumors. This controversy has generated significant interest in non-hormonal treatments among both physicians and patients. Our previous research has shown a positive effect of massage therapy on menopausal symptoms. We explored the hypothesis that massage therapy would produce beneficial effects in postmenopausal women through inflammatory and immunological changes. Recent results from self-report questionnaires have shown improvements in sleep pattern and quality of life following massage therapy. These findings demonstrate the effectiveness of massage therapy for the treatment of postmenopausal symptoms, particularly insomnia, and indicate that it is a promising line of research.

  4. The beneficial effects of massage therapy for insomnia in postmenopausal women.

    Science.gov (United States)

    Hachul, H; Oliveira, D S; Bittencourt, L R A; Andersen, M L; Tufik, S

    2014-06-01

    With increases life expectancy, the incidence of undesirable manifestations of menopause has increased as well. The effects of lost ovarian function include progressive decrease in estradiol secretion, trophic changes in the breast, vasomotor symptoms, anxiety, depression, and sleep disorders. Insomnia, which has physiological consequences and can result in a loss of quality of life, is prevalent in women after menopause. Hormone therapy has been widely used to reduce menopausal symptoms, but its use in recent years has been questioned because of the reported risks of cardiovascular events and increased incidence of tumors. This controversy has generated significant interest in non-hormonal treatments among both physicians and patients. Our previous research has shown a positive effect of massage therapy on menopausal symptoms. We explored the hypothesis that massage therapy would produce beneficial effects in postmenopausal women through inflammatory and immunological changes. Recent results from self-report questionnaires have shown improvements in sleep pattern and quality of life following massage therapy. These findings demonstrate the effectiveness of massage therapy for the treatment of postmenopausal symptoms, particularly insomnia, and indicate that it is a promising line of research.

  5. The heritability of insomnia progression during childhood/adolescence: results from a longitudinal twin study.

    Science.gov (United States)

    Barclay, Nicola L; Gehrman, Philip R; Gregory, Alice M; Eaves, Lindon J; Silberg, Judy L

    2015-01-01

    To determine prevalence and heritability of insomnia during middle/late childhood and adolescence; examine longitudinal associations in insomnia over time; and assess the extent to which genetic and environmental factors on insomnia remain stable, or whether new factors come into play, across this developmental period. Longitudinal twin study. Academic medical center. There were 739 complete monozygotic twin pairs (52%) and 672 complete dizygotic twin pairs (48%) initially enrolled and were followed up at three additional time points (waves). Mode ages at each wave were 8, 10, 14, and 15 y (ages ranged from 8-18 y). None. Clinical ratings of insomnia symptoms were assessed using the Child and Adolescent Psychiatric Assessment (CAPA) by trained clinicians, and rated according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R criteria for presence of 'clinically significant insomnia', over four sequential waves. Insomnia symptoms were prevalent but significantly decreased across the four waves (ranging from 16.6% to 31.2%). 'Clinically significant insomnia' was moderately heritable at all waves (h² range = 14% to 38%), and the remaining source of variance was the nonshared environment. Multivariate models indicated that genetic influences at wave 1 contributed to insomnia at all subsequent waves, and that new genetic influences came into play at wave 2, which further contributed to stability of symptoms. Nonshared environmental influences were time-specific. Insomnia is prevalent in childhood and adolescence, and is moderately heritable. The progression of insomnia across this developmental time period is influenced by stable as well as new genetic factors that come into play at wave 2 (modal age 10 y). Molecular genetic studies should now identify genes related to insomnia progression during childhood and adolescence. © 2014 Associated Professional Sleep Societies, LLC.

  6. Prevalence, awareness and reporting of symptoms of obstructive ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is the most common form of sleep- disordered breathing in adults and children. It is associated with many adverse health consequences. The objectives this study were to determine the prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized ...

  7. Self-reported Attention Deficit and Hyperactivity Disorder symptoms ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of self-reported attention deficit and hyperactivity disorder (ADHD) symptoms among university students in Eldoret, Kenya. Design: A cross-sectional descriptive study of all students who gave consent to participate in the study. Setting: Moi University's Town Campus, comprising the ...

  8. Associations of objective and subjective sleep disturbance with cognitive function in older men with comorbid depression and insomnia.

    Science.gov (United States)

    Biddle, Daniel J; Naismith, Sharon L; Griffiths, Kathleen M; Christensen, Helen; Hickie, Ian B; Glozier, Nicholas S

    2017-06-01

    To examine whether poor objective and subjective sleep quality are differentially associated with cognitive function. Cross-sectional. Participants were recruited from primary and secondary care, and directly from the community, in Sydney, Australia. The sample consisted of 74 men 50years and older (mean [SD], 58.4 [6.2] years), with comorbid depression and above-threshold insomnia symptoms, participating in a trial of online cognitive behavioral therapy for insomnia. Insomnia severity and depression severity were assessed via self-report. Objective sleep efficiency and duration were measured using actigraphy. Objective cognitive function was measured using 3 subtests of a computerized neuropsychological battery. Poor objective sleep efficiency was associated with slower reaction time (r=-0.249, P=.033) and poorer executive functioning (odds ratio, 4.14; 95% confidence interval, 1.35-12.69), but not memory. These associations remained after adjusting for age, education, depression severity, cardiovascular risk, and medication. Subjective sleep quality was not related to cognitive function. Among older men with depression and insomnia, objectively measured poor sleep efficiency may be associated with worse cognitive function, independent of depression severity. Objective poor sleep may be underpinned by neurobiological correlates distinct from those underlying subjective poor sleep and depression, and represent a potentially effective modifiable mechanism in interventions to improve cognitive functioning in this population. This supports the use of objective measures of sleep in diagnostic assessments and care. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  9. Sleep habits, insomnia, and daytime sleepiness in a large and healthy community-based sample of New Zealanders.

    Science.gov (United States)

    Wilsmore, Bradley R; Grunstein, Ronald R; Fransen, Marlene; Woodward, Mark; Norton, Robyn; Ameratunga, Shanthi

    2013-06-15

    To determine the relationship between sleep complaints, primary insomnia, excessive daytime sleepiness, and lifestyle factors in a large community-based sample. Cross-sectional study. Blood donor sites in New Zealand. 22,389 individuals aged 16-84 years volunteering to donate blood. N/A. A comprehensive self-administered questionnaire including personal demographics and validated questions assessing sleep disorders (snoring, apnea), sleep complaints (sleep quantity, sleep dissatisfaction), insomnia symptoms, excessive daytime sleepiness, mood, and lifestyle factors such as work patterns, smoking, alcohol, and illicit substance use. Additionally, direct measurements of height and weight were obtained. One in three participants report healthy sample) was associated with insomnia (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.50 to 2.05), depression (OR 2.01, CI 1.74 to 2.32), and sleep disordered breathing (OR 1.92, CI 1.59 to 2.32). Long work hours, alcohol dependence, and rotating work shifts also increase the risk of daytime sleepiness. Even in this relatively young, healthy, non-clinical sample, sleep complaints and primary insomnia with subsequent excess daytime sleepiness were common. There were clear associations between many personal and lifestyle factors-such as depression, long work hours, alcohol dependence, and rotating shift work-and sleep problems or excessive daytime sleepiness.

  10. Does cognitive behavioural therapy for insomnia improve cognitive performance? A systematic review and narrative synthesis.

    Science.gov (United States)

    Herbert, Vanessa; Kyle, Simon D; Pratt, Daniel

    2018-06-01

    Individuals with insomnia report difficulties pertaining to their cognitive functioning. Cognitive behavioural therapy for insomnia (CBT-I) is associated with robust, long-term improvements in sleep parameters, however less is known about the impact of CBT-I on the daytime correlates of the disorder. A systematic review and narrative synthesis was conducted in order to summarise and evaluate the evidence regarding the impact of CBT-I on cognitive functioning. Reference databases were searched and studies were included if they assessed cognitive performance as an outcome of CBT-I, using either self-report questionnaires or cognitive tests. Eighteen studies met inclusion criteria, comprising 923 individuals with insomnia symptoms. The standardised mean difference was calculated at post-intervention and follow-up. We found preliminary evidence for small to moderate effects of CBT-I on subjective measures of cognitive functioning. Few of the effects were statistically significant, likely due to small sample sizes and limited statistical power. There is a lack of evidence with regards to the impact of CBT-I on objective cognitive performance, primarily due to the small number of studies that administered an objective measure (n = 4). We conclude that adequately powered randomised controlled trials, utilising both subjective and objective measures of cognitive functioning are required. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Psychometric Properties of the Consensus Sleep Diary in Those With Insomnia Disorder.

    Science.gov (United States)

    Maich, Kristin H G; Lachowski, Angela M; Carney, Colleen E

    2018-01-01

    The Consensus Sleep Diary (CSD) is a standardized, prospective tool for tracking nightly subjective sleep. The current study evaluated the validity and utility of the CSD, with consideration for challenges inherent to psychometric evaluation of diary measures. Results showed that the CSD indices differentiated good sleepers from those with insomnia and were associated with similar objective indices and a subjective insomnia severity measure. The ability to detect treatment improvements after cognitive behavior therapy for insomnia (CBT-I) was tested by comparing pre- and post-CBT-I CSD indices with a subjective rating of insomnia symptom severity. Improvement in insomnia symptom severity was significantly related to improvement on the CSD indices. Completion rate of the CSD amongst participants across all 14 days was 99.8%. These findings provide support for the validity, clinical utility, and usability of the CSD.

  12. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    Toorn, S.L.M. van der; Huizink, A.C.; Utens, E.M.W.J.; Verhulst, F.C.; Ormel, J.; Ferdinand, R.F.

    2010-01-01

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  13. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    S.L.M. van der Toorn; A.C. Huizink (Anja); E.M.W.J. Utens (Elisabeth); F.C. Verhulst (Frank); J. Ormel (Johan Hans); R.F. Ferdinand (Robert)

    2010-01-01

    textabstractMaternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study

  14. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS study

    NARCIS (Netherlands)

    van der Toorn, Sonja L. M.; Huizink, Anja C.; Utens, Elisabeth M. W. J.; Verhulst, Frank C.; Ormel, Johan; Ferdinand, Robert F.

    2010-01-01

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  15. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children : a report on the TRAILS Study

    NARCIS (Netherlands)

    van der Toorn, Sonja L. M.; Huizink, Anja C.; Utens, Elisabeth M. W. J.; Verhulst, Frank C.; Ormel, Johan; Ferdinand, Robert F.

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  16. Influence of social factors on patient-reported late symptoms

    DEFF Research Database (Denmark)

    Kjaer, Trille Kristina; Johansen, Christoffer; Andersen, Elo

    2016-01-01

    BACKGROUND: The incidence of head and neck cancer and morbidity and mortality after treatment are associated with social factors. Whether social factors also play a role in the prevalence of late-onset symptoms after treatment for head and neck cancer is not clear. METHODS: Three hundred sixty...... ratio [OR] = 3.20; 95% confidence interval [CI] = 1.18-8.63). For survivors who lived alone, the adjusted ORs were significantly increased for physical functioning (2.17; 95% CI = 1.01-4.68) and trouble with social eating (OR = 2.26; 95% CI = 1.14-4.47). CONCLUSION: Self-reported severe late symptoms...... were more prevalent in survivors with short education and in those living alone, suggesting differences in perception of late symptoms between social groups. © 2015 Wiley Periodicals, Inc. Head Neck, 2015....

  17. Human physiological models of insomnia.

    Science.gov (United States)

    Richardson, Gary S

    2007-12-01

    Despite the wide prevalence and important consequences of insomnia, remarkably little is known about its pathophysiology. Available models exist primarily in the psychological domain and derive from the demonstrated efficacy of behavioral treatment approaches to insomnia management. However, these models offer little specific prediction about the anatomic or physiological foundation of chronic primary insomnia. On the other hand, a growing body of data on the physiology of sleep supports a reasonably circumscribed overview of possible pathophysiological mechanisms, as well as the development of physiological models of insomnia to guide future research. As a pragmatic step, these models focus on primary insomnia, as opposed to comorbid insomnias, because the latter is by its nature a much more heterogeneous presentation, reflecting the effects of the distinct comorbid condition. Current understanding of the regulation of sleep and wakefulness in mammalian brain supports four broad candidate areas: 1) disruption of the sleep homeostat; 2) disruption of the circadian clock; 3) disruption of intrinsic systems responsible for the expression of sleep states; or 4) disruption (hyperactivity) of extrinsic systems capable of over-riding normal sleep-wake regulation. This review examines each of the four candidate pathophysiological mechanisms and the available data in support of each. While studies that directly test the viability of each model are not yet available, descriptive data on primary insomnia favor the involvement of dysfunctional extrinsic stress-response systems in the pathology of primary chronic insomnia.

  18. Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review.

    Science.gov (United States)

    Cunningham, Jasmyn E A; Shapiro, Colin M

    2018-03-01

    Major depressive disorder is one of the most commonly diagnosed psychiatric illnesses, and it has a profound negative impact on an individual's ability to function. Up to 90% of individuals suffering from depression also report sleep and circadian disruptions. If these disruptions are not effectively resolved over the course of treatment, the likelihood of relapse into depression is greatly increased. Cognitive Behavioural Therapy for Insomnia (CBT-I) has shown promise in treating these sleep and circadian disturbances associated with depression, and may be effective as a stand-alone treatment for depression. This may be particularly relevant in cases where antidepressant medications are not ideal (e.g. due to contraindications, cost, or treatment resistance). A systematic literature review was conducted of trials investigating the use of CBT-I to treat depression in adults. Therapy included in-person CBT-I, as well as telehealth and group CBT-I. CBT-I presents a promising treatment for depression comorbid with insomnia. In-person therapy has the most supporting evidence for its efficacy, though treatment effects may not be additive with those of antidepressant medications. Insomnia improvement due to CBT-I may mediate the improvement in depressive symptoms. There is less evidence for the use of telehealth, though a stepped-care approach is indicated based on baseline depressive severity. More research on group therapy and telehealth modalities of delivering CBT-I are required before making recommendations. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Sleep board review question: insomnia in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Budhiraja R

    2013-11-01

    Full Text Available No abstract available. Article truncated after first page. What is the estimated prevalence of insomnia symptoms in patients with obstructive sleep apnea? 1. Less than 1% 2. 5%-10% 3. 20-30% 4. 40%-60% 5. Greater than 80%

  20. Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample.

    Science.gov (United States)

    Chaudhary, Ninad S; Grandner, Michael A; Jackson, Nicholas J; Chakravorty, Subhajit

    2016-01-01

    Insomnia symptoms have been individually associated with both caffeine consumption and sleep duration abnormalities in prior studies. The goal of this study was to determine whether caffeine consumption was associated with insomnia symptoms from a population perspective and whether this relationship depended on habitual sleep duration. Data were extracted from the 2007-2008 National Health and Nutritional Examination Survey (N = 4730). Caffeine consumption was quantified as mg/d from 2 typical days of use, 7 to 10 d apart. Insomnia symptoms were evaluated using frequencies of difficulty falling asleep (DFA), difficulty staying asleep (DSA), non-restorative sleep (NRS), and daytime sleepiness (DS). Habitual sleep duration was assessed as the hours of sleep obtained on a typical night. Binomial logistic regression analysis evaluated the relationships of individual insomnia and sleepiness symptoms (DFA, DSA, NRS, and DS) with caffeine consumption and sleep duration variables, after adjusting for covariates. The mean ± SD caffeine consumption was 176.6 ± 201 mg/d. Mean habitual sleep duration was 6.8 ± 1.4 h. Insomnia symptoms were prevalent in 19.1% to 28.4% of the respondents. Although caffeine consumption was associated with all insomnia symptoms in the unadjusted models, the adjusted models demonstrated a trend toward significance with DSA. Sleep duration was inversely associated with the insomnia symptoms in unadjusted and adjusted analysis. Finally, NRS was associated with an interaction between increased caffeine consumption and sleep duration. The association between caffeine use and insomnia symptoms depends on habitual sleep duration at a population level. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Assessment of patient-reported symptoms of anxiety

    Science.gov (United States)

    Rose, Matthias; Devine, Janine

    2014-01-01

    Patient self-reported symptoms are of crucial importance to identify anxiety disorders, as well as to monitor their treatment in clinical practice and research. Thus, for evidence-based medicine, a precise, reliable, and valid (ie, “objective”) assessment of the patient's reported “subjective” symptoms is warranted. There is a plethora of instruments available, which can provide psychometrically sound assessments of anxiety, but there are several limitations of current tools that need to be carefully considered for their successful use. Nevertheless, the empirical assessment of mental health status is not as accepted in medicine as is the assessment of biomarkers. One reason for this may be that different instruments assessing the same psychological construct use different scales. In this paper we present some new developments that promise to provide one common metric for the assessment of anxiety, to facilitate the general acceptance of mental health assessments in the future. PMID:25152658

  2. Bronchodilator responsiveness and reported respiratory symptoms in an adult population.

    Directory of Open Access Journals (Sweden)

    Wan C Tan

    Full Text Available BACKGROUND: The relationship between patient-reported symptoms and objective measures of lung function is poorly understood. AIM: To determine the association between responsiveness to bronchodilator and respiratory symptoms in random population samples. METHODS: 4669 people aged 40 years and older from 8 sites in Canada completed interviewer-administered respiratory questionnaires and performed spirometry before and after administration of 200 ug of inhaled salbutamol. The effect of anthropometric variables, smoking exposure and doctor-diagnosed asthma (DDA on bronchodilator responsiveness in forced expiratory volume in 1 second (FEV1 and in forced vital capacity (FVC were evaluated. Multiple logistic regression was used to test for association between quintiles of increasing changes in FEV1 and in FVC after bronchodilator and several respiratory symptoms. RESULTS: Determinants of bronchodilator change in FEV1 and FVC included age, DDA, smoking, respiratory drug use and female gender [p<0.005 to p<0.0001 ]. In subjects without doctor-diagnosed asthma or COPD, bronchodilator response in FEV1 was associated with wheezing [p for trend<0.0001], while bronchodilator response for FVC was associated with breathlessness. [p for trend <0.0001]. CONCLUSIONS: Bronchodilator responsiveness in FEV1 or FVC are associated with different respiratory symptoms in the community. Both flow and volume bronchodilator responses are useful parameters which together can be predictive of both wheezing and breathlessness in the general population.

  3. The societal costs of insomnia

    Directory of Open Access Journals (Sweden)

    Alan G Wade

    2010-12-01

    Full Text Available Alan G WadeCPS Research, Glasgow, ScotlandObjective: Insomnia can be broadly defined as difficulty initiating or maintaining sleep, or sleep that is not refreshing or of poor quality with negative effect on daytime function. Insomnia can be a primary condition or comorbid to an underlying disorder. Subjective measures of insomnia used in population studies, usually based on complaints of unsatisfactory sleep, put the prevalence at about 10%. Insomnia is more common in the elderly and in women, and is often associated with medical and psychiatric disorders. This review examines the measures used to assess quality of sleep (QOS and daytime functioning and the impact of insomnia on society using these measures.Methods: Literature searches were performed to identify all studies of insomnia (primary and comorbid in adults (aged 18–64 years and the elderly (aged ≥ 65 years with baseline and/or outcomes relating to QOS or daytime functioning. The impact of poor QOS on quality of life (QOL, psychomotor and cognitive skills, health care resource utilization, and other societal effects was examined.Results: Although definitions and measurement scales used to assess sleep quality vary widely, it is clear that the societal consequences of insomnia are substantial and include impaired QOL and increased health care utilization. The impact of poor QOS and impaired daytime functioning common in insomnia can lead to indirect effects such as lower work productivity, increased sick leave, and a higher rate of motor vehicle crashes.Conclusions: Insomnia is associated with substantial direct and indirect costs to society. It is almost impossible to separate the costs associated with primary and comorbid insomnia. More studies are required which control for the severity of any primary disorder to accurately evaluate the costs of comorbid insomnia. Development of standardized diagnostic and assessment scales will enable more accurate quantification of the true

  4. Self-reported versus informant-reported depressive symptoms in adults with mild intellectual disability.

    Science.gov (United States)

    Mileviciute, I; Hartley, S L

    2015-02-01

    Virtually nothing is known about potential differences in the types of depression symptoms reported by adults with mild intellectual disability (ID) on self-reported questionnaires as compared with the types of symptoms reported by caregivers on informant questionnaires. Moreover, little is known about how the presentation of depression among adults with mild ID varies based on socio-demographic characteristics. We compared findings from two self-reported questionnaires, the Self-Reported Depression Questionnaire (SRDQ) and the Glasgow Depression Scale for People with a Learning Disability (GDS), to that of an informant questionnaire of depressive symptoms, the Glasgow Depression Scale--Caregiver Supplement (CGDS), in 80 adults with mild ID. We also examined the association between age, sex, IQ and the presence of a co-occurring psychiatric disorder and frequency of affective, cognitive and somatic depressive symptoms in our sample of adults with mild ID. Adults with mild ID self-reported a higher frequency of affective and cognitive depressive symptoms than staff reported on the informant measure. Staff reported a higher frequency of somatic symptoms than adults with mild ID on one of the self-reported questionnaires (GDS) and a similar frequency on the other self-reported questionnaire (SRDQ). Important differences were found in the types of depressive symptoms based on their IQ, age and presence of a co-occurring psychiatric disorder. Informant questionnaires offer valuable information, but assessment should include self-reported questionnaires as these questionnaires add unique information about internalised experiences (affective and cognitive symptoms) of adults with mild ID that may not be apparent to caregivers. Health care providers should be made aware of the important differences in the presentation of depressive based on their IQ, age and presence of a co-occurring psychiatric disorder. © 2013 John Wiley & Sons Ltd, MENCAP & IASSID.

