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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are frequent in stroke patients. They deserve attention, because they may significantly influence rehabilitation process and functional outcome. In addition, SDB may increase the risk of stroke recurrence. More than 50% of stroke patients have SDB, mostly obstructive sleep apnea (OSA). In some patients, stroke recovery is accompanied by an improvement of SDB. The treatment of choice for OSA is continuous positive airway pressure. Oxygen, theophylline, and other forms of ventilation may be helpful in patients with other forms of SDB (eg, Cheyne-Stokes breathing). In at least 20% to 40% of stroke patients, SWD are present, mainly in form of increased sleep needs (hypersomnia), excessive daytime sleepiness, or insomnia. Depression, anxiety, SDB, stroke complications (eg, nocturia, dysphagia, and urinary or respiratory infections), and drugs may contribute to SWD and should be addressed first. In patients with SWD of primary neurologic origin, treatment with stimulants or dopaminergic drugs and hypnotics or sedating antidepressants, respectively, can be attempted.
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PMID:Sleep Apnea and Other Sleep-Wake Disorders in Stroke. 1267 Apr 13

Sleep disorders are pervasive in patients with multiple sclerosis (MS) although clinically underrecognized by most physicians. The most common sleep disorders seen in patients with MS include insomnia, nocturnal movement disorders, sleep-disordered breathing, narcolepsy, and rapid eye movement sleep behavior disorder. Factors that influence the quality of sleep in this patient population include pain, nocturia, depression, medication effect, location of lesions, and disease severity. Disrupted sleep has the potential to cause daytime somnolence, increased fatigue, and nonrefreshing sleep, and it may be associated with dangerous respiratory events. Awareness and treatment of these conditions is vital to improving health and quality of life in patients with MS.
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PMID:Sleep disorders in multiple sclerosis. 1579 38

The International Continence Society recognizes the overactive bladder (OAB) as a "symptom syndrome suggestive of lower urinary tract dysfunction" that is defined as "urgency, with or without urge incontinence, usually with frequency and nocturia." Patients who have OAB are often sleep deprived and their sexual life is hindered. These patients have a restricted social life and an increased risk for depression. Accurate prevalence figures are difficult to obtain because most patients consider OAB an inevitable part of aging and some patients are too embarrassed to seek diagnosis. Primary care physicians need to be educated about the importance of identifying this clinical problem and managing it in a way that will minimize morbidity and maximize quality-of-life improvement. This article describes the various aspects of OAB, with special emphasis on epidemiology and morbidity.
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PMID:The overactive bladder: Epidemiology and morbidity. 1701 78

Sleep apnea is highly prevalent in subjects after age 60, and affects older men and women similarly. Central apneas are often observed in addition to obstructive and mixed events. Pathogenesis of obstructive and central events during sleep in the elderly can be attributed to an amplification of well-established causes of sleep-disordered breathing (SDB) in younger adults. As in middle-aged adults, sleep-related complaints, cardiovascular diseases, depression and traffic accidents should prompt an evaluation by a sleep specialist. However, secondary enuresis and nocturia, cognitive impairment, ophthalmic conditions and repeated falls may be the main complaint in elderly subjects. Sleep studies in the elderly should systematically include reliable means to detect central apneas and periodic leg movements. Untreated SDB in the elderly appears to have a lesser impact on mortality than in middle-aged adults. However, the typical morbidity associated with the disorder in younger adults is observed in the elderly. Elderly symptomatic SDB patients tolerate CPAP no differently than younger patients and should be effectively treated. In conclusion, whether sleep apnea in the elderly represents a specific entity or the same disease as in younger subjects, with some distinctive features, is still unclear. Further research, in particular focusing on the impact of age on SDB outcomes, is needed.
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PMID:Sleep apnea in the elderly: a specific entity? 1731 40

