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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Information which has emerged thus far relates to the overall transmitter mechanisms of sleep. The data, while conflicting, point to the involvement of many neuroregulators at numerous integrative levels of the process. However the long term question still remain: what triggers and maintain sleep, what stops sleep, what occurs to the body and brain during sleep--in essence, why sleep? These questions are now problems for behavioral neurochemists, whereas in a previous era, they were problems for philosophers. Unfortunately, our answers to date, while in another idiom, have hardly been more complete or satisfying. To answer these questions, it will be necessary to understand, in detail, the manner in which neurobiochemical processes relate to the functional physiology of sleep. Although existing studies have given invaluable insight into the neurochemical anatomy of sleep, we have only recently acquired the technical and biochemical expertise necessary to investigate sleep as it occurs normally. Future research must focus on the dynamic changes associated with the regulatory mechanisms of neurotransmitters. Many questions can be asked. With sleep transitions, what changes occur in transmitter content, synthesis, or release? Are there changes in metabolic pathways, reflecting a shift from intra- to interneuronal metabolism? What changes occur in pre- and postsynaptic neurotransmitter receptors to affect sensitivity? What constraints do genetic (245) and environmental (246) factors impose upon these mechanisms? Knowledge of such parameters will allow us to construct more complete models of the neuroregulatory basis of sleep and waking. However, as we acquire this knowledge, we must avoid the temptation of assuming causation when the evidence merely shows correlation. Neuroregulation are involved in the control of number different behaviors; and, at present, we have few, if any, methods of establishing causative links between a specific neuroregulator and a specific behavioral state. Yet, even without an understanding of what "causes" sleep, we may be able to develop pharmacological agents which permits discrete alteration of sleep mechanisms in a more physiological and specific manner. This potential for manipulation of sleep is of obvious importance in illnesses such as insomnia, narcolepsy, and sleep apnea (247, 248). In addition, it may be valuable in the treatment of such conditions as psychosis and depression, where sleep disturbances are an important component of the illness. For example, delirium tremens might be best understood as a psychotic episode which is the result of an aspect of sleep emerging into wakefulness. The range and breadth of both the basic questions and the potential application of sleep research portend an exciting future for this field.
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PMID:Neuroregulators and sleep mechanisms. 16 54

The aim of this paper is to examine if a disturbance of slow-wave sleep may partly account for the imbalance between waking and sleep observed in insomnia. 40 normal subjects and 40 insomniacs were recorded in the laboratory. No direct interregulation appeared between total sleep and REM sleep on one hand, and between slow-wave sleep and REM sleep on the other. Slow-wave sleep, however, was linked to the waking-sleep imbalance, as low values of stages 3 and 4 were statistically associated with low total sleep duration. The reduction of slow-wave sleep could not merely be attributed to an increased pressure of wakefulness. Our results indicate that it represents probably a disturbance in itself, perhaps related in some cases to a precocious senescence of sleep, but do not account alone for all sleep disturbances.
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PMID:Is insomnia a disease of slow-wave sleep? 18 67

An open assessment of chlormezanone in the treatment of rheumatic sleep disturbances was carried out in general practice. Sixty-one patients received 400 mg chlormezanone (2 tablets) each night for 2 weeks. Patients' nightly sleep assessment showed a steady improvement over the 2-week period, and overall effectiveness was rated as good or excellent by 75% of patients. Only 1 patient stopped treatment because of side-effects. It was concluded that chlormezanone could prove a useful alternative to current therapy for treatment sleeplessness in rheumatic patients.
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PMID:Chlormezanone in the treatment of insomnia due to rheumatic stiffness. 31 73

Sleep disturbances are common in depressive states, and have been recently precised. Apart from insomnia, alterations of the organization of sleep and especially a shortening of paradoxical sleep latency, as well as modifications of slow wave sleep, have been reported. The main effect of classical antidepressant drugs is a marked decrease or a complete abolition of paradoxical sleep. However, some antidepressant drugs do not affect paradoxical sleep, and other drugs, devoid of antidepressant properties, depress markedly the production of paradoxical sleep. The investigation of the modifications of sleep in depressive states, as well as of the effect of antidepressant drugs, may contribute to a better understanding of the physiopathology of these diseases.
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PMID:[Biological approach to depressive conditions: study of sleep (author's transl)]. 44 13

Sleep is an enigma and the clinical importance of disturbed sleep is not clear. Much has been learnt in the past 25 years of the physiology of normal and abnormal sleep. Complaints of insomnia can be related to several causes--normal extreme patterns, psychiatric, physical, specific and drug-related. The treatment of insomnia is essentially that of the primary condition. Hypnotics have a limited role and their use should always be carefully considered.
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PMID:Sleep and hypnotics. 49 33