  5. People with insomnia: experiences with sedative hypnotics and risk perception.

    Science.gov (United States)

    Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Ellis, Jason G; Saini, Bandana

    2016-08-01

    Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia. To explore patient medication-taking beliefs, experiences and behavioural practices relating to the use of pharmacological/complementary sleep aids for insomnia. Specialist sleep/psychology clinics and the general community in Sydney, Australia. Semi-structured interviews were conducted with 51 people with insomnia using a schedule of questions to gauge their experiences, beliefs and current practices relating to insomnia medication use. Interviews were audio-recorded, transcribed verbatim and subjected to Framework Analysis to identify emergent themes. Participants held distinctive views about the safety and efficacy of complementary and pharmacological agents but do not intuitively turn to medications to resolve their sleep complaint. Medication use was affirmed through tangible medication-taking cues due to the ambivalence in current instructions and labelling. Practices such as dosage modification, medication substitution and delaying medication use might be important drivers for psychological dependence. Current labelling and instructions do not necessarily promote the quality use of sedative hypnotics due to the variability in patient interpretations. Clarifying the timing, quantity and frequency of medication administration as well as insomnia symptom recognition would play a significant role in optimizing the role of pharmacotherapy in the management of insomnia. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  6. Insomnia with physiological hyperarousal is associated with hypertension.

    Science.gov (United States)

    Li, Yun; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Bixler, Edward O; Sun, Yuanfeng; Zhou, Junying; Ren, Rong; Li, Tao; Tang, Xiangdong

    2015-03-01

    Previous studies have suggested that insomnia with objective short sleep duration is associated with a higher risk of hypertension, and it has been speculated that the underlying mechanism is physiological hyperarousal. In this study, we tested whether insomnia with physiological hyperarousal measured by Multiple Sleep Latency Test (MSLT), a standard test of sleepiness/alertness, is associated with increased risk of hypertension. Two hundred nineteen chronic insomniacs and 96 normal sleepers were included in this study. Chronic insomnia was defined based on standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent 1 night in laboratory polysomnography followed by a standard MSLT. We used the median mean MSLT value (ie, >14 minutes) and the 75th percentile of mean MSLT value (ie, >17 minutes) to define hyperarousal. Hypertension was defined based either on blood pressure measures or on diagnosis treatment by a physician. After controlling for age, sex, body mass index, apnea-hypopnea index, diabetes mellitus, smoking, alcohol, and caffeine use, insomnia combined with MSLT >14 minutes increased the odds of hypertension by 300% (odds ratio=3.27; 95% confidence interval=1.20-8.96), whereas insomnia combined with MSLT >17 minutes increased even further the odds of hypertension by 400% (odds ratio=4.33; 95% confidence interval=1.48-12.68) compared with normal sleepers with MSLT ≤14 minutes. Insomnia associated with physiological hyperarousal is associated with a significant risk of hypertension. Long MSLT values may be a reliable index of the physiological hyperarousal and biological severity of chronic insomnia. © 2015 American Heart Association, Inc.

  7. Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis

    Directory of Open Access Journals (Sweden)

    Romera Irene

    2013-02-01

    Full Text Available Abstract Background The degrees to which residual symptoms in major depressive disorder (MDD adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning. Methods Patients with MDD who responded (≥50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17 after 3 months of treatment (624/930 were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ≥1, residual insomnia-symptoms (HAMD-17 sleep subscale ≥1, residual anxiety-symptoms (HAMD-17-anxiety subscale ≥1, residual somatic-symptoms (HAMD-17 Item 13 ≥1, pain (Visual Analogue Scale ≥30, and functioning were assessed after 3 months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ≥80 as the dependent variable was used. Results After 3 months, 59.5% of patients (371/624 achieved normal functioning and 66.0% (412/624 were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6–16.7, absence of insomnia symptoms (OR 1.8; 95% CI, 1.2–2.7, episode length (4–24 weeks vs. ≥24 weeks [OR 2.0; 95% CI, 1.1–3.6] and better baseline functioning (OR 1.0; 95% CI, 1.0–1.1. A significant interaction between residual anxiety symptoms and pain was found (p = 0.0080. Conclusions Different residual symptoms are associated to different degrees with patient functioning. To achieve normal functioning, specific residual symptoms domains might be targeted for treatment.

  8. Behavioral interventions for insomnia: Theory and practice

    OpenAIRE

    Sharma, Mahendra P.; Andrade, Chittaranjan

    2012-01-01

    Insomnia is a general clinical term that refers to a difficulty in initiating or maintaining sleep. Insomnia is widely prevalent in the general population, especially in the elderly and in those with medical and psychiatric disorders. Hypnotic drug treatments of insomnia are effective but are associated with potential disadvantages. This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control th...

  9. The effects of mindfulness and relaxation training for insomnia (MRTI) on postmenopausal women: a pilot study.

    Science.gov (United States)

    Garcia, Marcelo C; Kozasa, Elisa H; Tufik, Sergio; Mello, Luiz Eugênio A M; Hachul, Helena

    2018-05-21

    The aim of the study was to evaluate the effects of mindfulness and relaxation training for insomnia on insomnia and quality of life in postmenopausal women. Thirty postmenopausal women aged 50 to 65 years, who were not using hormone therapy, and had a diagnosis of insomnia and an apnea-hypopnea index of less than 15, were randomly assigned to two groups: a mindfulness intervention group and a control group. They were assessed before the intervention, and 8 weeks after its completion using questionnaires assessing sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index), quality of life in menopause (Menopause-Specific Quality of Life), menopausal symptoms (Kupperman Menopausal Index), and level of attention (Mindfulness Awareness Attention Scale). They were also assessed through ambulatory polysomnography. This is a pilot study and is limited by its small sample size. The results of the questionnaires showed significant differences in the group that received mindfulness training compared with the control group, namely, improvements in sleep quality, a reduction in the severity of insomnia, a better quality of life, improved attention levels, and a reduction in menopausal and vasomotor symptoms. Polysomnography results showed no differences between the groups. Eight weeks mindfulness meditation training improved sleep quality, quality of life, attention levels, and reduced vasomotor symptoms in postmenopausal women with insomnia.

  10. Patient Preferences for Managing Insomnia: A Discrete Choice Experiment.

    Science.gov (United States)

    Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Saini, Bandana; Laba, Tracey-Lea

    2018-03-03

    Despite the rapid development of effective treatments, both pharmacological and non-pharmacological, insomnia management remains suboptimal at the practice interface. Patient preferences play a critical role in influencing treatment outcomes. However, there is currently a mismatch between patient preferences and clinician recommendations, partly perpetuated by a limited understanding of the patients' decision-making process. The aim of our study was to empirically quantify patient preferences for treatment attributes common to both pharmacological and non-pharmacological insomnia treatments. An efficient dual-response discrete choice experiment was conducted to evaluate patient treatment preferences for managing insomnia. The sample included 205 patients with self-reported insomnia and an Insomnia Severity Index ≥ 14. Participants were presented with two unlabelled hypothetical scenarios with an opt-out option across 12 choice sets. Data were analyzed using a mixed multinomial logit model to investigate the influence of five attributes (i.e. time, onset of action, maintainability of improved sleep, length of treatment, and monthly cost) on treatment preferences. Treatments were preferentially viewed if they conferred long-term sleep benefits (p managing insomnia.

  11. Familial Risk for Insomnia Is Associated With Abnormal Cortisol Response to Stress.

    Science.gov (United States)

    Drake, Christopher L; Cheng, Philip; Almeida, David M; Roth, Thomas

    2017-10-01

    Abnormalities in the stress system have been implicated in insomnia. However, studies examining physiological stress regulation in insomnia have not consistently detected differences in the hypothalamic-pituitary-adrenal (HPA)-axis response to stress. One explanation may be that deficits in the stress system are associated specifically with a biological vulnerability to insomnia rather than the phenotypic expression of insomnia. To examine stress response as a function of vulnerability to insomnia, this study tested response to the Trier Social Stress Test in a sample of healthy sleepers with varying familial risks for insomnia. Thirty-five healthy individuals with and without familial risk for insomnia were recruited to complete a laboratory stressor. Participants with one or both biological parents with insomnia were categorized as positive for familial risk, whereas those without biological parents with insomnia were categorized as negative for familial risk. Participants completed the Trier Social Stress Test in the laboratory, and psychological and physiological (autonomic and HPA-axis) responses were compared. Despite self-reported increases in anxiety, those positive for familial risk exhibited a blunted cortisol response relative to those without familial risk for insomnia. Individuals with blunted cortisol also reported heightened reactivity to personal life stressors, including increased sleep disturbances, elevated cognitive intrusions, and more behavioral avoidance. Findings from this study provide initial evidence that abnormal stress regulation may be a biological predisposing factor conferred via familial risk for insomnia. This deficit may also predict negative consequences over time, including insomnia and the associated psychiatric comorbidities. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  12. "Light switch" mental status changes and irritable insomnia are two particularly salient features of anti-NMDA receptor antibody encephalitis.

    Science.gov (United States)

    DeSena, Allen D; Greenberg, Benjamin M; Graves, Donna

    2014-07-01

    Anti-N-methyl-D-aspartate antibody encephalitis is becoming increasingly recognized as a cause of acute and subacute encephalopathy in both adults and children. The typical features of this disorder include some degree of encephalopathy, seizures, and often a movement disorder component. However, there is wide variability in its presentation, and diagnosis based on clinical features alone is often delayed. We report a series of four of 12 patients observed at our children's hospital between 2011 and 2013 that we chose as particularly representative examples of two distinct clinical features. In these individuals with anti-N-methyl-D-aspartate receptor antibody encephalitis, we note a very rapid on-off state between responsiveness and nonresponsiveness and/or insomnia accompanied by extreme irritability. We describe the abrupt mental status shift as "light switch" because the patients can awaken in seconds from a completely nonresponsive state. The insomnia noted in our patients was also impressive and often present early in the patients' courses. Light switch mental status changes and irritable insomnia are important early features of anti-N-methyl-D-aspartate receptor antibody encephalitis that can signal the presence of this disorder. The exact pathophysiology of these two symptoms has not been fully elucidated, and we feel that presence of one or both of these symptoms early in the disease course should prompt immediate concern for this disorder. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

    DEFF Research Database (Denmark)

    Ansari, Walid El; Khalil, Khalid; Stock, Christiane

    2014-01-01

    symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%-60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association...... between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15-2.02), depressive mood (OR 2.20; 95% CI 1.64-2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19-2.03). Other factors...... independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population....

  14. The Body Dysmorphic Disorder Symptom Scale: Development and preliminary validation of a self-report scale of symptom specific dysfunction.

    Science.gov (United States)

    Wilhelm, Sabine; Greenberg, Jennifer L; Rosenfield, Elizabeth; Kasarskis, Irina; Blashill, Aaron J

    2016-06-01

    The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a new self-report measure used to examine the severity of a wide variety of symptoms associated with body dysmorphic disorder (BDD). The BDD-SS was designed to differentiate, for each group of symptoms, the number of symptoms endorsed and their severity. This report evaluates and compares the psychometric characteristics of the BDD-SS in relation to other measures of BDD, body image, and depression in 99 adult participants diagnosed with BDD. Total scores of the BDD-SS showed good reliability and convergent validity and moderate discriminant validity. Analyses of the individual BDD-SS symptom groups confirmed the reliability of the checking, grooming, weight/shape, and cognition groups. The current findings indicate that the BDD-SS can be quickly administered and used to examine the severity of heterogeneous BDD symptoms for research and clinical purposes. Copyright © 2016. Published by Elsevier Ltd.

  15. Nocturnal heart rate variability in patients treated with cognitive-behavioral therapy for insomnia.

    Science.gov (United States)

    Jarrin, Denise C; Chen, Ivy Y; Ivers, Hans; Lamy, Manon; Vallières, Annie; Morin, Charles M

    2016-06-01

    Insomnia and reduced heart rate variability (HRV) increase the risk of cardiovascular disease and its precursors; thus, it is important to evaluate whether treatment for insomnia provides cardiovascular safeguards. The present study aimed to evaluate potential cardiovascular benefits of cognitive behavioral therapy for insomnia (CBT-I). The present study included 65 patients treated for chronic insomnia (M = 51.8 years, SD = 10.0; 66.2% female) at a university hospital. Patients received CBT-I over a 6-week period, and change scores from pre- to posttreatment derived from the Insomnia Severity Index, sleep diary, and polysomnography (PSG) were used as indices of sleep improvement. HRV variables (i.e., low frequency [LF], high frequency [HF], and the ratio of low to high frequency [LF:HF ratio]) were derived for Stage 2 (S2) and rapid-eye movement (REM) sleep at pre- and posttreatment. High HF (i.e., parasympathetic activity) and/or low LF:HF ratio (i.e., sympathovagal balance) were used as indices of HRV improvement. Following therapy, sleep improvements, particularly for sleep onset latency, were related with reduced HF in S2 (r = .30, p insomnia symptoms and increased HF in REM (r = -.21, p insomnia treatment might play a role in physiological changes associated with cardiovascular anomalies. Future research is needed to examine the long-term impact of treatment as a preventative tool against insomnia-related morbidity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. [Chronic insomnia: not always psychophysiological].

    Science.gov (United States)

    Neerings-Verberkmoes, Nicole E; Vlak, Monique H M; de Lau, Lonneke M L; Hamburger, Hans L

    2014-01-01

    To determine the sensitivity, specificity and the positive and negative predictive value of taking a detailed sleep history for making the diagnosis of psychophysiological insomnia. Retrospective case file study. We examined 767 patients referred to the Amsterdam Centre for Sleep and Wake Disorders, and who underwent polysomnography for the first time between 1 January and 31 December 2010. We compared the probable diagnosis made following history-taking with the final diagnosis made after polysomnography. In this we differentiated between organic and non-organic insomnia. The sensitivity, specificity, positive and negative predictive values of the sleep history were calculated. In 24.8% of the 303 patients whose histories did not indicate organic insomnia, polysomnography showed there to be an organic cause. Primary causes were obstructive sleep apnoea (13.2%), upper airway resistance syndrome (5.4%), and periodic limb movement disorder (4.0%) or a combination of these. In the histories of 464 patients there were indications that the insomnia had an organic cause and in 325 of them this was confirmed by polysomnography. The sensitivity of detailed history taking to psychophysiological insomnia was 62.1%, the specificity 81.3%, the positive predictive value was 75.2% and the negative predictive value was 70.0%. In patients under the age of 40 with a score on the Epworth sleepiness scale insomnia, organic insomnia could not be demonstrated, with the exception of one parasomnia. History-taking only meant that the organic cause was missed in a substantial percentage of patients with insomnia, in particular in older patients with hypersomnolence and a high BMI.

  17. Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic

    Science.gov (United States)

    Perlman, Lawrence M.; Arnedt, J. Todd; Earnheart, Kristie L.; Gorman, Ashley A.; Shirley, Katherine G.

    2008-01-01

    Effective cognitive-behavioral therapies for insomnia have been developed over the past 2 decades, but they have not been systematically evaluated in some clinical settings. While insomnia is common among veterans with mental health problems, the availability of effective treatments is limited. We report on the group application of a…

  18. A brief tool to differentiate factors contributing to insomnia complaints.

    Science.gov (United States)

    Townsend, Donald; Kazaglis, Louis; Savik, Kay; Smerud, Adam; Iber, Conrad

    2017-03-01

    A complaint of insomnia may have many causes. A brief tool examining contributing factors may be useful for nonsleep specialists. This study describes the development of the Insomnia Symptoms Assessment (ISA) for examining insomnia complaints. ISA questions were designed to identify symptoms that may represent 1 of 8 possible factors contributing to insomnia symptoms, including delayed sleep phase syndrome (DSPS), shift work sleep disorder (SWSD), obstructive sleep apnea (OSA), mental health, chronic pain, restless leg syndrome (RLS), poor sleep hygiene, and psychophysiological insomnia (PI). The ISA was completed by 346 new patients. Patients met with a sleep specialist who determined primary and secondary diagnoses. Mean age was 45 (18-85) years and 51% were male. Exploratory factor analysis (n = 217) and confirmatory factor analysis (n = 129) supported 5 factors with good internal consistency (Cronbach's alpha), including RLS (.72), OSA (.60), SWSD (.67), DSPS (.64), and PI (.80). Thirty percent had 1 sleep diagnosis with a mean of 2.2 diagnoses per patient. No diagnosis was entered for 1.2% of patients. The receiver operating characteristics were examined and the area under the curves calculated as an indication of convergent validity for the primary diagnosis (N = 346) were .97 for SWSD, .78 for OSA, .67 for DSPS, .54 for PI, and .80 for RLS. The ISA demonstrated good internal consistency and corresponds well to expert diagnoses. Next steps include setting sensitivity/specificity cutoffs to suggest initial treatment recommendations for use in other settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Health complaints and wind turbines: The efficacy of explaining the nocebo response to reduce symptom reporting.

    Science.gov (United States)

    Crichton, Fiona; Petrie, Keith J

    2015-07-01

    A number of people are reporting an environmental sensitivity to sub-audible windfarm sound (infrasound), characterised by the experience of recurrent non-specific symptoms. A causal link between exposure and symptoms is not indicated by empirical evidence. Research indicates symptoms may be explained by the nocebo response, whereby health concerns and negative expectations, created from social discourse and media reports, trigger symptom reporting. The experimental aim was to test whether providing a nocebo explanation for symptoms, to individuals reporting symptomatic experiences during infrasound exposure, would ameliorate symptoms during further exposure. Sixty-six volunteers were randomly assigned to nocebo explanation or biological explanation groups. Participants were concurrently exposed to infrasound and audible windfarm sound, while reporting on current symptoms and mood, during two exposure sessions. Preceding session one, participants watched a presentation integrating media warnings about purported health risks posed by windfarm infrasound. Before session two, nocebo explanation participants viewed material outlining how nocebo responding could explain symptom reporting. Instead biological explanation participants watched material presenting pathophysiological theories for symptoms. During session one, participants reported increased symptoms and mood deterioration from baseline assessment. During session two symptom reporting and mood deterioration was maintained by biological explanation participants, while mood and symptoms reported by nocebo explanation participants returned to baseline levels. Results indicate that providing an explanation of the nocebo response, followed by exposure to infrasound, has the potential to operate as an intervention to reduce symptomatic experiences in people reporting symptoms attributed to windfarm generated infrasound. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Self-Report of Depressive Symptoms in Low Back Pain Patients.

    Science.gov (United States)

    Crisson, James; And Others

    1986-01-01

    Presents two studies designed to examine the self-report of depressive symptoms in low back pain patients (N=134). Both studies found that patients were more likely to report somatic than cognitive symptoms of depression. Patients with multiple physical findings were not more likely to report somatic symptoms than patients with few physical…

  1. Electromagnetictherapy for Treatment of Insomnia: A clinical Trial Study

    Directory of Open Access Journals (Sweden)

    Fariba Sadeghi movahhed

    2012-04-01

    Full Text Available Background & Objectives: Insomnia is one of the most common sleep disorders in the world. It causes disruption in daily activities and increases the risk of major depression. Hence, clinically the appropriate and persistent treatment of insomnia is very important. Using of hypnotic drugs such as benzodiazepines is the common treatment for insomnia but they show several side effects and it seems that new medications should be used for treatment of sleep disorders. The aim of this study was comparison between the effects of electromagnetic therapy and conventional drug usage in the treatment of insomnia.   Methods: In a blind randomized clinical trial study, 60 people referred to the private office of the psychiatrist and experienced more than 3 months extended primary insomnia were selected. They were diagnosed by DSM-IV criteria and had no other underlying problems. The subjects were divided in two groups: 30 people in each and treated electromagnetically or with Alprazolam for 3 weeks. Before treatment, immediately and one month after treatment, quality of sleep and severity of the insomnia were evaluated by using the standard questionnaires and finally, the results were analyzed statistically.   Results : In this study, 60 individuals participated from whom 28 were male (46.7% and 32 patients were female (53.3%.The mean age was 37.3 years old in a range of 17- 65. The mean point of each questionnaire, before and immediately after treatment significantly didn't show any difference but one month after treatment, there was a significant difference in both groups.   Conclusion : To treat insomnia, electromagnetic therapy appears to be used as a replacement for sedative medicines. It also has more stability in comparison with other sedative medicines and no side effects have been reported yet.