Nocturia is defined as the patient's complaint of having to get up once or several times during the night to urinate, with each voiding preceded and followed by a period of sleep. The direct consequence of nocturia is impaired quality of sleep. The decreased daytime energy is responsible for depression and metabolic disorders and an indirect increase of mortality. Nocturia is a difficult problem to treat in the management of BPH. An effective treatment against nocturia can improve quality of life by acting on quality of sleep. Alpha-blockers, which control these symptoms, are a major component of treatment. However, the dosage forms available are often pharmacologically dependent on dosing conditions, and do not allow maintenance of constant blood levels of the drug. The OCAS (Oral Controlled Absorption System) form of tamsulosin allows absorption of the drug throughout gastrointestinal tract and maintenance of a constant plasma concentration over the 24-hour period.
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PMID:[Impact of nocturia on the daily life of patients with lower urinary tract symptoms due to benign prostatic hyperplasia]. 1796 86

The overactive bladder syndrome (OAB) associates urgency, frequency, nycturia, more or less associated with urinary incontinence. Its frequency is between 16 to 45 %, in the general population; the number of affected people in the USA being estimated at 34 million. Symptomatology is primarily marked by the abrupt, irrepressible need to urinate, impossible to defer, but also by a diurnal and night high mictional frequency. This OAB is more frequent when patients age increases, and affects indifferently men and women. The OAB induces a known negative impact on the quality of life and can lead to depression, sexual disorders, sleep disorders and a professional absenteism. The OAB medical treatment is actively concerned by the research since the discovery of oxybutinine. Tolterodin, solifenacin, darifenacin, trospium chloride supplement the therapeutic arsenal. New formulations (immediate and extended releases), new administration mediums (intravesical, transdermic, vaginal, rectal), new active ingredients (botulinic toxin, capsaicine, resiniferatoxine) are currently tested. The therapeutic options multiply, aiming at reducing to the maximum symptomatology, as well as the induced side effects.
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PMID:[Anticholinergic drugs in overactive bladder]. 1817 6

Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options.
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PMID:Insomnia and chronic heart failure. 1875 45

Changing sleep architecture in the elderly may increase their vulnerability to comorbid insomnia. Common comorbid conditions include chronic pain, depression, nocturia, and neurologic conditions such as Parkinson's and Alzheimer's disease. Diagnosing and treating comorbid insomnia in an older population poses special challenges for clinicians given the variety of coexisting medical and psychological conditions, polypharmacy, and the potential adverse effects of the most commonly used medications for insomnia in this population. Thus, the use of nonpharmacologic treatments, such as cognitive behavior therapy and relaxation techniques, is recommended before any medical approaches.
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PMID:Late-life comorbid insomnia: diagnosis and treatment. 1929 2

The aim of this study was to compare the results of the day-to-day self-evaluation of sleep quality by sleep logs with Parkinson's disease sleep scale (PDSS) in Parkinson's disease (PD) patients. Actigraphy was used as an independent analysis of nighttime activity interfering with sleep. A total of 71 idiopathic PD patients and 21 age- and sex-matched normal individuals lacking any type of sleep disturbance were recruited. Sleep was evaluated by PDSS, 7-d sleep log and actigraphy. Sleep logs and PDSS showed reduced sleep quality and daytime somnolence scores in moderate/severe PD patients as compared to healthy controls. Significant correlations were found between sleep quality in sleep logs and all domains of PDSS sleep quality, except for the presence of nocturia, which correlated with nocturnal activity. PD severity and depression were the only predictors of reduced sleep quality. The retrospective and day-to-day sleep self-evaluations were coincident. Reduced sleep quality was related to increased PD severity and depression scores.
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PMID:Parkinson's disease sleep scale, sleep logs, and actigraphy in the evaluation of sleep in parkinsonian patients. 1940 16

Nocturia is the most common and under-recognized urinary symptom, experienced by the majority of older people and increasing in prevalence with advancing age. It is associated with a range of debilitating effects including sleep disturbances, falls and instability, depression, and social isolation, yet it is accepted by many as a natural consequence of ageing. However nocturia, like most other lower urinary tract symptoms, is responsive to a range of simple lifestyle advice and behavioural interventions that may be delivered by nurses. This article calls for a raised awareness of this 'silent condition' to enable nurses to recognize nocturia, identify its impact on individuals and initiate and deliver intervention to improve the health and well-being of older people.
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PMID:The impact of nocturia on older people - implications for nursing practice. 1949 32


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