The Stanford Sleep Inventory was given to 639, 11th- and 12th-grade students to assess the prevalence and correlates of poor sleep among an adolescent population. Of the sample reported, 49.8% had no sleep problems, whereas 37.6% reported occasional sleep disturbance and 12.6% reported chronic and severe sleep disturbance. Students complaining of disturbed sleep were more likely than good sleepers to describe negatively their physical and personality characteristics. The clinical implications of these data for developing educationally-based nondrug treatment of the complaint of insomnia among adolescents are discussed.
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PMID:Prevalence and correlates of poor sleep among adolescents. 65 41

The authors have studied the sleep of 6 hydrocephalic infants. In 4 cases disturbed sleep was noticed, characterized by insomnia in 2 cases, and frequent interruptions of sleep in the other 2 cases. In the last cases no other particular alterations were observed. The research was continued in 2 cases, operated on with the Pudenz Valve. In one of which the valve functioned well, sleep was restructured. In the second case the valve did not function well and sleep was not restructured. This suggests the hypothesis that the endocranial hypertension may alter the sleep cycles.
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PMID:[Sleep cycles of hydrocephalic infants (author's transl)]. 92 10

Forty-one patients completed the study where Visken was added to the treatment regimen of patients whose blood pressures were poorly controlled on methyldopa or who were experiencing side-effects with methyldopa. Supine blood pressure was reduced from 177/108 mm Hg before Visken therapy to 159/96 mm Hg after twelve weeks of taking Visken. The dose of methyldopa was reduced from a mean 921 mg at the start to 445 mg at the end. Fourteen patients were able to stop methyldopa therapy. The number of side-effects reported was reduced as the study continued and fifteen patients commented that they felt better on Visken. Nine patients did not complete the trial, three of these because of side-effects, viz insomnia, lethargy and sleep disturbances.
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PMID:The addition of Visken to methyldopa therapy in hypertension: a multicentre study. 102 42

Modern warfare requires protection of the entire civilian population, and a main feature of Swiss planning is the provision of adequate shelter space for every inhabitant. The medical and psychologic problems of prolonged shelter living are considered, with reference to the literature on experience in other countries. The study centers on description of a shelter occupancy experiment. 25 men with an average age of 37 years spent 7 days in a closed shelter during the hottest part of the year. Floor space was 1.2 m2 and room volume 2.5 m3 per person. The experiment revealed that in-shelter climatic conditions remained tolerable. Initially several members of the group suffered from insomnia and nausea, while sleep disturbances, headache and gastrointestinal symptoms also occurred in the course of the stay. Daily self-rating of condition with appropriate scales showed a positive correlation of "irritability" with air humidity and a negative correlation of "vitality" with room temperature. Good shelter management and a trained leader are essential prerequisites for prolonged shelter occupancy.
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PMID:[Medical and psychological problems relating to emergency shelters in case of war]. 112 61

Very few epidemiological surveys have specifically studied relationships between sleep disturbances and psychiatric diseases. In this review, we preferred to use the classification proposed in 1979 by the Association of Sleep Disorders Centers. It includes four main categories: insomnias, excessive sleepiness, troubles of the wake/sleep schedule and parasomnias. Evaluating psychiatric disorders among general populations is easier owing to DSM III and DSM III-R criteria, but there are not equivalent criteria in evaluating sleep disorders. It is almost impossible to realize polysomnographic recordings in large samples, therefore sleep disorders are to be detected by questionnaires. It has been shown that there is a good correlation between self-reports and polysomnographic recordings among clinical and general samples. The prevalence of insomnia, defined as difficulties of initiating and maintaining sleep, is estimated between 9 and 31%. It is higher among women, elderly people, separated and divorced subjects, and low educational levels' groups. It has to be noticed that polysomnographic records of some subjective insomniacs are not different from those of good sleepers, sleep latency excepted. These subjective (and not objective) insomniacs have high scores in anxiety scale, depression scale, or psychologic distress. Insomnia is more frequently noted amongst subjects with psychiatric diagnoses, especially major depressive disorders and anxiety disorders. Depressive disorders are present in 21-40% of insomniacs versus 0-1% of non-insomniacs, and anxiety disorders in 13-24% of insomniacs versus 3-10% of non-insomniacs. In depressive disorders, sleep alterations are frequently noted: they are difficulties of initiating and maintaining sleep, decreasing proportion of slow-wave sleep, decreasing time of REM (rapid eye movement) sleep and REM sleep latency, and increasing density of REM sleep. Of these modifications, the last two ones seem to be specific for depression. The relationships between sleep, aging and depression are more complex than previously noted. For example, differences between depressed and non-depressed subjects depend on the age of the population. The prevalence of hypersomnia is lower than the insomnia's. It varies between 2 and 4%. It is more frequently noted among young people, and never married subjects. Two specific aetiologies must be looked for: sleep apnea syndrome and narcolepsy. These diagnoses are respectively found in 45% and 24% of hypersomniacs examined in American Sleep Centers. Hypersomnias are objectived by the Multiple Sleep Latency Test, which measures the physiologic sleep tendency.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Sleep disorders in psychiatric diseases. Epidemiological aspects]. 129 83


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