  2. Validation of a self-reported HIV symptoms list: the ISS-HIV symptoms scale.

    Science.gov (United States)

    Bucciardini, Raffaella; Pugliese, Katherina; Francisci, Daniela; Costantini, Andrea; Schiaroli, Elisabetta; Cognigni, Miriam; Tontini, Chiara; Lucattini, Stefano; Fucili, Luca; Di Gregorio, Massimiliano; Mirra, Marco; Fragola, Vincenzo; Pompili, Sara; Murri, Rita; Vella, Stefano

    2016-01-01

    To describe the development and the psychometric properties of the Istituto Superiore di Sanità-HIV symptoms scale (lSS-HIV symptoms scale). The ISS-HIV symptom scale was developed by an Italian working team including researchers, physicians and people living with HIV. The development process went through the following steps: (1) review of HIV/AIDS literature; (2) focus group; (3) pre-test analysis; (4) scale validation. The 22 symptoms of HIV-ISS symptoms scale were clustered in five factors: pain/general discomfort (7 items); depression/anxiety (4 items); emotional reaction/psychological distress (5 items); gastrointestinal discomfort (4 items); sexual discomfort (2 items). The internal consistence reliability was for all factors within the minimum accepted standard of 0.70. The results of this study provide a preliminary evidence of the reliability and validity of the ISS-HIV symptoms scale. In the new era where HIV infection has been transformed into a chronic diseases and patients are experiencing a complex range of symptoms, the ISS-HIV symptoms scale may represent an useful tool for a comprehensive symptom assessment with the advantage of being easy to fill out by patients and potentially attractive to physicians mainly because it is easy to understand and requires short time to interpret the results.

  3. Chronic koro-like symptoms – two case reports

    Directory of Open Access Journals (Sweden)

    Kar Nilamadhab

    2005-10-01

    Full Text Available Abstract Background Koro is a culture bound syndrome, which has been reported usually from Asian countries. It has been described as an acute, brief lasting illness, which often occurs in epidemics. There is no description in literature of a chronic form of this syndrome. Case presentation Two sporadic cases with koro-like symptoms from East India are presented where the illness had a chronic course with durations spanning more than ten years. In contrast to acute, good prognosis, psycho-education responsive form that is usually seen in epidemics; the chronic form, appeared to be associated with greater morbidity and poorer response to interventions. Conclusion There is a possibility of a chronic form of koro syndrome.

  4. Syncope as initial symptom for nephrotic syndrome: a case report

    Science.gov (United States)

    Wu, Xuemei; Wang, Guangliang; Feng, Jiachun

    2015-01-01

    Although syncope and nephrotic syndrome are frequently encountered independently in pediatric practice, syncope as the initial symptom for nephrotic syndrome is rarely observed in the pediatric age group. In this report, we present the case of 3-year-old boy with nephrotic syndrome who presented with a history of three episodes of syncope before admission. The syncope occurred after excessive fluid loss or inadequate intake of fluids and was relieved spontaneously. History taking revealed that the early morning palpebral edema, and laboratory tests showed decreased plasma protein levels and elevated serum lipid levels. Nephrotic syndrome was diagnosed, but could not be confirmed histopathologically because the patient’s parent refused consent for biopsy. The patient was managed with fluid expansion, correction of acidosis, and improvement of microcirculation to prevent recurrence of syncope, and glucocorticoids were administered to prevent disease progression. PMID:26629237

  5. Electroacupuncture for treating insomnia in patients with cancer: a study protocol for a randomised pilot clinical trial.

    Science.gov (United States)

    Kim, Mikyung; Kim, Jung-Eun; Lee, Hye-Yoon; Kim, Ae-Ran; Park, Hyo-Ju; Kwon, O-Jin; Kim, Bo-Kyung; Cho, Jung Hyo; Kim, Joo-Hee

    2017-08-11

    Although insomnia is one of the most prevalent and disturbing symptoms among patients with cancer, it has not been properly managed. Electroacupuncture (EA) has received attention as a promising intervention for insomnia, and a few previous studies have reported that this intervention may be beneficial for treating insomnia in patients with cancer. The aim of this pilot study is to explore the feasibility and preliminary effectiveness of EA on the sleep disturbance of patients with cancer with insomnia using a subjective method, patient-reported questionnaires and an objective tool, actigraphy, to measure the quality of sleep. This is a study protocol for a randomised, three-arm, multicentre, pilot clinical trial. A total of 45 patients with cancer who have continuous insomnia related to cancer treatment or cancer itself will be randomly allocated to an EA group, sham EA group or usual care group in equal proportions. The EA group will receive 10 sessions of EA treatment over 4 weeks. The sham EA group will receive sham EA at non-acupoints using non-penetrating Streitberger acupuncture needles with mock EA. The usual care group will not receive EA treatment. All participants will be provided a brochure on the management of sleep disorders regardless of their group assignment. The primary outcome measure is the mean change in the insomnia severity index from the baseline to week 5. Information related to sleep quality will also be obtained through the Pittsburgh Sleep Quality Index, a sleep diary and actigraphy. Participants will complete the trial by visiting the research centre at week 9 for follow-up assessment. This study protocol was approved by the institutional review boards of each research centre. Written informed consent will be obtained from all participants. The result of this study will be published in peer-reviewed journals or presented at academic conferences. KCT0002162; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated

  6. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    van der Toorn, S.L.M.; Huizink, A.C.; Utens, E.M.W.J.; Verhulst, F.C.; Ormel, J.; Ferdinand, R.F.

    2010-01-01

    Maternal internalizing problems affect reporting of child’s problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child’s internalizing problems. The study sample

  7. Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression.

    Science.gov (United States)

    Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J; Gosling, John A; Thorndike, Frances P; Ritterband, Lee M; Glozier, Nick; Griffiths, Kathleen M

    2017-09-01

    Insomnia treatment using an internet-based cognitive-behavioural therapy for insomnia (CBT-I) program reduces depression symptoms, anxiety symptoms and suicidal ideation. However, the speed, longevity and consistency of these effects are unknown. To test the following: whether the efficacy of online CBT-I was sustained over 18 months; how rapidly the effects of CBT-I emerged; evidence for distinct trajectories of change in depressive symptoms; and predictors of these trajectories. A randomised controlled trial compared the 6-week Sleep Healthy Using the Internet (SHUTi) CBT-I program to an attention control program. Adults ( N =1149) with clinical insomnia and subclinical depression symptoms were recruited online from the Australian community. Depression, anxiety and insomnia decreased significantly by week 4 of the intervention period and remained significantly lower relative to control for >18 months (between-group Cohen's d =0.63, 0.47, 0.55, respectively, at 18 months). Effects on suicidal ideation were only short term. Two depression trajectories were identified using growth mixture models: improving (95%) and stable/deteriorating (5%) symptoms. More severe baseline depression, younger age and limited comfort with the internet were associated with reduced odds of improvement. Online CBT-I produced rapid and long-term symptom reduction in people with subclinical depressive symptoms, although the initial effect on suicidal ideation was not sustained. P.J.B. has received grants from the National Health and Medical Research Council (NHMRC) during the conduct of the study. H.C. has received grants from the NHMRC and the Australian Research Council during the conduct of the study. L.M.R. receives research funding from the National Institutes of Health (NIH) that, in part, focuses on insomnia. F.P.T. and L.M.R. have equity ownership in BeHealth Solutions (Charlottesville, VA, USA), a company that develops and makes available products related to the research reported

  8. Optimizing Sleep in Older Adults: Treating Insomnia

    OpenAIRE

    Wennberg, Alexandra M.; Canham, Sarah L.; Smith, Michael T.; Spira, Adam P.

    2013-01-01

    As the world’s population ages, the elevated prevalence of insomnia in older adults is a growing concern. Insomnia is characterized by difficulty falling or remaining asleep, or by non-restorative sleep, and resultant daytime dysfunction. In addition to being at elevated risk for primary insomnia, older adults are at greater risk for comorbid insomnia, which results from, or occurs in conjunction with another medical or psychiatric condition. In this review, we discuss normal changes in sleep...

  9. [Present status and future of hypnotic drug treatment for insomnia].

    Science.gov (United States)

    Uchiyama, Makoto; Konno, Michiko

    2012-07-01

    Pharmacological treatments of insomnia have become safer since the first benzodiazepine receptor agonist (BzRA) hypnotic was introduced in the 1960's. Though BzRAs could hardly cause a fatal condition even in cases of overdosing, they had inherited the arguments on addiction and withdrawal from the prior studies of barbiturate hypnotics that indicated they are strongly addictive. In the 2000s, it was repeatedly demonstrated that insomnia as well as sleep deprivation underlie the development and deterioration of comorbid diseases such as hypertension, cardiovascular diseases, diabetes and depression, and that the proper use of hypnotic drugs is unlikely to cause tolerance, addiction nor rebound phenomena, but likely to be associated with improvement of QOL. Thus, the 2005's consensus report on chronic insomnia by NIH has recommended general physicians to facilitate insomnia treatment to prevent the development of physical and/or mental disorders. The author reviewed in this article the efficacy and side effects of BzRA hypnotics, a hypnotic drug therapy combined with cognitive and behavioral interventions, uses of melatonin receptor agonist in general and sleep medicine practices, and future utilization of newly-developed orexin antagonists for insomnia treatment.

  10. Quality Measures for the Care of Patients with Insomnia

    Science.gov (United States)

    Edinger, Jack D.; Buysse, Daniel J.; Deriy, Ludmila; Germain, Anne; Lewin, Daniel S.; Ong, Jason C.; Morgenthaler, Timothy I.

    2015-01-01

    The American Academy of Sleep Medicine (AASM) commissioned five Workgroups to develop quality measures to optimize management and care for patients with common sleep disorders including insomnia. Following the AASM process for quality measure development, this document describes measurement methods for two desirable outcomes of therapy, improving sleep quality or satisfaction, and improving daytime function, and for four processes important to achieving these goals. To achieve the outcome of improving sleep quality or satisfaction, pre- and post-treatment assessment of sleep quality or satisfaction and providing an evidence-based treatment are recommended. To realize the outcome of improving daytime functioning, pre- and post-treatment assessment of daytime functioning, provision of an evidence-based treatment, and assessment of treatment-related side effects are recommended. All insomnia measures described in this report were developed by the Insomnia Quality Measures Workgroup and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with insomnia. Citation: Edinger JD, Buysse DJ, Deriy L, Germain A, Lewin DS, Ong JC, Morgenthaler TI. Quality measures for the care of patients with insomnia. J Clin Sleep Med 2015;11(3):311–334. PMID:25700881

  11. Insomnia and Personality-A Network Approach

    NARCIS (Netherlands)

    Dekker, Kim; Blanken, Tessa F; Van Someren, Eus J W

    2017-01-01

    Studies on personality traits and insomnia have remained inconclusive about which traits show the most direct associations with insomnia severity. It has moreover hardly been explored how traits relate to specific characteristics of insomnia. We here used network analysis in a large sample (N= 2089)

  12. Insomnia and Personality-A Network Approach

    NARCIS (Netherlands)

    Dekker, Kim; Blanken, Tessa F; Van Someren, Eus J W

    2017-01-01

    Studies on personality traits and insomnia have remained inconclusive about which traits show the most direct associations with insomnia severity. It has moreover hardly been explored how traits relate to specific characteristics of insomnia. We here used network analysis in a large sample (N =

  13. Long-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer.

    Science.gov (United States)

    Savard, Josée; Ivers, Hans; Savard, Marie-Hélène; Morin, Charles M

    2016-04-01

    The goal of this randomized controlled trial, conducted in breast cancer patients, was to assess the long-term efficacy of a video-based cognitive behavioral therapy for insomnia (VCBT-I), as compared to a professionally administered intervention (PCBT-I) and to a no-treatment group (CTL). An earlier report revealed that, at posttreatment, VCBT-I patients showed significantly greater sleep improvements than CTL, but that PCBT-I produced superior effects than VCBT-I on some sleep and secondary outcomes. In this report, long-term effects are compared. Two hundred forty-two women with breast cancer and with insomnia symptoms or using hypnotic medications participated to this three-arm randomized controlled trial: (1) PCBT-I (n = 81); (2) VCBT-I (n = 80); or (3) no treatment (CTL; n = 81) group. PCBT-I was composed of six weekly, individual sessions of approximately 50 min, whereas VCBT-I comprised a 60-min animated video and six booklets. Study measures (sleep and secondary variables) were administered at pretreatment and posttreatment, and at a 3-, 6-, and 12-mo follow-up. Treatment gains were well sustained at follow-up in both PCBT-I and VCBT-I. As at posttreatment, the remission rate of insomnia at follow-up was greater in PCBT-I than in VCBT-I, which was greater than in CTL. Although face-to-face therapy remains the optimal format to efficaciously administer CBT for insomnia in cancer patients, a minimal intervention, such as the video-based intervention tested in this study, produces significant and sustainable treatment effects. ClinicalTrials.gov identifier NCT00674830. © 2016 Associated Professional Sleep Societies, LLC.

  14. Increased Symptom Reporting in Young Athletes Based on History of Previous Concussions.

    Science.gov (United States)

    Moser, Rosemarie Scolaro; Schatz, Philip

    2017-01-01

    Research documents increased symptoms in adolescents with a history of two or more concussions. This study examined baseline evaluations of 2,526 younger athletes, ages 10 to 14. Between-groups analyses examined Post Concussion Symptom Scale symptoms by concussion history group (None, One, Two+) and clusters of Physical, Cognitive, Emotional, and Sleep symptoms. Healthy younger athletes with a concussion history reported greater physical, emotional, and sleep-related symptoms than those with no history of concussion, with a greater endorsement in physical/sleep symptom clusters. Findings suggest younger athletes with a history of multiple concussions may experience residual symptoms.

  15. Patient-reported symptoms during radiotherapy : Clinically relevant symptom burden in patients treated with palliative and curative intent.

    Science.gov (United States)

    Körner, Philipp; Ehrmann, Katja; Hartmannsgruber, Johann; Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael; van Oorschot, Birgitt

    2017-07-01

    The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom

  16. Patient-reported symptoms during radiotherapy. Clinically relevant symptom burden in patients treated with palliative and curative intent

    International Nuclear Information System (INIS)

    Koerner, Philipp; Ehrmann, Katja; Hartmannsgruber, Johann; Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael; Oorschot, Birgitt van

    2017-01-01

    The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom burden

  17. 针灸治疗慢性失眠的疗效研究%Study on the therapeutic effect of acupuncture on chronic insomnia

    Institute of Scientific and Technical Information of China (English)

    阮经文; 郑佩仪; 胡跃华

    2002-01-01

    Objective To evaluate therapeutic effect of acupuncture on chronic insomnia.Methods Head-acupuncture, galvano-acupuncture, and body acupuncture were used to treat the chronic insomnia. Statistical analysis was conducted therapeutic effect by using self-made Sleep Index Form(FormⅠ ) and the self-made clinical symptoms Form(FormⅡ ). Results P< 0.01. Therapeutic effect after treatment compared with that before treatment. Conclusion Acupuncture is effective in treating insomnia without obvious adverse effects.

  18. Medical Surveillance Monthly Report (MSMR). Volume 21, Number 10, October 2014

    Science.gov (United States)

    2014-10-01

    Rev. 2002; 6(2): 97–111. 5. M cLay RN, Klam WP, Volkert SL. Insomnia is the most commonly reported symptom and predicts other symptoms of post...eat a large meal close to bedtime. Also, empty your bladder before you go to bed, so that the urge to urinate does not disrupt your sleep. The

  19. Media use and insomnia after terror attacks in France.

    Science.gov (United States)

    Goodwin, Robin; Lemola, Sakari; Ben-Ezra, Menachem

    2018-03-01

    Direct exposure to traumatic events often precipitates sleep disorders. Sleep disturbance has also been observed amongst those indirectly exposed to trauma, via mass media. However, previous work has focused on traditional media use, rather than contemporary social media. We tested associations between both traditional and social media consumption and insomnia symptoms following 2015 terror attacks in Paris France, controlling for location and post-traumatic symptomology. 1878 respondents, selected to represent the national French population, completed an internet survey a month after the Bataclan attacks (response rate 72%). Respondents indicated different media use, post-traumatic stress and insomnia. Controlling for demographics, location and PTSD, insomnia was associated with both traditional (β 0.10, P = .001) and social media use (β 0.12, P = .001). Associations between social media and insomnia were independent of traditional media use. Interventions targeted at social media may be particularly important following mass trauma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Beyond symptom self-report: use of a computer "avatar" to assess post-traumatic stress disorder (PTSD) symptoms.

    Science.gov (United States)

    Myers, Catherine E; Radell, Milen L; Shind, Christine; Ebanks-Williams, Yasheca; Beck, Kevin D; Gilbertson, Mark W

    2016-11-01

    Post-traumatic stress disorder (PTSD) can occur in the wake of exposure to a traumatic event. Currently, PTSD symptoms are assessed mainly through self-report in the form of questionnaire or clinical interview. Self-report has inherent limitations, particularly in psychiatric populations who may have limited awareness of deficit, reduced attention span, or poor vocabulary and/or literacy skills. Diagnosis and evaluation of treatment efficacy would be aided by behavioral measures. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, a sample of 82 veterans, self-assessed for PTSD symptoms was administered such a task, in which the avatar was confronted with situations that might evoke avoidant behavior, a core feature of PTSD. Results showed a strong correlation between PTSD symptom burden and task performance; in fact, the ability to predict PTSD symptom burden based on simple demographic variables (age, sex, combat exposure) was significantly improved by adding task score as a predictor variable. The results therefore suggest that virtual environments may provide a new way to assess PTSD symptoms, while avoiding at least some of the limitations associated with symptom self-report, and thus might be a useful complement to questionnaire or clinical interview, potentially facilitating both diagnosis and evaluation of treatment efficacy.

  1. Determinan Insomnia pada Lanjut Usia

    Directory of Open Access Journals (Sweden)

    Andi Zulkifli Abdullah

    2012-11-01

    Full Text Available Insomnia merupakan gangguan tidur yang paling sering ditemukan pada lanjut usia (lansia dengan prevalensi sekitar 67%. Penelitian ini bertujuan untuk menilai hubungan antara kecemasan, depresi, dukungan keluarga, dan kondisi lingkungan dengan kejadian insomnia pada lansia di Panti Sosial Tresna Werdha Gau Mabaji Kabupaten Gowa. Penelitian ini menggunakan desain studi observasional dengan rancangan cross sectional dan metode exhausive sampling. Data dianalisis dengan uji chi square, koefisien phi (f dengan a = 0,05. Sebanyak 96 lansia penghuni panti memenuhi kriteria penelitian. Uji chi square menunjukkan bahwa terdapat hubungan antara kecemasan (nilai p = 0,014; f = 0,251, depresi (nilai p = 0,019; f = 0,238, dukungan keluarga (nilai p = 0,000; f = 0,797, dan kondisi lingkungan panti (nilai p < 0,05; f = 0,238 dengan kejadian insomnia. Pemberian penyuluhan kepada keluarga lansia adalah salah satu kegiatan yang penting dilakukan untuk meningkatkan pengetahuan keluarga lansia bahwa lansia tidak hanya sekadar diperhatikan kebutuhan fisiknya tetapi juga kebutuhan psikologisnya. Kata kunci: Depresi, insomnia, kecemasan Abstract Insomnia is sleep disorder, most often found on elderly with high prevalence about 67%. The aim of this research is to prove the relation between anxiousness, depression, family support, and environmental condition with the occurence of insomnia at old ages in social institution Tresna Werdha Gau Mabaji Gowa Regency. This research used an observasional study with cross sectional design, using the exhausive sampling method. Data were analysed by chi square test, phi coefficient with a = 0,05. About 96 elderly in social institution met the research criteria, chi square test indicates that there are relation between anxiousness (p value = 0,014; f = 0,251, depression (p value = 0,019; f = 0,238, family support (p value = 0,000; f = 0,797, and environmental condition of social institution (p value = 0,019; f = 0,238 with the

  2. Managing severe behavioral symptoms of a patient with anti-NMDAR encephalitis: case report and findings in current literature

    Directory of Open Access Journals (Sweden)

    Vanina Lima Monteiro

    2015-03-01

    Full Text Available Objective: Psychiatric symptoms emerge in the early stages of anti-N-methyl-D-aspartate receptor (anti-NMDAR encephalitis, and patients often seek treatment in psychiatric departments before visiting any other general medical services. Numerous articles about anti-NMDAR encephalitis have been published in the scientific community worldwide, but few emphasize the role of psychiatry in symptom management.Case description: We describe the case of a patient with anti- -NMDAR encephalitis seen in our service and discuss the management of behavioral symptoms based on current scientific literature. High doses of atypical antipsychotics and benzodiazepines were used to control agitation, and trazodone was administered to treat insomnia.Comments: Consultation-liaison psychiatry may help the healthcare team adjust the management of neuropsychiatric complications that might affect inpatients with anti-NMDAR encephalitis.

  3. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

    Science.gov (United States)

    Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

  4. Behavioral interventions for insomnia: Theory and practice.

    Science.gov (United States)

    Sharma, Mahendra P; Andrade, Chittaranjan

    2012-10-01

    Insomnia is a general clinical term that refers to a difficulty in initiating or maintaining sleep. Insomnia is widely prevalent in the general population, especially in the elderly and in those with medical and psychiatric disorders. Hypnotic drug treatments of insomnia are effective but are associated with potential disadvantages. This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches. These are briefly explained. Research indicates that behavioral interventions are efficacious, effective, and likely cost-effective treatments for insomnia that yield reliable, robust, and long-term benefits in adults of all ages. Detailed guidance is provided for the practical management of patients with insomnia.

  5. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Cokorda Istri Devi Larayanthi

    2013-04-01

    Full Text Available Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, general medical conditions, medications, certain substances, and others. Management of insomnia in geriatric patients were divided into 3 method: 1 manage underlying cause, 2 nonpharmacological therapies such as cognitive behavior therapy (CBT, and 3 pharmacological therapies such as benzodiazepine and non-benzodiazepine that eszopiclone and Ramelteon. Pharmacological treatment in geriatrics should follow the rule "start low, go slow", starting dose of ½ of the adult dose, and its use in the short term.

  6. The Heritability of Insomnia Progression during Childhood/Adolescence: Results from a Longitudinal Twin Study

    Science.gov (United States)

    Barclay, Nicola L.; Gehrman, Philip R.; Gregory, Alice M.; Eaves, Lindon J.; Silberg, Judy L.

    2015-01-01

    Study Objectives: To determine prevalence and heritability of insomnia during middle/late childhood and adolescence; examine longitudinal associations in insomnia over time; and assess the extent to which genetic and environmental factors on insomnia remain stable, or whether new factors come into play, across this developmental period. Design: Longitudinal twin study. Setting: Academic medical center. Patients or Participants: There were 739 complete monozygotic twin pairs (52%) and 672 complete dizygotic twin pairs (48%) initially enrolled and were followed up at three additional time points (waves). Mode ages at each wave were 8, 10, 14, and 15 y (ages ranged from 8–18 y). Interventions: None. Measurements and Results: Clinical ratings of insomnia symptoms were assessed using the Child and Adolescent Psychiatric Assessment (CAPA) by trained clinicians, and rated according to Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition—Revised criteria for presence of “clinically significant insomnia,” over four sequential waves. Insomnia symptoms were prevalent but significantly decreased across the four waves (ranging from 16.6% to 31.2%). “Clinically significant insomnia” was moderately heritable at all waves (h2 range = 14% to 38%), and the remaining source of variance was the nonshared environment. Multivariate models indicated that genetic influences at wave 1 contributed to insomnia at all subsequent waves, and that new genetic influences came into play at wave 2, which further contributed to stability of symptoms. Nonshared environmental influences were time-specific. Conclusion: Insomnia is prevalent in childhood and adolescence, and is moderately heritable. The progression of insomnia across this developmental time period is influenced by stable as well as new genetic factors that come into play at wave 2 (modal age 10 y). Molecular genetic studies should now identify genes related to insomnia progression during childhood and

  7. Severe insomnia is associated with hypertriglyceridemia in women with major depression treated in psychiatry settings.

    Science.gov (United States)

    Costemale-Lacoste, Jean-François; Trabado, Séverine; Verstuyft, Céline; El Asmar, Khalil; Butlen-Ducuing, Florence; Colle, Romain; Ferreri, Florian; Polosan, Mircea; Haffen, Emmanuel; Balkau, Beverley; Falissard, Bruno; Feve, Bruno; Becquemont, Laurent; Corruble, Emmanuelle

    2017-08-01

    Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

    Science.gov (United States)

    Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

    2013-01-01

    Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P insomnia at follow-up (P insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

  9. Retrospective, nonrandomized controlled study on autoadjusting, dual-pressure positive airway pressure therapy for a consecutive series of complex insomnia disorder patients

    Directory of Open Access Journals (Sweden)

    Krakow B

    2017-03-01

    Full Text Available Barry Krakow,1–3 Natalia D McIver,1,2 Victor A Ulibarri,1,2 Michael R Nadorff4,5 1Sleep & Human Health Institute, 2Maimonides Sleep Arts & Sciences, Ltd, Albuquerque, 3Los Alamos Medical Center, Los Alamos, NM, 4Department of Psychology, Mississippi State University, Mississippi, MS, 5Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA Purpose: Emerging evidence shows that positive airway pressure (PAP treatment of obstructive sleep apnea (OSA and upper airway resistance syndrome (UARS in chronic insomnia patients (proposed “complex insomnia” disorder leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients.Patients and methods: Chronic insomnia disorder patients (mean [SD] insomnia severity index [ISI] =19.11 [3.34] objectively diagnosed with OSA or UARS and using either autobilevel PAP device or adaptive servoventilation (ASV device after failing CPAP therapy (frequently due to intolerance to pressurized air, poor outcomes, or emergence of CSA were divided into PAP users (≥20 h/wk and partial users (<20 h/wk for comparison. Subjective and objective baseline and follow-up measures were analyzed.Results: Of the 302 complex insomnia patients, PAP users (n=246 averaged 6.10 (1.78 nightly hours and 42.71 (12.48 weekly hours and partial users (n=56 averaged 1.67 (0.76 nightly hours and 11.70 (5.31 weekly hours. For mean (SD decreases in total ISI scores, a significant (group × time interaction was observed (F[1,300]=13.566; P<0.0001 with PAP users (–7.59 [5.92]; d=1.63 showing superior results to partial users (-4.34 [6.13]; d=0.81. Anecdotally, patients reported better tolerability with advanced PAP

  10. Effectiveness of Cognitive Behavior Therapy on the Quality of Sleep in Elderly People With Insomnia Disorder

    Directory of Open Access Journals (Sweden)

    Reza Mottaghi

    2016-07-01

    Full Text Available Objectives: Taking into consideration the high prevalence of insomnia disorder in the elderly population, this study aims to examine the effectiveness of cognitive behavioral therapy (CBT in improving the overall quality of sleep and the subscales of sleep quality in the elderly. Methods & Materials: The present study employs experimental research design including 5000 elderly participants from the Jahandedehgan center in Shiraz, Iran. Based on the inclusion and exclusion criteria, a total of 44 subjects were selected randomly. After losing 7.85 percent of the participants, 39 subjects with the mean age of 68 years who were suffering from primary insomnia disorder were evaluated with Pittsburgh Sleep Quality Index (PSQI in addition to pretest, posttest, and follow-up tests. The intervention took place twice a week within a period of four weeks employing cognitive behavioral therapy based on the ESPIE commands. The SPSS 21 statistical software and covariance of single and multivariate analysis including (ANCOVA and MANCOVA were used to analyze the collected data. Results: The mean of the overall quality of sleep before and after the intervention in the experimental and control groups were reported to be 12.95 and 12.7, respectively, that later changed to 10.03 and 13.07 in the post-test, and 9.51 and 13.36 during the follow up after three months. From the statistical point of view, the mean of the overall quality of sleep after the intervention was noted to be significant at P<0.001. Conclusion: The present study showed that the cognitive behavioral therapy can enhance the overall quality of sleep and reduce the symptoms of insomnia disorder in the elderly people.

  11. Subjective insomnia is associated with low sleep efficiency and fatigue in middle-aged women.

    Science.gov (United States)

    Hirose, A; Terauchi, M; Akiyoshi, M; Owa, Y; Kato, K; Kubota, T

    2016-08-01

    Many middle-aged women are affected by sleep disturbance. We investigated how subjective insomnia is associated with objective sleep parameters and other background characteristics. This cross-sectional study used baseline data obtained from 95 women aged 40-59 years who participated in another study assessing the effects of a dietary supplement. Participants wore an actigraph unit for 3 days to collect information concerning physical activities and objective sleep parameters and were then evaluated for body composition, cardiovascular parameters, and menopausal symptoms including insomnia and fatigue, and lifestyle factors. Stratifying Athens Insomnia Scale scores as low (0-5 points, control group) and high (≥ 6 points, subjective insomnia group), we sought to identify the parameters that are independently associated with subjective insomnia. Women with subjective insomnia (n = 30) had lower sleep efficiency than did the controls. They were also older; had more live births, lower height, higher body mass index, lower ankle brachial index, and more severe menopausal symptoms including fatigue; took more naps; smoked more cigarettes; and more of them were full-time workers. Multivariate logistic regression analysis revealed that low sleep efficiency (adjusted odds ratio, 1.44 per 1% decrease in sleep efficiency; 95% confidence interval 1.06-2.05) and fatigue assessed with Brief Fatigue Inventory (BFI) (adjusted odds ratio, 1.57 per 1-point increase in BFI score; 95% confidence interval 1.19-2.13) were independent contributors to subjective insomnia. Low sleep efficiency and feeling of fatigue were found to be independently associated with subjective insomnia in middle-aged women.

  12. Sleep spindles may predict response to cognitive-behavioral therapy for chronic insomnia.

    Science.gov (United States)

    Dang-Vu, Thien Thanh; Hatch, Benjamin; Salimi, Ali; Mograss, Melodee; Boucetta, Soufiane; O'Byrne, Jordan; Brandewinder, Marie; Berthomier, Christian; Gouin, Jean-Philippe

    2017-11-01

    While cognitive-behavioral therapy for insomnia constitutes the first-line treatment for chronic insomnia, only few reports have investigated how sleep architecture relates to response to this treatment. In this pilot study, we aimed to determine whether pre-treatment sleep spindle density predicts treatment response to cognitive-behavioral therapy for insomnia. Twenty-four participants with chronic primary insomnia participated in a 6-week cognitive-behavioral therapy for insomnia performed in groups of 4-6 participants. Treatment response was assessed using the Pittsburgh Sleep Quality Index and the Insomnia Severity Index measured at pre- and post-treatment, and at 3- and 12-months' follow-up assessments. Secondary outcome measures were extracted from sleep diaries over 7 days and overnight polysomnography, obtained at pre- and post-treatment. Spindle density during stage N2-N3 sleep was extracted from polysomnography at pre-treatment. Hierarchical linear modeling analysis assessed whether sleep spindle density predicted response to cognitive-behavioral therapy. After adjusting for age, sex, and education level, lower spindle density at pre-treatment predicted poorer response over the 12-month follow-up, as reflected by a smaller reduction in Pittsburgh Sleep Quality Index over time. Reduced spindle density also predicted lower improvements in sleep diary sleep efficiency and wake after sleep onset immediately after treatment. There were no significant associations between spindle density and changes in the Insomnia Severity Index or polysomnography variables over time. These preliminary results suggest that inter-individual differences in sleep spindle density in insomnia may represent an endogenous biomarker predicting responsiveness to cognitive-behavioral therapy. Insomnia with altered spindle activity might constitute an insomnia subtype characterized by a neurophysiological vulnerability to sleep disruption associated with impaired responsiveness to

  13. Evaluation of the CAARS Infrequency Index for the Detection of Noncredible ADHD Symptom Report in Adulthood

    Science.gov (United States)

    Fuermaier, Anselm B. M.; Tucha, Lara; Koerts, Janneke; Weisbrod, Matthias; Grabemann, Marco; Zimmermann, Marco; Mette, Christian; Aschenbrenner, Steffen; Tucha, Oliver

    2016-01-01

    The reliance on self-reports in detecting noncredible symptom report of attention-deficit/hyperactivity disorder in adulthood (aADHD) has been questioned due to findings showing that symptoms can easily be feigned on self-report scales. In response, Suhr and colleagues developed an infrequency index for the Conners' Adult ADHD Rating Scale (CII)…

  14. The impact of personality on the reporting of unfounded symptoms and illness.

    Science.gov (United States)

    Feldman, P J; Cohen, S; Doyle, W J; Skoner, D P; Gwaltney, J M

    1999-08-01

    This study examined the role of personality in the reporting of symptoms and illness not supported by underlying pathology. After assessment of the Big Five personality factors, 276 healthy volunteers were inoculated with a common cold virus. On each of the following 5 days, objective indicators of pathology, self-reported symptoms, and self-reported illness onset were assessed. Neuroticism was directly associated with reports of unfounded (without a physiological basis) symptoms in individuals at baseline and postinoculation in those with and without colds. Neuroticism was also indirectly associated with reports of unfounded illness through reports of more symptoms. Openness to Experience was associated with reporting unfounded symptoms in those with verifiable colds, whereas Conscientiousness was associated with reporting unfounded illness in those who were not ill.

  15. A virtual sleepcoach for people suffering from insomnia

    NARCIS (Netherlands)

    Horsch, C.H.G.

    2016-01-01

    People suffering from insomnia have problems falling asleep or staying asleep. Insomnia impairs people’s daily life and their quality of life decreases. Approximately 10% of the population suffers from insomnia. The common treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I),

  16. Impact of Cabin Ozone Concentrations on Passenger Reported Symptoms in Commercial Aircraft

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Allen, Joseph G.; Weschler, Charles J.

    2015-01-01

    relatively low (median: 9.5 ppb). On thirteen flights (16%) ozone levels exceeded 60 ppb, while the highest peak level reached 256 ppb for a single flight. The most commonly reported symptoms were dry mouth or lips (26%), dry eyes (22.1%) and nasal stuffiness (18.9%). 46% of passengers reported at least one...... symptom related to the eyes or mouth. A third of the passengers reported at least one upper respiratory symptom. Using multivariate logistic (individual symptoms) and linear (aggregated continuous symptom variables) regression, ozone was consistently associated with symptoms related to the eyes...... and certain upper respiratory endpoints. A concentration-response relationship was observed for nasal stuffiness and eye and upper respiratory symptom indicators. Average ozone levels, as opposed to peak concentrations, exhibited slightly weaker associations. Medium and long duration flights were...

  17. Full Spectrum of Reported Symptoms of Bilateral Vestibulopathy Needs Further Investigation—A Systematic Review

    Directory of Open Access Journals (Sweden)

    Florence Lucieer

    2018-06-01

    Full Text Available ObjectiveTo systematically review the symptoms reported by patients with bilateral vestibulopathy (BV in clinical studies and case reports. This would serve as the first step in establishing a validated patient-reported outcome measures (PROM for BV.MethodsA search on symptoms reported by patients with BV was performed in PubMed, and all publications covering these symptoms were included. Exclusion criteria comprised reviews and insufficient details about the frequency of occurrence of symptoms.Results1,442 articles were retrieved. 88 studies were included (41 clinical studies, 47 case reports. In consensus, 68 descriptions of symptoms were classified into 6 common and generic symptoms. Frequency of symptoms in clinical studies and case reports were reviewed, respectively; imbalance (91 and 86%, chronic dizziness (58 and 62%, oscillopsia (50 and 70%, and recurrent vertigo (33 and 67%. BV could be accompanied by hearing loss (33 and 43% and tinnitus (15 and 36%. 15 clinical studies and 10 case reports reported symptoms beyond vestibular and hearing deficits such as limited social activities, depression, concentration, and memory impairment and reduced quality of life in general.ConclusionThe literature on BV symptomatology mainly focuses on classic symptoms such as imbalance and oscillopsia, while only few report additional symptoms such as cognitive memory impairment and performing dual tasks. In fact, none of the reviewed clinical studies and case reports provided a comprehensive overview of BV symptoms. To develop a validated PROM, qualitative research using semi-structured and unstructured interviews is needed to explore the full spectrum of BV symptoms.

  18. The exploratory power of sleep effort, dysfunctional beliefs and arousal for insomnia severity and polysomnography-determined sleep.

    Science.gov (United States)

    Hertenstein, Elisabeth; Nissen, Christoph; Riemann, Dieter; Feige, Bernd; Baglioni, Chiara; Spiegelhalder, Kai

    2015-08-01

    Differences between subjective sleep perception and sleep determined by polysomnography (PSG) are prevalent, particularly in patients with primary insomnia, indicating that the two measures are partially independent. To identify individualized treatment strategies, it is important to understand the potentially different mechanisms influencing subjective and PSG-determined sleep. The aim of this study was to investigate to what extent three major components of insomnia models, i.e., sleep effort, dysfunctional beliefs and attitudes about sleep, and presleep arousal, are associated with subjective insomnia severity and PSG-determined sleep. A sample of 47 patients with primary insomnia according to DSM-IV criteria and 52 good sleeper controls underwent 2 nights of PSG and completed the Glasgow Sleep Effort Scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale, the Pre-Sleep Arousal Scale and the Insomnia Severity Index. Regression analyses were conducted to investigate the impact of the three predictors on subjective insomnia severity and PSG- determined total sleep time. All analyses were adjusted for age, gender, depressive symptoms and group status. The results showed that subjective insomnia severity was associated positively with sleep effort. PSG-determined total sleep time was associated negatively with somatic presleep arousal and dysfunctional beliefs and attitudes about sleep. This pattern of results provides testable hypotheses for prospective studies on the impact of distinct cognitive and somatic variables on subjective insomnia severity and PSG-determined total sleep time. © 2015 European Sleep Research Society.

  19. Group cognitive behavioural therapy for insomnia: Effects on sleep and depressive symptomatology in a sample with comorbidity.

    Science.gov (United States)

    Norell-Clarke, Annika; Jansson-Fröjmark, Markus; Tillfors, Maria; Holländare, Fredrik; Engström, Ingemar

    2015-11-01

    To investigate the effects of group CBT for insomnia (CBT-I) on insomnia and depressive symptomatology in a comorbid sample through a randomised controlled trial with a 6 month follow-up. 64 participants were recruited through advertisements and randomised to receive CBT-I or an active control (relaxation training: RT) during four group sessions. Insomnia Severity Index and BDI-II were the primary outcome measures, assessed pre-treatment, post-treatment and at 6 month follow-up. Insomnia and depressive diagnoses, and functional impairment were assessed before and after treatment, whereas sleep diary data was gathered continuously from one week before treatment until after treatment. CBT-I was more efficient than RT in reducing insomnia severity and equally effective in reducing depressive symptoms, although CBT-I was associated with a higher proportion of remitted persons than RT, regarding both insomnia and depression diagnoses. Also, CBT-I was associated with less functional impairment, shorter sleep onset latency and wake after sleep onset but both treatments had equal improvements of sleep quality, early morning awakenings and total sleep time. Group CBT-I is an efficient form of insomnia-treatment for people with insomnia comorbid with depressive symptomatology. The mixed results regarding depression outcomes warrants replication and further studies into treatment mechanisms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. The caudate : a key node in the neuronal network imbalance of insomnia?

    NARCIS (Netherlands)

    Stoffers, Diederick; Altena, Ellemarije; van der Werf, Ysbrand D; Sanz-Arigita, Ernesto J; Voorn, Thom A; Astill, Rebecca G; Strijers, Rob L M; Waterman, Dé; Van Someren, Eus J W

    Insomnia is prevalent, severe and partially heritable. Unfortunately, its neuronal correlates remain enigmatic, hampering the development of mechanistic models and rational treatments. Consistently reported impairments concern fragmented sleep, hyper-arousal and executive dysfunction. Because

  1. The caudate: a key node in the neuronal network imbalance of insomnia?

    NARCIS (Netherlands)

    Stoffers, D.; Altena, E.; van der Werf, Y.D.; Sanz-Arigita, E.J.; Voorn, T.A.; Astill, R.G.; Strijers, R.L.M.; Waterman, D.; van Someren, E.J.W.

    2014-01-01

    Insomnia is prevalent, severe and partially heritable. Unfortunately, its neuronal correlates remain enigmatic, hampering the development of mechanistic models and rational treatments. Consistently reported impairments concern fragmented sleep, hyper-arousal and executive dysfunction. Because

  2. Clinical Observation on Intractable Insomnia Treated by Point Pressure in 42 Cases

    Institute of Scientific and Technical Information of China (English)

    张庆萍

    2002-01-01

    @@ The author have in recent years treated 42 cases of intractable insomnia (with a history of over 2 years) by point pressure, yielding quite satisfactory results when compared with those treated with clonazepam. This is reported as follows.

  3. Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia.

    Science.gov (United States)

    Dong, Lu; Soehner, Adriane M; Bélanger, Lynda; Morin, Charles M; Harvey, Allison G

    2018-03-01

    Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  4. Associação entre sintomas de insônia, cochilo diurno e quedas em idosos da comunidade Asociación entre síntomas de insomnio, siesta breve diurna y caídas en ancianos de una comunidad desfavorecida Association between insomnia symptoms, daytime napping, and falls in community-dwelling elderly

    Directory of Open Access Journals (Sweden)

    Anita Liberalesso Neri

    2013-03-01

    Full Text Available Essa pesquisa investigou associações entre sintomas de insônia, cochilo diurno, e quedas em idosos da comunidade. Estudo transversal de base populacional e amostra probabilística envolvendo 689 idosos da comunidade. O protocolo continha variáveis de autorrelato e de desempenho físico. Foi utilizada a análise de regressão logística univariada e multivariada, e o nível de significância estatística adotado foi de p 80 anos (OR = 3,48; IC95%: 1,54-7,85, cochilo diurno (OR = 2,24; IC95%: 1,24-4,05 e sintomas depressivos (OR = 1,98; IC95%: 1,11-3,53. A associação entre cochilo diurno e quedas replicam dados de pesquisa internacional. Identificar fatores de risco modificáveis pode auxiliar programas de prevenção de quedas.Esta investigación se centró en las asociaciones entre síntomas de insomnio, siesta breve diurna, y caídas en ancianos de una comunidad desfavorecida. Estudio transversal de base poblacional y muestreo probabilístico involucrando a 689 ancianos de una comunidad desfavorecida. El protocolo contenía variables de autorrelato y de desempeño físico. Se utilizó un análisis de regresión logística univariada y multivariada, y el nivel de significancia estadística adoptado fue de p 80 años (OR = 3,48; IC95%: 1,54-7,85, siesta breve diurna (OR = 2,24; IC95%: 1,24-4,05 y síntomas depresivos (OR = 1,98; IC95%: 1,11-3,53. La asociación entre siesta breve diurna y caídas replican datos de investigaciones internacionales. Identificar factores de riesgo modificables pueden auxiliar en programas de prevención de caídas.This study focused on associations between insomnia symptoms, daytime napping, and falls in community-dwelling elderly, using a population-based cross-sectional design and probability sample with 689 community-dwelling elders. The protocol consisted of self-reported and physical performance variables. The study used univariate and multivariate logistic regression analysis with statistical significance

  5. Insomnia and hallucinations in the general population: Findings from the 2000 and 2007 British Psychiatric Morbidity Surveys.

    Science.gov (United States)

    Sheaves, Bryony; Bebbington, Paul E; Goodwin, Guy M; Harrison, Paul J; Espie, Colin A; Foster, Russell G; Freeman, Daniel

    2016-07-30

    Insomnia is common in people experiencing psychosis. It has been identified as a contributory cause of paranoia, but any causal relationship with hallucinations has yet to be established. We tested the hypotheses that insomnia i) has a cross-sectional association with hallucinations ii) predicts new inceptions of hallucinations and iii) that these associations remain after controlling for depression, anxiety, and paranoia. Data from the second (2000, N=8580) and third (2007, N=7403) British Psychiatric Morbidity Surveys were used to assess cross-sectional associations between insomnia and hallucinations. The 2000 dataset included an 18 month follow up of a subsample (N=2406) used to test whether insomnia predicted new inceptions of hallucinations. Insomnia was associated with hallucinations in both cross-sectional datasets. Mild sleep problems were associated with 2-3 times greater odds of reporting hallucinations, whilst chronic insomnia was associated with four times greater odds. Insomnia was also associated with increased odds of hallucinations occurring de novo over the next 18 months. These associations remained significant, although with smaller odds ratios, after controlling for depression, anxiety and paranoia. This is the first longitudinal evidence that insomnia is associated with the development of hallucinatory experiences. Effective treatment of insomnia may lessen the occurrence of hallucinations. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  6. Mobile Devices and Insomnia: Understanding Risks and Benefits.

    Science.gov (United States)

    Khan, Mohammed N; Nock, Rebecca; Gooneratne, Nalaka S

    2015-12-01

    Mobile devices (smartphones and tablet computers) have become widely prevalent due to rapid improvements in function and decreasing costs. As of 2014, 90 % of US adults have a mobile phone, with 58 % having a smartphone, 32 % owning some type of e-reader, and 42 % of US adults owning a tablet computer. Mobile devices are particularly well-suited for the study of common conditions such as sleep difficulties because of their ubiquity. Around 35 to 49 % of the US adult population have problems falling asleep or have daytime sleepiness. These sleep disorders are often under-recognized because of patient-physician communication difficulties, low rates of medical awareness resulting in underreporting of insomnia symptoms, and limited primary care physician (PCP) training in insomnia recognition. Mobile devices have the potential to bridge some of these gaps, but they can also lead to sleep difficulties when used inappropriately.

  7. Chronic insomnia cases detection with the help of Athens Insomnia Scale and SF-36 health survey

    Science.gov (United States)

    Wasiewicz, P.; Skalski, M.; Fornal-Pawlowska, Malgorzata

    2011-10-01

    Standardization of the diagnostic process of insomnia is a highly important task in clinical practice, epidemiological considerations and treatment outcomes assessment. In this paper we describe standard surveys relationships within cluster groups with the same insomnia degrees.

  8. Long-term safety and efficacy of ramelteon in Japanese patients with chronic insomnia.

    Science.gov (United States)

    Uchiyama, Makoto; Hamamura, Misako; Kuwano, Tomoaki; Nagata, Hiroshi; Hashimoto, Takamasa; Ogawa, Atsushi; Uchimura, Naohisa

    2011-02-01

    To evaluate the safety of ramelteon, a highly selective MT₁/MT₂ melatonin receptor agonist, during 24 weeks' treatment of Japanese patients with chronic insomnia. In a single-blind, flexible-titration, multicenter study incorporating placebo run-in and run-out periods, 190 adults with chronic insomnia received ramelteon 4 or 8 mg, titrated up to 16 mg if necessary, for 24 weeks. Primary endpoints included adverse events, residual effects, rebound insomnia, withdrawal symptoms, and dependence. Secondary endpoints included subjective sleep latency and total sleep time. Drug-related adverse events occurred in 11.6% of patients. No clinically important changes occurred in biochemical, hematological or endocrine parameters. There were no signs of next-day residual effect, rebound insomnia, withdrawal symptoms or dependence. Mean subjective sleep latency decreased significantly, and total sleep time increased significantly; both reached a plateau by week 20 and were sustained thereafter (Pinsomnia and did not cause deterioration of efficacy, residual effects, rebound insomnia, withdrawal symptoms, or dependence after 24 weeks' treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Employment type, workplace interpersonal conflict, and insomnia: a cross-sectional study of 37,646 employees in Japan.

    Science.gov (United States)

    Sakurai, Kenji; Nakata, Aknori; Ikeda, Tomoko; Otsuka, Yasumasa; Kawahito, Junko

    2014-01-01

    This study explored whether workplace interpersonal conflict (WIC) is associated with insomnia, and whether the relationship between WIC and insomnia differs across different employment groups. A total of 37,646 Japanese full-time employees participated in a cross-sectional survey. Employment types included permanent employment and 2 forms of temporary employment: direct-hire and temporary work agent (TWA). Insomnia symptoms, including difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening were measured. Insomnia was defined as having experienced 1 or more of these symptoms on ≥3 nights per week over the past 12 months. Results showed that WIC was significantly associated with an increased risk of insomnia (odds ratio OR = 1.63; 95% confidence interval CI = 1.55-1.71), controlling for confounders. However, the relationship between WIC and the risk of insomnia was significantly stronger for TWAs than for permanent employees (OR = 1.97; 95% CI = 1.13-3.45). A frequent exposure to WIC may increase the risk of insomnia, particularly for TWAs.

  10. Alcohol use, anxiety, and insomnia in older adults with generalized anxiety disorder

    Science.gov (United States)

    Ivan, M. Cristina; Amspoker, Amber B.; Nadorff, Michael R.; Kunik, Mark E.; Cully, Jeffrey A.; Wilson, Nancy; Calleo, Jessica; Kraus-Schuman, Cynthia; Stanley, Melinda A.

    2013-01-01

    Objectives We examined the presence and frequency of alcohol consumption among older primary care patients with generalized anxiety disorder (GAD) and their relation to demographic variables, insomnia, worry, and anxiety. We expected alcohol-use distribution to be similar to previous reports and alcohol use to be associated with higher anxiety and insomnia. A third aim was to examine the moderating role of alcohol use on the relation between anxiety and insomnia. We expected alcohol use to worsen the relation between anxiety and insomnia. Design Baseline data from a randomized controlled trial Sample 223 patients, age 60 and older, with DSM-IV GAD diagnoses Setting Patients were recruited through internal medicine, family practice, and geriatric clinics at 2 diverse healthcare settings: Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine. Measurements Measures addressed alcohol use (presence and frequency); insomnia (Insomnia Severity Index); self-reported worry severity (Penn State Worry Questionnaire − Abbreviated); clinician-rated worry severity (Generalized Anxiety Disorder Severity Scale); self-reported anxiety severity (State-Trait Anxiety Inventory - Trait); and clinician-rated anxiety (Structured Interview Guidelines for the Hamilton Anxiety Rating Scale). Results Most patients endorsed alcohol use in the past month, but overall weekly frequency was low. Presence and frequency of use among patients with GAD were greater than in prior reports of primary care samples. Alcohol use among patients with GAD was associated with higher education and female gender. Higher education also was associated with more drinks per week, and Caucasians reported more drinks per week than African Americans. Alcohol use was associated with less severe insomnia, lower self-reported anxiety, and less clinician-rated worry and anxiety. More drinks per week were associated with lower clinician-rated anxiety. Moderation analyses revealed lower

  11. Prison life: television, sports, work, stress and insomnia in a remand prison.

    Science.gov (United States)

    Elger, Bernice S

    2009-01-01

    To compare how prisoners complaining of insomnia and prisoners without sleep problems describe their daily activities, stress factors and the perceived reasons for their sleep quality in prison. 102 randomly chosen remanded prisoners complaining of insomnia and 61 randomly chosen prisoners who did not complain of insomnia. Prisoners complaining of insomnia and those reporting good sleep differed significantly in their lifestyle in prison. A significantly higher percentage of the former than of the latter reported writing letters, diaries or a book in prison, as well as doing "arts-related" activities such as painting and listening to music. A significantly higher percentage of non insomniac prisoners than of prisoners complaining of insomnia practiced sports in prison, watched television, and spent their day discussing and meeting other detainees. PSQI and GHQ scores were significantly different between insomniac and non insomniac prisoners. Insomniac prisoners complained significantly more often than non-insomniac prisoners about sleep disturbances, in the first place by roommates, but also by guards. Activities in prison and stressful events were significant factors associated with the variable "insomnia versus no insomnia" Worries about medical problems (odds ratio: 12.9), being separated or divorced (odds ratio: 8.8), having experienced stressful events during the past week (odds ratio: 8.7), "art" activity (odds ratio: 8.6), and having a GHQ score>10 (odds ratio: 7.7) had the highest odds ratios among the tested covariates. No sports in prison and some activities were also predictors of insomnia when entered separately or conditionally. Our study provides arguments on how to alleviate insomnia in prison: changing conditions of imprisonment is of public health benefit. Increased opportunities to practice sports in prison as well as adequate care for medical problems and psychological support to reduce context related stress should be routinely offered to

  12. Brief Report: Autism Symptoms in Infants with Fragile X Syndrome

    Science.gov (United States)

    Roberts, Jane E.; Tonnsen, Bridgette L.; McCary, Lindsay M.; Caravella, Kelly E.; Shinkareva, Svetlana V.

    2016-01-01

    Fragile X syndrome (FXS) is the most common known genetic cause of autism spectrum disorder (ASD). Although 50-75% of children with FXS meet ASD criteria, no studies have compared ASD symptoms in infants with FXS versus other high risk groups, such as siblings of children with ASD (ASIBs). Using the Autism Observation Scale for Infants, our…

  13. A Cross-Cultural Study of Self-Report Depressive Symptoms among College Students.

    Science.gov (United States)

    Crittenden, Kathleen S.; And Others

    1992-01-01

    A study of self-report depressive symptoms measured by the Zung Self-Rating Depression Scale was conducted in Korea, the Philippines, Taiwan, and the United States with 953 college students. There are marked differences among countries in symptoms reported. Research designs and measurement strategies for cross-cultural research are discussed. (SLD)

  14. Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety

    Directory of Open Access Journals (Sweden)

    Julie Kristine Aasvik

    2015-09-01

    Full Text Available Abstract: Objective: The aim of this study was to identify symptoms associated with subjective memory complaints among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety and insomnia. Methods: This was a cross-sectional study, subjects (n = 167 who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index and Everyday Memory Questionnaire – Revised. General linear modeling (GLM was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value <= 0.001 and anxiety (p-value = 0.001 were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice.

  15. NEEDLING BODY ACUPOINTS COMBINED WITH OTOPOINT-PELLET PRESSING THERAPY FOR TREATMENT OF 43 CASES OF INSOMNIA

    Institute of Scientific and Technical Information of China (English)

    王英; 郭喜军

    2001-01-01

    Insomnia is characterized by difficulty in falling asleep, being liable to wake up during sleep, and even being unable to sleep during whole night. The author of the present paper employed body aeupoints combined with otopoint-pellet pressing to treat insomnia and achieved satisfactory results. Here is the report.

  16. The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y M; Sohng, K Y [Kangwon Tourism College, Kangwon-Do (Republic of Korea). Department of Nursing

    2005-12-15

    The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

  17. [The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis].

    Science.gov (United States)

    Lee, Young-Mee; Sohng, Kyeong-Yae

    2005-12-01

    The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

  18. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, J

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  19. Symptoms and side effects in chronic non-cancer pain:patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, Jette

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  20. Transient insomnia versus chronic insomnia: a comparison study of sleep-related psychological/behavioral characteristics.

    Science.gov (United States)

    Yang, Chien-Ming; Lin, Shih-Chun; Cheng, Chung-Ping

    2013-10-01

    Vulnerability to transient insomnia is regarded as a predisposing factor for chronic insomnia. However, most individuals with transient insomnia do not develop chronic insomnia. The current study investigated the differential contributing factors for these two conditions to further the understanding of this phenomenon. Chronic insomnia patients and normal sleepers with high and low vulnerability to transient insomnia completed measures of pre-sleep arousal, dysfunctional sleep beliefs, and sleep-related safety behaviors. Both cognitive and somatic pre-sleep arousals were identified as significant predictors for transient insomnia. Dysfunctional beliefs regarding worry about insomnia and cognitive arousal were predictors for chronic insomnia. Sleep-related safety behavior, although correlated with insomnia severity, was not a significant predictor for both conditions. Dysfunctional beliefs associated with worry and losing control over sleep are the most critical factors in differentiating chronic insomnia from transient insomnia. These factors should be addressed to help prevent individuals with high sleep vulnerability from developing chronic sleep disturbance. © 2013 Wiley Periodicals, Inc.

  1. Associations between reporting of cancer alarm symptoms and socioeconomic and demographic determinants

    DEFF Research Database (Denmark)

    Svendsen, Rikke Pilsgaard; Paulsen, Maja Skov; Larsen, Pia Veldt

    2012-01-01

    ABSTRACT: BACKGROUND: Reporting of symptoms which may signal cancer is the first step in the diagnostic pathway of cancer diseases. Cancer alarm symptoms are common in the general population. Public awareness and knowledge of cancer symptoms are sparse, however, and many people do not seek medical...... help when having possible cancer symptoms. As social inequality is associated with cancer knowledge, cancer awareness, and information-seeking, our hypothesis is that social inequality may also exist in the general population with respect to reporting of cancer alarm symptoms. The aim of this study...... was to investigate possible associations between socioeconomic and demographic determinants and reporting of common cancer alarm symptoms. METHODS: A cross-sectional questionnaire survey was performed based on a stratified sample of the Danish general population. A total of 13 777 randomly selected persons aged 20...

  2. "Stomach Insomnia"on the pathogenesis of insomnia%“胃不和则卧不安”的失眠病机浅论

    Institute of Scientific and Technical Information of China (English)

    谭丽进; 李海元

    2014-01-01

    大量文献对“胃不和则卧不安”进行了诸多的论述,文章就其在失眠病症的一些病机予浅论,希望能为临床中的失眠病症诊疗有一定的指导作用。%Extensive literature on "Stomach Insomnia" had a lot of discussion, this paper discusses the pathogenesis of some sleep disorders, hoping for the clinical treatment of insomnia symptoms have some guidance.

  3. Reporting of symptoms in randomized controlled trials of atopic eczema treatments: a systematic review.

    Science.gov (United States)

    Gerbens, L A A; Chalmers, J R; Rogers, N K; Nankervis, H; Spuls, P I

    2016-10-01

    'Symptoms' is a core outcome domain for atopic eczema (AE) trials, agreed by consensus as part of the Harmonising Outcome Measures for Eczema (HOME) initiative. To standardize and validate the core domain symptoms and symptom instruments for AE trials the HOME roadmap is followed. Its first step is to establish if and how symptoms have been measured in published AE treatment trials. Therefore the Global Resource for Eczema Trials database was used to collect all randomized controlled trials (RCTs) of treatments for AE between January 2000 and April 2014. Study selection and data extraction were performed by three reviewers independently. We identified the use of symptoms in 295 of 378 trials (78%). Symptoms as a primary end point were applied by 147 RCTs (50%). Seventeen different symptoms were measured, but mostly itch and sleep loss. Symptoms were assessed by only 37% of trials by a stand-alone symptom measurement. Overall 63% of RCTs used a composite instrument, and 30 different instruments were identified. The Scoring Atopic Dermatitis (SCORAD) index was the most commonly applied, but only 23% of RCTs reported the SCORAD symptom score separately. This systematic review demonstrates that symptoms, most frequently itch and sleep loss, are commonly reported in AE treatment trials, but are measured using many different instruments. Often symptoms are evaluated as part of a composite instrument, and currently it is not possible to extract symptoms-only data from most published studies. Future trials should report symptom scores to permit meta-analysis of the core outcomes. © 2016 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

  4. Profile of suvorexant in the management of insomnia

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    Sutton EL

    2015-11-01

    Full Text Available Eliza L Sutton Department of Medicine, University of Washington, Seattle, WA, USA Abstract: Suvorexant, approved in late 2014 in the United States and Japan for the treatment of insomnia characterized by difficulty achieving and/or maintaining sleep, is a dual orexin receptor antagonist and the first drug in its class to reach the market. Its development followed from the 1998 discovery of orexins (also called hypocretins, excitatory neuropeptides originating from neurons in the hypothalamus involved in regulation of sleep and wake, feeding behavior and energy regulation, motor activity, and reward-seeking behavior. Suvorexant objectively improves sleep, shortening the time to achieve persistent sleep and reducing wake after sleep onset, although at approved doses (≤20 mg the benefit was subjectively assessed as modest. Its half-life of 12 hours is relatively long for a modern hypnotic; however, at approved doses (≤20 mg next-day sedation and driving impairment were much less apparent than at higher doses. Suvorexant is metabolized by the hepatic CYP3A system and should be avoided in combination with strong CYP3A inhibitors. Drug levels are higher in women and obese people; hence, dosing should be conservative in obese women. Administration with food delays drug absorption and is not advised. No dose adjustment is needed for advanced age, renal impairment, or mild-to-moderate hepatic impairment. Suvorexant in contraindicated in narcolepsy and has not been studied in children. In alignment with the changes begun in 2013 in the labeling of other hypnotics, the United States Food and Drug Administration advises that the lowest dose effective to treat symptoms be used and that patients be advised of the possibility of next-day impairment in function, including driving. Infrequent but notable side effects included abnormal dreams, sleep paralysis, and suicidal ideation that were dose-related and reported to be mild. Given its mechanism of

  5. Moderators and Mediators of the Relationship Between Stress and Insomnia: Stressor Chronicity, Cognitive Intrusion, and Coping

    Science.gov (United States)

    Pillai, Vivek; Roth, Thomas; Mullins, Heather M.; Drake, Christopher L.

    2014-01-01

    Study Objectives: To assess moderators, such as stressor chronicity, and mediators, including stress response in the form of cognitive intrusion and coping behavior, of the prospective association between naturalistic stress and incident insomnia. Design: Longitudinal. Setting: Epidemiological. Participants: A community-based sample of good sleepers (n = 2,892) with no lifetime history of insomnia. Interventions: None. Measurements and Results: Participants reported the number of stressful events they had encountered at baseline, as well as the perceived severity and chronicity of each event. Similarly, volitional stress responses such as coping, as well as more involuntary responses such as cognitive intrusion were assayed for each stressor. Follow-up assessment 1 y hence revealed an insomnia incidence rate of 9.1%. Stress exposure was a significant predictor of insomnia onset, such that the odds of developing insomnia increased by 19% for every additional stressor. Chronicity significantly moderated this relationship, such that the likelihood of developing insomnia as a result of stress exposure increased as a function of chronicity. Cognitive intrusion significantly mediated the association between stress exposure and insomnia. Finally, three specific coping behaviors also acted as mediators: behavioral disengagement, distraction, and substance use. Conclusions: Most studies characterize the relationship between stress exposure and insomnia as a simple dose-response phenomenon. However, our data suggest that certain stressor characteristics significantly moderate this association. Stress response in the form of cognitive intrusion and specific maladaptive coping behaviors mediate the effects of stress exposure. These findings highlight the need for a multidimensional approach to stress assessment in future research and clinical practice. Citation: Pillai V, Roth T, Mullins HM, Drake CL. Moderators and mediators of the relationship between stress and insomnia

  6. How Hyperarousal and Sleep Reactivity Are Represented in Different Adult Age Groups: Results from a Large Cohort Study on Insomnia.

    Science.gov (United States)

    Altena, Ellemarije; Chen, Ivy Y; Daviaux, Yannick; Ivers, Hans; Philip, Pierre; Morin, Charles M

    2017-04-14

    Hyperarousal is a 24-h state of elevated cognitive and physiological activation, and is a core feature of insomnia. The extent to which sleep quality is affected by stressful events-so-called sleep reactivity-is a vulnerability factor for developing insomnia. Given the increasing prevalence of insomnia with age, we aimed to investigate how hyperarousal and sleep reactivity were related to insomnia severity in different adult age groups. Data were derived from a large cohort study investigating the natural history of insomnia in a population-based sample ( n = 1693). Baseline data of the Arousal Predisposition Scale (APS) and Ford Insomnia Response to Stress Test (FIRST) were examined across age and sleep/insomnia subgroups: 25-35 ( n = 448), 35-45 ( n = 528), and 45-55 year olds ( n = 717); good sleepers ( n = 931), individuals with insomnia symptoms ( n = 450), and individuals with an insomnia syndrome ( n = 312). Results from factorial analyses of variance (ANOVA) showed that APS scores decreased with increasing age, but increased with more severe sleep problems. FIRST scores were not significantly different across age groups, but showed the same strong increase as a function of sleep problem severity. The findings indicate that though arousal predisposition and sleep reactivity increase with more severe sleep problems, only arousal decreases with age. How arousing events affect an individual during daytime thus decreases with age, but how this arousal disrupts sleep is equivalent across different adult age groups. The main implication of these findings is that treatment of insomnia could be adapted for different age groups and take into consideration vulnerability factors such as hyperarousal and stress reactivity.

  7. Sleep patterns and insomnia among adolescents: a population-based study.

    Science.gov (United States)

    Hysing, Mari; Pallesen, Ståle; Stormark, Kjell M; Lundervold, Astri J; Sivertsen, Børge

    2013-10-01

    The aim of the current study was to examine sleep patterns and rates of insomnia in a population-based study of adolescents aged 16-19 years. Gender differences in sleep patterns and insomnia, as well as a comparison of insomnia rates according to DSM-IV, DSM-V and quantitative criteria for insomnia (Behav. Res. Ther., 41, 2003, 427), were explored. We used a large population-based study in Hordaland county in Norway, conducted in 2012. The sample included 10,220 adolescents aged 16-18 years (54% girls). Self-reported sleep measurements included bedtime, rise time, time in bed, sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, rate and frequency and duration of difficulties initiating and maintaining sleep and rate and frequency of tiredness and sleepiness. The adolescents reported short sleep duration on weekdays (mean 6:25 hours), resulting in a sleep deficiency of about 2 h. A majority of the adolescents (65%) reported sleep onset latency exceeding 30 min. Girls reported longer sleep onset latency and a higher rate of insomnia than boys, while boys reported later bedtimes and a larger weekday-weekend discrepancy on several sleep parameters. Insomnia prevalence rates ranged from a total prevalence of 23.8 (DSM-IV criteria), 18.5 (DSM-V criteria) and 13.6% (quantitative criteria for insomnia). We conclude that short sleep duration, long sleep onset latency and insomnia were prevalent in adolescents. This warrants attention as a public health concern in this age group. © 2013 European Sleep Research Society.

  8. Job stress, social support, and prevalence of insomnia in a population of Japanese daytime workers.

    Science.gov (United States)

    Nakata, Akinori; Haratani, Takashi; Takahashi, Masaya; Kawakami, Norito; Arito, Heihachiro; Kobayashi, Fumio; Araki, Shunichi

    2004-10-01

    To clarify the relationship between perceived job stress, social support and prevalence of insomnia in Japanese daytime workers, 1161 male white-collar employees of an electric equipment manufacturing company (age, 23-60 years, mean age of 37.0) were surveyed by means of a mailed questionnaire. Perceived job stress was evaluated with the Japanese version of the generic NIOSH job stress questionnaire. Insomnia was diagnosed if workers had at least 1 of 3 types of symptoms on an almost nightly basis. The symptoms were (1) taking more than 30 min to fall asleep (Difficulty Initiating Sleep, DIS), (2) difficulty in maintaining sleep (DMS), or (3) early morning awakening (EMA). The overall prevalence of insomnia was 23.6% and the prevalences of the three subtypes were 11.3% for DIS, 14.2% for DMS, and 1.9% for EMA. Workers with high intragroup conflict (OR 1.6), high job dissatisfaction (OR 1.5), and high symptoms of depression (OR 2.0) (CES-D > 16) had a significantly increased risk for insomnia after adjusting for multiple confounding factors. Low employment opportunities, physical environment and low coworker support also were weakly associated with risk for insomnia among workers. Furthermore, high depressive symptoms significantly increased the risk of DIS (OR 2.4). Therefore in white-collar male daytime workers, psychological job stress factors such as interpersonal conflicts with fellow employees, job satisfaction, and social support were independently associated with a modestly increased risk of insomnia that included three different subtypes that were considered to be defining for the disorder.

  9. Cognitive Behavioral Insomnia Therapy for Those With Insomnia and Depression: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Carney, Colleen E; Edinger, Jack D; Kuchibhatla, Maragatha; Lachowski, Angela M; Bogouslavsky, Olya; Krystal, Andrew D; Shapiro, Colin M

    2017-04-01

    To compare cognitive behavioral therapy for insomnia (CBT-I) + antidepressant medication (AD) against treatments that target solely depression or solely insomnia. A blinded, randomized split-plot experimental study. Two urban academic clinical centers. 107 participants (68% female, mean age 42 ± 11) with major depressive disorder and insomnia. Randomization was to one of three groups: antidepressant (AD; escitalopram) + CBT-I (4 sessions), CBT-I + placebo pill, or AD + 4-session sleep hygiene control (SH). Subjective sleep was assessed via 2 weeks of daily sleep diaries (use of medication was covaried in all analyses); although there were no statistically significant group differences detected, all groups improved from baseline to posttreatment on subjective sleep efficiency (SE) and total wake time (TWT) and the effect sizes were large. Objective sleep was assessed via overnight polysomnographic monitoring at baseline and posttreatment; analyses revealed both CBT groups improved on TWT (p = .03), but the AD + SH group worsened. There was no statistically significant effect for PSG SE (p = .07). There was a between groups medium effect observed for the AD + SH and CBT + placebo group differences on diary TWT and both PSG variables. All groups improved significantly from baseline to posttreatment on the Hamilton Rating Scale for Depression (HAMD-17); the groups did not differ. Although all groups self-reported sleeping better after treatment, only the CBT-I groups improved on objective sleep, and AD + SH's sleep worsened. This suggests that we should be treating sleep in those with depression with an effective insomnia treatment and relying on self-report obscures sleep worsening effects. All groups improved on depression, even a group with absolutely no depression-focused treatment component (CBT-I + placebo). The depression effect in CBT-I only group has been reported in other studies, suggesting that we should further investigate the antidepressant properties of

  10. Sleep Disturbance, Daytime Symptoms, and Functional Performance in Patients With Stable Heart Failure: A Mediation Analysis.

    Science.gov (United States)

    Jeon, Sangchoon; Redeker, Nancy S

    2016-01-01

    Sleep disturbance is common among patients with heart failure (HF) who also experience symptom burden and poor functional performance. We evaluated the extent to which sleep-related, daytime symptoms (fatigue, excessive daytime sleepiness, and depressive symptoms) mediate the relationship between sleep disturbance and functional performance among patients with stable HF. We recruited patients with stable HF for this secondary analysis of data from a cross-sectional, observational study. Participants completed unattended ambulatory polysomnography from which the Respiratory Disturbance Index was calculated, along with a Six-Minute Walk Test, questionnaires to elicit sleep disturbance (Pittsburgh Sleep Quality Index, Insomnia Symptoms from the Sleep Habits Questionnaire), daytime symptoms (Center for Epidemiologic Studies Depression Scale, Global Fatigue Index, Epworth Sleepiness Scale), and self-reported functional performance (Medical Outcomes Study SF36 V2 Physical Function Scale). We used structural equation modeling with latent variables for the key analysis. Follow-up, exploratory regression analysis with bootstrapped samples was used to examine the extent to which individual daytime symptoms mediated effects of sleep disturbance on functional performance after controlling for clinical and demographic covariates. The sample included 173 New York Heart Association Class I-IV HF patients (n = 60/34.7% women; M = 60.7, SD = 16.07 years of age). Daytime symptoms mediated the relationship between sleep disturbance and functional performance. Fatigue and depression mediated the relationship between insomnia symptoms and self-reported functional performance, whereas fatigue and sleepiness mediated the relationship between sleep quality and functional performance. Sleepiness mediated the relationship between the respiratory index and self-reported functional performance only in people who did not report insomnia. Daytime symptoms explain the relationships between sleep

  11. Insomnia is a frequent finding in adults with Asperger syndrome

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    von Wendt Lennart

    2003-10-01

    Full Text Available Abstract Background Asperger syndrome (AS is a neurodevelopmental disorder belonging to autism spectrum disorders with prevalence rate of 0,35% in school-age children. It has been most extensively studied in childhood while there is scarcity of reports concerning adulthood of AS subjects despite the lifelong nature of this syndrome. In children with Asperger syndrome the initiation and continuity of sleep is disturbed because of the neuropsychiatric deficits inherent of AS. It is probable that sleep difficulties are present in adulthood as well. Our hypothesis was that adults with AS suffer from difficulty in initiating and maintaining sleep and nonrestorative sleep (insomnia. Methods 20 AS without medication were compared with 10 healthy controls devoid of neuropsychiatric anamnesis. Clinical examination, blood test battery and head MRI excluded confounding somatic illnesses. Structured psychiatric interview for axis-I and axis-II disorders were given to both groups as well as Beck Depression Inventory and Wechsler adult intelligence scale, revised version. Sleep quality was assessed with sleep questionnaire, sleep diary during 6 consecutive days and description of possible sleep problems by the participants own words was requested. Results compared with controls and with normative values of good sleep, AS adults had frequent insomnia. In sleep questionnaire 90% (18/20, in sleep diary 75% (15/20 and in free description 85% (17/20 displayed insomnia. There was a substantial psychiatric comorbidity with only 4 AS subject devoid of other axis-I or axis-II disorders besides AS. Also these persons displayed insomnia. It can be noted that the distribution of psychiatric diagnoses in AS subjects was virtually similar to that found among patient with chronic insomnia. Conclusions the neuropsychiatric deficits inherent of AS predispose both to insomnia and to anxiety and mood disorders. Therefore a careful assessment of sleep quality should be an

  12. Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial.

    Science.gov (United States)

    Irwin, Michael R; Olmstead, Richard; Carrillo, Carmen; Sadeghi, Nina; Nicassio, Perry; Ganz, Patricia A; Bower, Julienne E

    2017-08-10

    Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

  13. Complaints of insomnia among midlife employed people: The contribution of childhood and present socioeconomic circumstances

    OpenAIRE

    Lallukka, T; Arber, S; Rahkonen, O; Lahelma, E

    2010-01-01

    Background Studies using conventional socioeconomic indicators have reported inconsistent evidence on socioeconomic differences in complaints of insomnia. We lack studies using a comprehensive socioeconomic framework over the life course ranging from childhood to adulthood. This study therefore aimed to examine the associations of both past and present socioeconomic circumstances with complaints of insomnia. Methods Data were derived from cross-sectional postal surveys (2000–2002) representat...

  14. Mediastinal pancreatic pseudocyst with isolated thoracic symptoms: a case report

    Directory of Open Access Journals (Sweden)

    Drescher Robert

    2008-05-01

    Full Text Available Abstract Introduction Mediastinal pancreatic pseudocysts represent a rare complication of acute or chronic pancreatitis. Case presentation A 55-year-old man with a history of chronic pancreatitis was admitted with intermittent dyspnea, dysphagia and weight loss. Chest X-ray, computed tomography and magnetic resonance imaging revealed a large paracardial pancreatic pseudocyst causing cardiac and esophageal compression. Conclusion Mediastinal pancreatic pseudocysts are a rare complication of chronic pancreatitis. These pseudocysts may lead to isolated thoracic symptoms. For accurate diagnostic and therapy planning, a multimodal imaging approach is necessary.

  15. Pharmacotherapy of Insomnia with Ramelteon: Safety, Efficacy and Clinical Applications

    Directory of Open Access Journals (Sweden)

    Seithikurippu R. Pandi-Perumal

    2011-01-01

    Full Text Available Ramelteon is a tricyclic synthetic analog of melatonin that acts specifically on MT 1 and MT 2 melatonin receptors. Ramelteon is the first melatonin receptor agonist approved by the Food and Drug Administration (FDA for the treatment of insomnia characterized by sleep onset difficulties. Ramelteon is both a chronobiotic and a hypnotic that has been shown to promote sleep initiation and maintenance in various preclinical and in clinical trials. The efficacy and safety of ramelteon in patients with chronic insomnia was initially confirmed in short-term placebo-controlled trials. These showed little evidence of next-day residual effects, withdrawal symptoms or rebound insomnia. Other studies indicated that ramelteon lacked abuse potential and had a minimal risk of producing dependence or adverse effects on cognitive or psychomotor performance. A 6-month placebo-controlled international study and a 1-year open-label study in the USA demonstrated that ramelteon was effective and well tolerated. Other potential off-label uses of ramelteon include circadian rhythm sleep disorders such as shift-work and jet lag. At the present time the drug should be cautiously prescribed for short-term treatment only.

  16. PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program.

    Science.gov (United States)

    Greer, George R; Grob, Charles S; Halberstadt, Adam L

    2014-01-01

    New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

  17. Insomnia among Adolescents: Implications for Counselors.

    Science.gov (United States)

    Morrison, Jack R.

    Adolescent underachievers may be, in fact, victims of insomnia or other types of sleep disorders. Insomnia is a greatly overlooked affliction that affects approximately 13% of the adolescent population, creating daytime side-effects that could impair intellectual functioning, such as imposing learning constraints. Poor sleepers among the…

  18. Nocturnal Regrets and Insomnia in Elderly People

    Science.gov (United States)

    Schmidt, Ralph E.; Renaud, Olivier; Van Der Linden, Martial

    2011-01-01

    Despite their importance for general health, emotion-related factors have rarely been considered in the etiology of late-life insomnia. This study explored the relations between impulsivity, regret experiences, use of different thought-control strategies, and insomnia severity in a sample of older adults whose age ranged from 51 to 98 years.…

  19. Causes and Treatment of Insomnia among Adolescents.

    Science.gov (United States)

    Morrison, Jack R.; And Others

    1985-01-01

    As much as 13 percent of the adolescent population may suffer from chronic insomnia, which can impair the victim's daily existence and affect personal life, school performance, and school attendance. The prevalence of adolescent insomnia, and its cause, diagnosis, and treatment are examined. (Author/CB)

  20. Obsessive-compulsive personality disorder features and response to behavioral therapy for insomnia among patients with hypnotic-dependent insomnia.

    Science.gov (United States)

    Petrov, Megan E; Emert, Sarah E; Lichstein, Kenneth L

    2018-06-05

    To compare therapeutic response to behavioral therapy for insomnia (BT-I) among hypnotic-dependent insomnia (HDI) patients with and without Cluster C personality disorders. Twenty-three adults with HDI (17 females), aged between 33 and 68 (M = 53; SD = 9.9) were included in the study. Participants completed a personality disorder assessment (baseline), as well as sleep diaries, polysomnography (PSG), and an insomnia severity assessment (baseline, posttreatment, and one-year follow-up). Treatment consisted of eight weeks of individual BT-I and gradual hypnotic medication withdrawal. Multilevel mixed-effects linear regression models examined the interaction between study visit and Cluster C personality disorders status on treatment response to BT-I. Obsessive-compulsive personality disorder (OCPD) was the most prevalent of the Cluster C personality disorders with 38% (n = 8) of participants meeting criteria. There were no significant treatment differences by OCPD status across time as measured by sleep diaries and insomnia severity status. However, there were significant treatment differences by OCPD status by one-year follow-up on PSG outcomes, indicating that patients with OCPD status had shorter and more disrupted sleep than patients without OCPD status. Based on self-reported sleep measures, patients with insomnia and features of OCPD responded equivalently to BT-I at one-year follow-up compared to patients without features of OCPD. However, polysomnography outcomes indicated objective sleep deteriorated in these patients, which may suggest greater vulnerability to relapse.

  1. Sibutramine-associated psychotic symptoms and zolpidem-induced complex behaviours: implications for patient safety.

    Science.gov (United States)

    Wiglusz, Mariusz S; Cubała, Wiesław Jerzy; Nowak, Paweł; Jakuszkowiak-Wojten, Katarzyna; Landowski, Jerzy; Krysta, Krzysztof

    2013-09-01

    Sibutramine is a weight loss agent recently withdrawn from the European market due to cardiovascular risk concerns. It was used for long-term obesity treatment. Zolpidem is a short acting hypnotic agent commonly used in the treatment of insomnia. A number of case reports describing psychotic reaction to sibutramine were reported in the literature. We present a case of a 61-year-old Caucasian woman who developed two psychotic episodes related to sibutramine treatment. The second psychotic episode was complicated with complex behaviours after zolpidem use due to insomnia. Sibutramine and zolpidem discontinuation resulted in rapid resolution of psychotic symptoms. This case suggests a possibility of incidence of psychotic symptoms and complex behaviour disturbances in patients prescribed sibutramine or other monoaminergic reuptake inhibitors.

  2. The Relationship between ADHD Symptoms, Mood Instability, and Self-Reported Offending

    Science.gov (United States)

    Gudjonsson, Gisli H.; Sigurdsson, Jon Fridrik; Adalsteinsson, Tomas F.; Young, Susan

    2013-01-01

    Objective: To investigate the relative importance of ADHD symptoms, mood instability, and antisocial personality disorder traits in predicting self-reported offending. Method: A total of 295 Icelandic students completed two scales of offending behavior and measures of ADHD symptoms, mood instability, and antisocial personality traits. Results:…

  3. Emergency Department Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

    Science.gov (United States)

    Sawyer, Patricia; Kennedy, Richard; Williams, Courtney; Brown, Cynthia J.

    2016-01-01

    Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization. PMID:28131350

  4. Patient-reported symptoms during radiotherapy. Clinically relevant symptom burden in patients treated with palliative and curative intent

    Energy Technology Data Exchange (ETDEWEB)

    Koerner, Philipp [Universitaetsklinikum Wuerzburg, Interdisziplinaeres Zentrum Palliativmedizin, Wuerzburg (Germany); Universitaetsklinikum Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany); Ehrmann, Katja [Universitaetsklinikum Wuerzburg, Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Wuerzburg (Germany); Hartmannsgruber, Johann [Praxis Landshut, Kinderzahnheilkunde, Landshut (Germany); Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael [Universitaetsklinikum Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany); Oorschot, Birgitt van [Universitaetsklinikum Wuerzburg, Interdisziplinaeres Zentrum Palliativmedizin, Wuerzburg (Germany)

    2017-07-15

    The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom burden

  5. COMBINATION OF ESZOPICLONE AND MIND-BODY THERAPY AS NOVEL STRATEGY IN INSOMNIA TREATMENT

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    AAD Dalem Dwi Putra

    2013-02-01

    Full Text Available Insomnia is defined as a disorder of difficulty initiating sleep, difficulty maintaining sleep, sleep is not fresh during 1 month or more that makes a significant clinical disturbance or distress. Insomnia affects 15% to 40% of world general population and predominantly in women 65 to 79 years. Insomnia also reported in individuals aged 18 to 34 years. If neglected for a long time, insomnia can diminish job performance and quality of live for each individuals. The new strategy to solve this problem in the future is combining pharmacotherapy like eszopiclone a nonbenzodiazepine derivate and mind-body therapy (MBT to the patients. It can lowering severe risk of conventional drugs side effects, but from pharmacoeconomic this drug is not costly effective. It must combine with MBT to decrease frequency and duration of drug consumption.

  6. Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder.

    Science.gov (United States)

    Srisurapanont, Manit; Likhitsathian, Surinporn; Chua, Hong Choon; Udomratn, Pichet; Chang, Sungman; Maneeton, Narong; Maneeton, Benchaluk; Chen, Chia-Hui; Shih-Yen Chan, Edwin; Bautista, Dianne; Bin Sulaiman, Ahmad Hatim

    2015-11-01

    Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD. Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS). Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p'sdepression and anxiety severity, and poor physical health. These findings may implicate the treatment of comorbid MDD and severe insomnia, for example, sleep hygiene education, pharmacological treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Connecting the dots: could microbial translocation explain commonly reported symptoms in HIV disease?

    Science.gov (United States)

    Wilson, Natalie L; Vance, David E; Moneyham, Linda D; Raper, James L; Mugavero, Michael J; Heath, Sonya L; Kempf, Mirjam-Colette

    2014-01-01

    Microbial translocation within the context of HIV disease has been described as one of the contributing causes of inflammation and disease progression in HIV infection. HIV-associated symptoms have been related to inflammatory markers and sCD14, a surrogate marker for microbial translocation, suggesting a plausible link between microbial translocation and symptom burden in HIV disease. Similar pathophysiological responses and symptoms have been reported in inflammatory bowel disease. We provide a comprehensive review of microbial translocation, HIV-associated symptoms, and symptoms connected with inflammation. We identify studies showing a relationship among inflammatory markers, sCD14, and symptoms reported in HIV disease. A conceptual framework and rationale to investigate the link between microbial translocation and symptoms is presented. The impact of inflammation on symptoms supports recommendations to reduce inflammation as part of HIV symptom management. Research in reducing microbial translocation-induced inflammation is limited, but needed, to further promote positive health outcomes among HIV-infected patients. Published by Elsevier Inc.

  8. Subtle Symptoms Associated with Self-Reported Mild Head Injury.

    Science.gov (United States)

    Segalowitz, Sidney J.; Lawson, Sheila

    1995-01-01

    A survey of 1,345 high school students and 2,321 university students found that 30-37% reported having experienced a head injury, with 12-15% reporting loss of consciousness. Significant relationships were found between mild head injury incidence and gender; sleep difficulties; social difficulties; handedness pattern; and diagnoses of attention…

  9. Objective but Not Subjective Short Sleep Duration Associated with Increased Risk for Hypertension in Individuals with Insomnia.

    Science.gov (United States)

    Bathgate, Christina J; Edinger, Jack D; Wyatt, James K; Krystal, Andrew D

    2016-05-01

    To examine the relationship between hypertension prevalence in individuals with insomnia who have short total sleep duration insomnia disorder (MAge = 46.2 y, SDAge = 13.7 y) participated in this study at two large university medical centers. Two nights of polysomnography, 2 w of sleep diaries, questionnaires focused on sleep, medical, psychological, and health history, including presence/absence of hypertension were collected. Logistic regressions assessed the odds ratios of hypertension among persons with insomnia with short sleep duration insomnia with a sleep duration ≥ 6 h, measured both objectively and subjectively. Consistent with previous studies using objective total sleep duration, individuals with insomnia and short sleep duration insomnia with sleep duration ≥ 6 h. Increased risk for hypertension was independent of major confounding factors frequently associated with insomnia or hypertension. No significant risk was observed using subjectively determined total sleep time groups. Receiver operating characteristic curve analysis found that the best balance of sensitivity and specificity using subjective total sleep time was at a 6-h cutoff, but the area under the receiver operating characteristic curve showed low accuracy and did not have good discriminant value. Objectively measured short sleep duration increased the odds of reporting hypertension more than threefold after adjusting for potential confounders; this relationship was not significant for subjectively measured sleep duration. This research supports emerging evidence that insomnia with objective short sleep duration is associated with an increased risk of comorbid hypertension. © 2016 Associated Professional Sleep Societies, LLC.

  10. Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2014-01-01

    To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.

  11. Yoga as Treatment for Insomnia Among Cancer Patients and Survivors: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Karen M. Mustian

    2013-10-01

    Full Text Available Between 15-90% of cancer patients and survivors report some form of insomnia or sleep quality impairment during and post-treatment, such as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia and sleep quality impairment are among the most prevalent and distressing problems reported by cancer patients and survivors, and can be severe enough to increase cancer mortality. Despite the ubiquity of insomnia and sleep quality impairment, they are under-diagnosed and under-treated in cancer patients and survivors. When sleep problems are present, providers and patients are often hesitant to prescribe or take pharmaceuticals for sleep problems due to polypharmacy concerns, and cognitive behavioural therapy for insomnia can be very difficult and impractical for patients to adhere to throughout the cancer experience. Research suggests yoga is a well-tolerated exercise intervention with promising evidence for its efficacy in improving insomnia and sleep quality impairment among survivors. This article provides a systematic review of existing clinical research on the effectiveness of yoga for treating insomnia and sleep quality impairment among cancer patients and survivors.

  12. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents.

    Science.gov (United States)

    Yen, Cheng-Fang; Ko, Chih-Hung; Yen, Ju-Yu; Cheng, Chung-Ping

    2008-11-01

    The aim of this study was to examine the correlates associated with short nocturnal sleep duration and subjective insomnia, including individual factors, family factors, peer factors, school factors, and the problematic use of high-tech devices among a large-scale representative population of Taiwanese adolescents. Cross-sectional study. A total of 23 junior high and 29 senior high/vocational schools were randomly selected across southern Taiwan. Eight thousand four adolescent students. N/A. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia were examined using chi2 automatic interaction detection analysis and logistic regression analysis models. The results indicated that an older age, self-reported depression, being in the third year of school, drinking coffee at night, and problematic Internet use were significantly associated with short nocturnal sleep duration in adolescents. Furthermore, self-reported depression, low school affinity, high family conflict, low connectedness to their peer group, and problematic Internet use were associated with subjective insomnia in adolescents. The results of this study indicate that a variety of individual, family, peer, and school factors were associated with short nocturnal sleep duration and subjective insomnia in adolescents. Furthermore, the correlates of short sleep duration were not identical to those of subjective insomnia. Parents and health professionals should be wary of sleep patterns among adolescents who have the identified correlates of short nocturnal sleep duration and subjective insomnia.

  13. Forty-eight cases of insomnia treated with acupuncture and cupping on the back%针刺加背部走罐治疗失眠48例

    Institute of Scientific and Technical Information of China (English)

    胡仲波; ZHANG Nan

    2010-01-01

    @@ Insomnia also known as sleepless, is a condition that occurs when a person in unable to get normal sleep.With the quickening rhythm of modern life,increasing working and economic pressures, more and more people are suffering from insomnia, and the quality of life is influenced.In recent years, the author has treated 48 cases of insomnia with acupuncture and cupping on the back.The report is as follows.

  14. Assessing Stress-Induced Sleep Reactivity in College Students: The European Portuguese Version of the Ford Insomnia Response to Stress Test (FIRST)

    OpenAIRE

    Marques, Daniel Ruivo; Allen Gomes, Ana; Drake, Christopher Lawrence; Roth, Thomas; de Azevedo, Maria Helena Pinto

    2016-01-01

    Over the past few years, the comprehensive models of insomnia have exhibited impressive developments. However, there is scarce knowledge on predisposing or vulnerability factors for insomnia. One of the most promising constructs to aid in filling this gap is stress-induced sleep reactivity assessed through self-report. Our aim was to study the psychometric properties of the European Portuguese version of the Ford Insomnia Response to Stress Test (FIRST).

  15. Gender Differences in Symptom Reporting on Baseline Sport Concussion Testing Across the Youth Age Span.

    Science.gov (United States)

    Moser, Rosemarie Scolaro; Olek, Lauren; Schatz, Philip

    2018-02-06

    Little is known regarding gender differences in concussion symptom reporting developmentally across the age span, specifically in pre-adolescent athletes. The present study asks: Do boys and girls differ in symptom reporting across the pre-adolescent to post-adolescent age span? This retrospective study utilized baseline assessments from 11,695 10-22 year-old athletes assigned to 3 independent groups: Pre-adolescent 10-12 year olds (n = 1,367; 12%), Adolescent 13-17 year olds (n = 2,974; 25%), and Late Adolescent 18-22 year olds (n = 7,354; 63%). Males represented 60% of the sample. Baseline ImPACT composite scores and Post-Concussion Symptom Scale scores (Total, Physical, Cognitive, Emotional, Sleep) were analyzed for the effects of age and gender. Statistically significant main effects were found for age and gender on all ImPACT composites, Total Symptoms, and Symptom factors. Significant interaction effects were noted between age and gender for all ImPACT composites, Total Symptoms, and Symptom factors. Total Symptoms and all Symptom factors were highest in adolescents (ages 13-17) for males and females. In the 10-12 age group, females displayed lower Total Symptoms, Physical, and Sleep factors than males. The notion of females being more likely than males to report symptoms does not appear to apply across the developmental age span, particularly prior to adolescence. Females show greater emotional endorsement across the youth age span (10-22 years). Adolescence (13-17 years) appears to be a time of increased symptomatology that may lessen after the age of 18. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Extremely prematurely born adolescents self-report of anxiety symptoms, and the mothers' reports on their offspring

    DEFF Research Database (Denmark)

    Sømhovd, M J; Esbjørn, B H; Hansen, B M

    2018-01-01

    AIM: To compare anxiety symptoms in adolescents born extremely prematurely to term-born controls. METHODS: We had 96 preterm-born adolescents and 40 term-born controls from Denmark, and their mothers score the adolescents on the Revised Children Anxiety and Depression scale. We analysed group...... differences, cross-informant correlations and relative risks for elevated anxiety symptoms. RESULTS: Self-reported anxiety symptoms did not significantly differ, although the upper confidence limit (95% CI: -3.3 to 5.1) supported an odds ratio of 2 for the preterm-born participants. Mothers of the preterm......-born participants reported higher social anxiety symptoms than did mothers of controls (51.7 versus 46.8, p = 0.001). The relative risk for being above a threshold indicating distressing anxiety was small from self-reports (1.39; p = 0.60). From mother-reports, the relative risk was noticeable but not significant...

  17. Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia.

    Science.gov (United States)

    Blom, Kerstin; Jernelöv, Susanna; Rück, Christian; Lindefors, Nils; Kaldo, Viktor

    2016-06-01

    To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period. The trial was registered, together with a parallel trial, at Clinicaltrials.gov as "Internet-CBT for Insomnia" registration ID: NCT01256099. © 2016 Associated Professional Sleep Societies, LLC.

  18. Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers

    Directory of Open Access Journals (Sweden)

    Gale M. Lucas

    2017-10-01

    Full Text Available A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD. However, research shows (increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA—even though both conditions control for stigma and ramifications for service members’ military records—virtual human interviewers that build rapport may provide a superior option to encourage reporting.

  19. Prevalence and consequences of insomnia in pediatric population.

    OpenAIRE

    Magda Kaczor; Michał Skalski

    2016-01-01

    Insomnia presents an increasing and significant health issue in paediatric population. As the problem had grown over past decade, it became recognised by the specialists dealing with children and adolescents. In a recent study American Academy of Child and Adolescent Psychiatry members were asked about their experience with patients complaining about sleep disturbances. Doctors reported that sleep was a problem for 1/3 of their patients out of which 1/4 required pharmacotherapy [1]. Multiple ...

  20. Spontaneously Reported Symptoms by Informants Are Associated with Clinical Severity in Dementia Help-Seekers.

    Science.gov (United States)

    Xu, Jia-Qi; Choy, Jacky C P; Tang, Jennifer Y M; Liu, Tian-Yin; Luo, Hao; Lou, Vivian W Q; Lum, Terry Y S; Wong, Gloria H Y

    2017-09-01

    To investigate the predictive value of symptoms of dementia that the person or an informant noticed spontaneously in determining the clinical severity of dementia. Cross-sectional. Community-based open-referral dementia assessment service in Hong Kong between 2005 and 2013. Help-seekers for dementia assessment service and their informants (N = 965 dyads). Participants underwent a clinical dementia interview based on the Clinical Dementia Rating. Spontaneous complaints that the person and the informant made that had prompted their help-seeking of groups with interview results suggestive of no impairment, mild cognitive impairment, and dementia were compared. Logistic regression was used to evaluate the predictive value of spontaneous complaints for clinical severity. Independent raters blinded to clinical results coded spontaneously reported symptoms into theoretical themes: memory, executive function, language, time and place orientation, neuropsychiatric, mood, and avolition. Memory problems were the most frequently reported complaints for participants (87.7%) and their informants (95.5%), followed by self-reported language (33.0%) and informant-reported orientation (33.0%) difficulties. Informant-reported but not self-reported symptoms predicted clinical severity. Compared with the persons themselves, informants reported more pervasive symptoms corresponding to clinical severity. Persons with dementia self-reported fewer types of symptoms than their healthy or mildly impaired counterparts. Spontaneously reported language and orientation symptoms by the informant distinguished persons with mild or worse dementia (P < .001, Nagelkerke coefficient of determination = 29.7%, percentage correct 85.6%). The type and pervasiveness of symptoms spontaneously that informants reported predicted clinical severity. This may provide a quick reference for triage. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review.

    Science.gov (United States)

    Morin, C M; Hauri, P J; Espie, C A; Spielman, A J; Buysse, D J; Bootzin, R R

    1999-12-15

    This paper reviews the evidence regarding the efficacy of nonpharmacological treatments for primary chronic insomnia. It is based on a review of 48 clinical trials and two meta-analyses conducted by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on non-drug therapies for the clinical management of insomnia. The findings indicate that nonpharmacological therapies produce reliable and durable changes in several sleep parameters of chronic insomnia sufferers. The data indicate that between 70% and 80% of patients treated with nonpharmacological interventions benefit from treatment. For the typical patient with persistent primary insomnia, treatment is likely to reduce the main target symptoms of sleep onset latency and/or wake time after sleep onset below or near the 30-min criterion initially used to define insomnia severity. Sleep duration is also increased by a modest 30 minutes and sleep quality and patient's satisfaction with sleep patterns are significantly enhanced. Sleep improvements achieved with these behavioral interventions are sustained for at least 6 months after treatment completion. However, there is no clear evidence that improved sleep leads to meaningful changes in daytime well-being or performance. Three treatments meet the American Psychological Association (APA) criteria for empirically-supported psychological treatments for insomnia: Stimulus control, progressive muscle relaxation, and paradoxical intention; and three additional treatments meet APA criteria for probably efficacious treatments: Sleep restriction, biofeedback, and multifaceted cognitive-behavior therapy. Additional outcome research is needed to examine the effectiveness of treatment when it is implemented in clinical settings (primary care, family practice), by non-sleep specialists, and with insomnia patients presenting medical or psychiatric comorbidity.

  2. Self-reported temporomandibular disorder symptoms and severity of malocclusion in prospective orthognathic-surgical patients.

    Science.gov (United States)

    Svedström-Oristo, Anna-Liisa; Ekholm, Heidi; Tolvanen, Mimmi; Peltomäki, Timo

    2016-08-01

    The objective of this study is to analyze the association between self-reported symptoms of temporomandibular joint disorder (TMD) and the severity of malocclusion in prospective orthognathic-surgical patients. The subjects consisted of 50 consecutive patients (13 males and 37 females) referred to two university clinics for assessment of orthodontic-surgical treatment need. Data considering self-reported TMD symptoms were gathered using a semi-structured diary. At the first appointment, all patients rated the importance of treatment (on a scale of 1-10) and assessed self-perceived dental appearance using a VAS scale. The scale was anchored with photographs 1 and 10 from the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Study models were assessed by an experienced orthodontic specialist using the Peer Assessment Rating (PAR) index and the Index of Complexity, Outcome and Need (ICON). Association between the PAR and ICON scores and the number of reported symptoms was analyzed statistically. Seventy-one percent of patients reported experiencing TMD symptoms. The most prevalent symptoms were pain in the head and/or neck region and fatigue in the TMJ region. The number of symptoms was highest in the morning. Ninety percent of males and 86% of females rated the importance of treatment as high; males experiencing TMD symptoms tended to rate surgery as more important compared with males with no symptoms (p = 0.056). In this sample, the results cannot unambiguously confirm an association between self-reported symptoms of TMD and objectively defined severity of malocclusion.

  3. Pathological changes in the subsynovial connective tissue increase with self-reported carpal tunnel syndrome symptoms.

    Science.gov (United States)

    Tat, Jimmy; Wilson, Katherine E; Keir, Peter J

    2015-05-01

    Fibrosis and thickening of the subysnovial connective tissue are the most common pathological findings in carpal tunnel syndrome. The relationship between subsynovial connective tissue characteristics and self-reported carpal tunnel syndrome symptoms was assessed. Symptoms were characterized using the Boston Carpal Tunnel Questionnaire and Katz hand diagram in twenty-two participants (11 with symptoms, 11 with no symptoms). Using ultrasound, the thickness of the subsynovial connective tissue was measured using a thickness ratio (subsynovial thickness/tendon thickness) and gliding function was assessed using a shear strain index ((Displacement(tendon)-Displacement(subsynovial))/Displacement(tendon)x 100). For gliding function, participants performed 10 repeated flexion-extension cycles of the middle finger at a rate of one cycle per second. Participants with symptoms had a 38.5% greater thickness ratio and 39.2% greater shear strain index compared to participants without symptoms (p<0.05). Ultrasound detected differences the SSCT in symptomatic group that was characterized by low self-reported symptom severity scores. This study found ultrasound useful for measuring structural and functional changes in the SSCT that could provide insight in the early pathophysiology associated with carpal tunnel syndrome symptoms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Prepontine Schwannoma Presenting With Atypical Facial Symptoms - A Case Report

    Directory of Open Access Journals (Sweden)

    Rishi Kumar Bali

    2005-01-01

    Full Text Available Face is an important landmark and any pathological condition affecting it has tremendous bearing on psychological make up of the patient. This report describes a rare case of a young female who presented with Hemifacial dysaesthesia complicated by ipsilateral masticatory complex dyskinesia.

  5. Randomized placebo-controlled trial of cognitive behavioral therapy and armodafinil for insomnia after cancer treatment.

    Science.gov (United States)

    Roscoe, Joseph A; Garland, Sheila N; Heckler, Charles E; Perlis, Michael L; Peoples, Anita R; Shayne, Michelle; Savard, Josée; Daniels, Nina P; Morrow, Gary R

    2015-01-10

    Insomnia is a distressing and often persisting consequence of cancer. Although cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice in the general population, the use of CBT-I in patients with cancer is complicated, because it can result in transient but substantial increases in daytime sleepiness. In this study, we evaluated whether CBT-I, in combination with the wakefulness-promoting agent armodafinil (A), results in better insomnia treatment outcomes in cancer survivors than CBT-I alone. We report on a randomized trial of 96 cancer survivors (mean age, 56 years; female, 87.5%; breast cancer, 68%). The primary analyses examined whether ≥ one of the 7-week intervention conditions (ie, CBT-I, A, or both), when compared with a placebo capsule (P) group, produced significantly greater clinical gains. Insomnia was assessed by the Insomnia Severity Index and sleep quality by the Pittsburgh Sleep Quality Inventory. All patients received sleep hygiene instructions. Analyses controlling for baseline differences showed that both the CBT-I plus A (P = .001) and CBT-I plus P (P = .010) groups had significantly greater reductions in insomnia severity postintervention than the P group, with effect sizes of 1.31 and 1.02, respectively. Similar improvements were seen for sleep quality. Gains on both measures persisted 3 months later. CBT-I plus A was not significantly different from CBT-I plus P (P = .421), and A alone was not significantly different from P alone (P = .584). CBT-I results in significant and durable improvements in insomnia and sleep quality. A did not significantly improve the efficacy of CBT-I or independently affect insomnia or sleep quality. © 2014 by American Society of Clinical Oncology.

  6. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.

    Science.gov (United States)

    Böhn, Lena; Störsrud, Stine; Törnblom, Hans; Bengtsson, Ulf; Simrén, Magnus

    2013-05-01

    Despite the fact that food and diet are central issues, that concern patients with irritable bowel syndrome (IBS), the current understanding about the association between the intake of certain foods/food groups and the gastrointestinal (GI) symptom pattern, psychological symptoms, and quality of life is poor. The aim of this study was to determine which food groups and specific food items IBS patients report causing GI symptoms, and to investigate the association with GI and psychological symptoms and quality of life. We included 197 IBS patients (mean age 35 (18-72) years; 142 female subjects) who completed a food questionnaire in which they specified symptoms from 56 different food items or food groups relevant to food intolerance/allergy. The patients also completed questionnaires to assess depression and general anxiety (Hospital Anxiety and Depression), GI-specific anxiety (Visceral Sensitivity Index), IBS symptoms (IBS-Severity Scoring System), somatic symptoms (Patient Health Questionnaire-15), and quality of life (Irritable Bowel Syndrome Quality of Life Questionnaire). In all, 84% of the studied population reported symptoms related to at least one of the food items surveyed. Symptoms related to intake of food items with incompletely absorbed carbohydrates were noted in 138 (70%) patients; the most common were dairy products (49%), beans/lentils (36%), apple (28%), flour (24%), and plum (23%). Of these, 58% experienced GI symptoms from foods rich in biogenic amines, such as wine/beer (31%), salami (22%), and cheese (20%). Histamine-releasing foods, such as milk (43%), wine/beer (31%), and pork (21%), were also considered causes of symptoms in IBS patients. GI symptoms were also frequently reported after intake of fried and fatty foods (52%). With increasing IBS symptom severity, patients reported more food items responsible for their GI symptoms (P=0.004), and this was also found in patients with more severe somatic symptoms (Psleep (r=-0.25; P=0

  7. The prevalence of insomnia in the general population in China: A meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiao-Lan Cao

    Full Text Available This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, EMBASE and Chinese databases (China National Knowledge Interne (CNKI, WanFang Data and SinoMed. Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval [CI]: 12.1%-18.5%. No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6% was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%. The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001. The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults.CRD 42016043620.

  8. Patients with primary insomnia in the sleep laboratory: do they present with typical nights of sleep?

    Science.gov (United States)

    Hirscher, Verena; Unbehaun, Thomas; Feige, Bernd; Nissen, Christoph; Riemann, Dieter; Spiegelhalder, Kai

    2015-08-01

    The validity of sleep laboratory investigations in patients with insomnia is important for researchers and clinicians. The objective of this study was to examine the first-night effect and the reverse first-night effect in patients with chronic primary insomnia compared with good sleeper controls. A retrospective comparison of a well-characterised sample of 50 patients with primary insomnia and 50 good sleeper controls was conducted with respect to 2 nights of polysomnography, and subjective sleep parameters in the sleep laboratory and the home setting. When comparing the first and second sleep laboratory night, a significant first-night effect was observed across both groups in the great majority of the investigated polysomnographic and subjective variables. However, patients with primary insomnia and good sleeper controls did not differ with respect to this effect. Regarding the comparison between the sleep laboratory nights and the home setting, unlike good sleeper controls, patients with primary insomnia reported an increased subjective sleep efficiency on both nights (in part due to a reduced bed time) and an increased subjective total sleep time on the second night. These results suggest that even the second sleep laboratory night does not necessarily provide clinicians and researchers with a representative insight into the sleep perception of patients with primary insomnia. Future studies should investigate whether these findings also hold for other patient populations. © 2015 European Sleep Research Society.

  9. CLINICAL OBSERVATION ON TREATMENT OF 61 CASES OF INSOMNIA WITH AURICULAR PLASTER THERAPY

    Institute of Scientific and Technical Information of China (English)

    张家彤; 王月

    2003-01-01

    Objective: To observe the therapeutic effect of auricular plaster (otopoint-pressure) therapy in thetreatment of insomnia. Methods: In this paper, 61 cases of insomnia patients including 16 males and 45 females weretreated with Ershenmen (MA-TF 1), Zhen (MA-AT), Yuanzhong (MA-AT), Nao Dian and E (MA-AT), combined withother otopoints according to symptoms. The otopoint was stuck with a piece of plaster adhered with vaccaria seeds andpressured by the patient him- or her-self. The treatment was given twice a week, with 7 times being a therapeuticcourse. Results: After 1 - 2 courses of treatment, 19 (31.15%) cases were cured, 34 (55.74 % ) had improvementand 8 (13.11%) had no changes, with the total effective rate being 86.9%. Conclusion: Auricular plaster therapyworks well in the treatment of insomnia patient.

  10. Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV.

    Science.gov (United States)

    Laverick, Rosanna; Haddow, Lewis; Daskalopoulou, Marina; Lampe, Fiona; Gilson, Richard; Speakman, Andrew; Antinori, Andrea; Bruun, Tina; Vassilenko, Anna; Collins, Simon; Rodger, Alison

    2017-11-01

    We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics. HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in 5 domains, psychosocial factors, and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with a decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment. Four hundred forty-eight patients completed the assessments [mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm, median time since HIV diagnosis 9.9 years, 81% virologically suppressed (HIV-1 plasma RNA symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment. Patients' own assessments of everyday function and symptoms were associated with objectively measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies.

  11. 'Rules' for boys, 'guidelines' for girls: Gender differences in symptom reporting during childhood and adolescence.

    Science.gov (United States)

    Maclean, Alice; Sweeting, Helen; Hunt, Kate

    2010-02-01

    The emergence of higher reported morbidity in females compared with males is a feature of adolescent health in a large proportion of the world's industrialised countries. In this paper, qualitative data from twenty-five single-sex focus groups (90 participants in total) conducted with 10-, 13-, and 15-year olds in two Scottish schools is used to explore whether symptom reporting is influenced by perceived societal gender- and age-related expectations and the social context of symptom experiences. The degree to which these factors can help explain quantitative evidence of increases in gender differences in symptom reporting during adolescence is also examined. Accounts suggested gender-related expectations act as strict 'rules' for boys and less prohibitive 'guidelines' for girls. An unexpected finding was the extent of similarity between these 'rules' and 'guidelines'. Both boys and girls presented themselves as pressured to react to symptoms in stoic, controlled and independent ways, particularly when in the company of their peers, and both perceived that boys and girls could incur negative consequences if seen to have physical (e.g. stomach ache) or, especially, psychological symptoms (e.g. feeling like crying). These qualitative findings do not suggest that girls are simply more willing than boys to report their symptoms as they get older, which is one potential explanation for the quantitative evidence of increasing gender differences in symptom reporting in adolescence. Rather, the findings suggest a need to highlight both the potentially damaging effects of gender stereotypes which make boys reluctant to seek help for physical and, particularly, psychological symptoms, and the misconception that girls are not similarly reluctant to report illness. Copyright 2009 Elsevier Ltd. All rights reserved.

  12. Lack of Resilience Is Related to Stress-Related Sleep Reactivity, Hyperarousal, and Emotion Dysregulation in Insomnia Disorder.

    Science.gov (United States)

    Palagini, Laura; Moretto, Umberto; Novi, Martina; Masci, Isabella; Caruso, Danila; Drake, Christopher L; Riemann, Dieter

    2018-05-15

    According to the diathesis-stress model of insomnia, insomnia may develop in vulnerable individuals in response to stress. Resilience is a psychobiological factor that determines an individual's capacity to adapt successfully to stressful events and low resilience increases vulnerability for development of mental disorders. The aim was to explore resilience in subjects with insomnia and its relationship with the factors that contribute to its development and perpetuation. The study consisted of 58 subjects with Insomnia Disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and 38 good sleepers. Resilience Scale for Adults (RSA), Ford Insomnia Response to Stress Test (FIRST), Pre-sleep Arousal Scale (PSAS), and Difficulties in Emotion Regulation Scale (DERS) were administered while taking into account psychiatric symptoms. Differences in means between groups were assessed using t test or Mann-Whitney U /Wilcoxon test. Linear/multivariable regression analyses and mediation analyses were performed. Subjects with insomnia (24 females, mean age 49 ± 2.1 years) had lower RSA and higher FIRST, DERS, and PSAS scores than good sleepers (22 females, mean age 47.2 ± 1.2 years). After controlling for anxiety/depressive symptoms, low resilience correlated with high stress-related sleep reactivity ( P = .004), pre-sleep cognitive hyperarousal ( P = .01) and emotion dysregulation ( P = .01). Emotion dysregulation mediated the relationship between low resilience and cognitive hyperarousal (Z = 2.06, P = .03). Subjects with insomnia showed low resilience, which was related to high stress-related sleep reactivity, emotional dysregulation, and hyperarousal. If resilience helps to minimize the extent of pathogenesis in the developmental process, an early identification of vulnerable candidates should be useful for preventing insomnia development and maintenance. A commentary on this article appears in this issue on page 709. © 2018 American

  13. Altered resting state connectivity in right side frontoparietal network in primary insomnia patients

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    Li, Shumei; Tian, Junzhang; Li, Meng; Wang, Tianyue; Lin, Chulan; Yin, Yi; Jiang, Guihua [Guangdong Second Provincial General Hospital, Department of Medical Imaging, Guangzhou (China); Zeng, Luxian [Guangdong Second Provincial General Hospital, Department of Science and Education, Guangzhou (China); Li, Cheng [Guangdong Second Provincial General Hospital, Department of Renal Transplantation, Guangzhou (China)

    2018-02-15

    This study investigated alterations of resting-state networks (RSNs) in primary insomnia patients as well as relationships between these changes and clinical features. Fifty-nine primary insomnia patients and 53 healthy control subjects underwent a resting-state fMRI scan (rs-fMRI). Ten RSNs were identified using independent component analysis of rs-fMRI data. To assess significant differences between the two groups, voxel-wise analysis of ten RSNs was conducted using dual regression with FSL randomised non-parametric permutation testing and a threshold-free cluster enhanced technique to control for multiple comparisons. Relationships between abnormal functional connectivity and clinical variables were then investigated with Pearson's correlation analysis. Primary insomnia patients showed decreased connectivity in regions of the right frontoparietal network (FPN), including the superior parietal lobule and superior frontal gyrus. Moreover, decreased connectivity in the right middle temporal gyrus and right lateral occipital cortex with the FPN showed significant positive correlations with disease duration and self-rated anxiety, respectively. Our study suggests that primary insomnia patients are characterised by abnormal organisation of the right FPN, and dysfunction of the FPN is correlated with disease duration and anxiety. The results enhance our understanding of neural substrates underlying symptoms of primary insomnia from the viewpoint of resting-state networks. (orig.)

  14. Group cognitive-behavioral therapy for insomnia: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Beatriz Navarro-Bravo

    2015-01-01

    Full Text Available Background: insomnia is a highly prevalent disorder in the general population and in clinical practice. Although pharmacological treatment is the most widespread choice, psychological treatment appears to have longer lasting effects. The main objective of this meta-analysis was to assess the cognitive-behavioural group therapy treatment for insomnia. Method: a systematic search for cognitive-behavioural therapy clinical trials in Pubmed, PsycINFO, PsycARTICLES, Scielo, WOK, Cochrane, Scopus and Embase. 153 articles were reviewed, of which 9 met inclusion criteria for the metaanalysis. Adding up the data from all 9 trials, a total of 699 people completed the post-test phase. Results: after finishing cognitive-behavioural therapy, significant improvements regarding insomnia were found according to the Pittsburgh Sleep Quality Index and Insomnia Severity Index, sleep latency, wake after sleep onset and sleep efficiency. There were no significant improvements in total sleep time. Conclusions: the results from experimental studies on cognitive-behavioural therapy as an insomnia treatment clearly suggest a positive impact on symptoms, as assessed using both validated scales and sleep diaries.

  15. Altered resting state connectivity in right side frontoparietal network in primary insomnia patients

    International Nuclear Information System (INIS)

    Li, Shumei; Tian, Junzhang; Li, Meng; Wang, Tianyue; Lin, Chulan; Yin, Yi; Jiang, Guihua; Zeng, Luxian; Li, Cheng

    2018-01-01

    This study investigated alterations of resting-state networks (RSNs) in primary insomnia patients as well as relationships between these changes and clinical features. Fifty-nine primary insomnia patients and 53 healthy control subjects underwent a resting-state fMRI scan (rs-fMRI). Ten RSNs were identified using independent component analysis of rs-fMRI data. To assess significant differences between the two groups, voxel-wise analysis of ten RSNs was conducted using dual regression with FSL randomised non-parametric permutation testing and a threshold-free cluster enhanced technique to control for multiple comparisons. Relationships between abnormal functional connectivity and clinical variables were then investigated with Pearson's correlation analysis. Primary insomnia patients showed decreased connectivity in regions of the right frontoparietal network (FPN), including the superior parietal lobule and superior frontal gyrus. Moreover, decreased connectivity in the right middle temporal gyrus and right lateral occipital cortex with the FPN showed significant positive correlations with disease duration and self-rated anxiety, respectively. Our study suggests that primary insomnia patients are characterised by abnormal organisation of the right FPN, and dysfunction of the FPN is correlated with disease duration and anxiety. The results enhance our understanding of neural substrates underlying symptoms of primary insomnia from the viewpoint of resting-state networks. (orig.)

  16. Parent-Reported Penicillin Allergy Symptoms in the Pediatric Emergency Department.

    Science.gov (United States)

    Vyles, David; Chiu, Asriani; Simpson, Pippa; Nimmer, Mark; Adams, Juan; Brousseau, David C

    2017-04-01

    Children often present to the pediatric emergency department (ED) with a reported penicillin allergy. The true incidence of pediatric penicillin allergy is low, and patients may be inappropriately denied first-line antibiotics. We hypothesized that more than 70% of reported penicillin allergies in the pediatric ED are low risk for true allergy. Parents of children presenting to the pediatric ED with parent-reported penicillin allergy completed an allergy questionnaire. The questionnaire included age at allergy diagnosis, symptoms of allergy, and time to allergic reaction from first dose. The allergy symptoms were dichotomized into high and low risk in consultation with a pediatric allergist before questionnaire implementation. A total of 605 parents were approached; 500 (82.6%) completed the survey. The median (interquartile range) age of the children at diagnosis was 1 year (7 months, 2 years); 75% were diagnosed before their third birthday. Overall, 380 (76%) (95% confidence interval 72.3, 79.7) children had exclusively low-risk symptoms. The most commonly reported symptoms were rash (466, 92.8%) and itching (203, 40.6%). Of the 120 children with one or more high-risk symptom, facial swelling (50, 10%) was the most common. Overall, 354 children (71%) were diagnosed after their first exposure to penicillin. Symptom onset within 24 hours of medication administration occurred in 274 children (54.8%). Seventy-six percent of patients with parent-reported penicillin allergy have symptoms unlikely to be consistent with true allergy. Determination of true penicillin allergy in patients with low-risk symptoms may permit the increased use of first-line penicillin antibiotics. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Somatic syndromes, insomnia, anxiety, and stress among sleep disordered breathing patients.

    Science.gov (United States)

    Amdo, Tshering; Hasaneen, Nadia; Gold, Morris S; Gold, Avram R

    2016-05-01

    We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress. We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients. From medical records, we characterized each patient in terms of the presence of syndromes and symptoms into three categories: somatic syndromes (six syndromes), anxiety (anxiety disorders, nightmares, use of benzodiazepines), and insomnia (sleep onset, sleep maintenance, and use of hypnotics). For the pooled sample of SDB patients, we modeled the correlation of the BSQ score with the presence of each syndrome/symptom parameter within each of the three categories, with adjustment for male vs. female. Mean BSQ scores in females were significantly higher than those in males (32.5 ± 11.1 vs. 26.9 ± 8.2; mean ± SD). Increasing BSQ scores significantly correlated with increasing prevalence rates of somatic syndromes (p insomnia (p ≤ 0.0001). In general, females had higher prevalence rates of somatic syndromes and symptoms of anxiety than males at any BSQ score while rates of insomnia were similar. In patients with SDB, there is a strong association between the level of somatic arousal and the presence of stress-related disorders like somatic syndromes, anxiety, and insomnia.

  18. Efficacy of Exercise for Menopausal Symptoms: A Randomized Controlled Trial

    Science.gov (United States)

    Sternfeld, Barbara; Guthrie, Katherine A.; Ensrud, Kristine E.; LaCroix, Andrea Z.; Larson, Joseph C.; Dunn, Andrea L.; Anderson, Garnet L.; Seguin, Rebecca A.; Carpenter, Janet S.; Newton, Katherine M.; Reed, Susan D.; Freeman, Ellen W.; Cohen, Lee S.; Joffe, Hadine; Roberts, Melanie; Caan, Bette J.

    2013-01-01

    OBJECTIVE To determine efficacy of exercise training for alleviating vasomotor and other menopausal symptoms. METHODS Late-peri and post-menopausal, sedentary women with frequent vasomotor symptoms (VMS) participated in a randomized controlled trial conducted at three sites: 106 to exercise and 142 to usual activity. The exercise intervention consisted of individual, facility-based aerobic exercise training 3 times/week for 12 weeks. VMS frequency and bother were recorded on daily diaries at baseline and weeks 6 and 12. Intent to treat analyses compared between group differences in changes in VMS frequency and bother, sleep symptoms (Insomnia Severity Index, Pittsburgh Sleep Quality Index) and mood (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7 questionnaire). RESULTS At the end of week 12, changes in VMS frequency in the exercise group (mean change of −2.4/day, 95% CI −3.0, −1.7) and VMS bother (mean change of −0.5 on a 4 point scale, 95% CI −0.6, −0.4) were not significantly different from those in the control group (−2.6 VMS/day, 95% CI −3.2, −2.0, p=0.43; −0.5 points, 95% CI −0.6, −0.4, p=0.75). The exercise group reported greater improvement in insomnia symptoms (p=0.03), subjective sleep quality (p=0.01), and depressive symptoms (p=0.04), but differences were small and not statistically significant when p values were adjusted for multiple comparisons. Results were similar when considering treatment-adherent women only. CONCLUSION These findings provide strong evidence that 12-weeks of moderate-intensity aerobic exercise does not alleviate VMS but may result in small improvements in sleep quality, insomnia and depression in midlife, sedentary women. PMID:23899828

  19. Tic Symptoms Induced by Atomoxetine in Treatment of ADHD: A Case Report and Literature Review.

    Science.gov (United States)

    Yang, Rongwang; Li, Rong; Gao, Weijia; Zhao, Zhengyan

    Patients with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for tic disorders. Atomoxetine (ATX) has been accepted as an alternative medication for patients with ADHD and a comorbid tic disorder. It is rarely reported that tic symptoms are induced by ATX. This present report described a boy with ADHD who developed tic symptoms during ATX initiation. We used an ABAB trial to confirm the tics were related to ATX administration. In addition, we reviewed the published literature of patients whose tic symptoms were confirmed or suspected of relating to ATX usage. This present case with an ABAB design showed on-off control of tics with or without ATX, which allowed us to make a strong conclusion that the tics were related to ATX administration. Literature review also indicated that ATX might induce tic symptoms in children with ADHD, especially in those being boys and having a history of tics. The time from starting ATX to tics symptoms appearing was approximately 19 days. The most common tic symptoms were eye blinking, vocal tics, or throat clearing, and neck movements. These tics symptoms in most cases could be resolved after discontinuing ATX without further pharmacotherapy. Pediatricians and child psychiatrists should be well aware of this potential adverse effect in children with ADHD receiving ATX.

  20. Insomnia

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    ... a warm bath, reading or listening to soft music. By Mayo Clinic Staff . Mayo Clinic Footer Legal Conditions and Terms Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Terms and Conditions Privacy Policy Notice ...

  1. Insomnia

    Science.gov (United States)

    ... Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  2. Insomnia

    Science.gov (United States)

    ... They include: Emotional conditions – depression, anxiety, and posttraumatic stress disorder Neurological disorders – Alzheimer’s or Parkinson’s disease Pain conditions – arthritis and headache disorders Gastrointestinal disorders – heartburn, GERD Sleep