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

Twenty years (1963-1983) of experience with polyhypnography (polygraphical all night recordings of sleep: EEG, EOG, ECG, EMG etc.) and ambulatory treatment of insomnia consequently resulted in the fact that sleep disturbances are not easy to classify. Procedure is to evade to framework-diagnosis, whereby only for practical purposes tab. 2 is provided. Approximately 25-32% of the population suffer from sleep disturbances resulting in lack of sleep.
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PMID:[Sleep disorders. 1. Classification and incidence]. 669 72

Eleven patients suffering from chronic insomnia were given 30 mg flurazepam for 28 nights. While EEG measures of total sleep time and sleep efficiency were improved, changes in sleep latency and intermittent waking time were small and nonsignificant. Subjective benefits in sleep were confined to the first 2 nights. There was neither increased nor decreased daytime sleepiness. Cognitive functioning was significantly decreased during the first 2 days, and patients were unaware of these changes. Simple motor tasks were relatively unaffected. Desalkylflurazepam concentrations showed significant accumulation over time, but were not predictive of sleep measures or daytime performance in individual subjects. The withdrawal period was characterized by subjectively disturbed sleep and daytime dysphoria.
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PMID:A clinical study of flurazepam. 676 26

The safety and efficacy of zopiclone (7.5 mg) and pentobarbitone (100 mg) were compared in 60 adult outpatients suffering from insomnia. The patients were randomly assigned to one of the two treatment groups, and the medication was taken at bedtime for 16 days. Zopiclone and pentobarbitone, compared with placebo, improved sleep onset, duration of sleep, number of night time awakenings, and quality of sleep. Zopiclone was superior to pentobarbitone with regard to sleep quality, judgement of therapy, and condition in the morning. Side effects were reported in each treatment group, but were less frequent in the zopiclone group (p less than 0.005). Zopiclone is a useful drug for the treatment of sleep disturbances, not only because of its efficacy, but also because of its tolerability.
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PMID:Comparative study of zopiclone and pentobarbitone as hypnotics. 676 43

Interval therapy is the concept of intermittent applications with drug-free intervals, based on the observation that in many cases L-tryptophan has the best effects on disturbed sleep during the drug-free interval after-short-term application. This concept was formulated as an experimental hypothesis to be tested in the sleep laboratory in a predictive, double-blind design, comparing a 4-night placebo period following repetitive 3 X 2 g L-tryptophan application with baseline. All patients, severe chronic insomniacs, 5 males and 3 females (mean age 38.4 years) improved significantly at the predefined level of 0.05. Analyses of the polygraphic recordings proved highly significant sleep improvements in the parameters that are indicators of insomnia. No side effects were seen. It can be concluded that the interval therapy with L-tryptophan is a potent treatment for chronic primary insomnia.
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PMID:Interval therapy with L-tryptophan in severe chronic insomniacs. A predictive laboratory study. 703 60

The clinically observed results in 40 patients, from 1 to 15 years old, presenting sleep disturbances, in a comparative and statistically approached study of flurazepam 15mg daily against placebo, are reported. Placebo was administered, followed by the drug, during 14 days each. The chief complaints were sleepwalking, sleep-talking, sleep terror, sleep-related bruxism, sleep-related headbanging, insomnia and excessive movements during sleep. A significant effect of flurazepam on sleepwalking, sleep-talking, bruxism, sleep terror and excessive movement during sleep, was observed. The insomniac headbanging patients were not enough for statistical analysis. Flurazepam side effects were excessive drowsiness during daytime in 3 cases; irritability, 3 cases; nausea and vomiting, 2 cases, and were not correlated with age. Placebo side effects were similar, except for nausea and vomiting which were not observed. It was necessary to discontinue flurazepam in 2 cases, because of excessive drowsiness during daytime, which did not improve when reducing the dose.
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PMID:Evaluation of flurazepam and placebo on sleep disorders in childhood. 704 99

Polygraphic recordings of the sleep of patients complaining of insomnia has led to recognition of specific patterns of disturbed sleep corresponding to different etiologies of insomnia. This study presents results of polygraphic recordings of the sleep of 26 patients with chronic pain for which no physical cause can be found. All 26 also complained of insomnia. Sleep parameters of this group were compared with those to two other groups also complaining of insomnia: 12 patients whose disturbed sleep was judged secondary to psychiatric disorder, and 16 patients with the subjective complaint of insomnia in whom no objective evidence of sleep disturbance could be demonstrated. The three groups differed significantly in terms of their sleep parameters. The pain patients slept less than the subjective insomnia patients. The sleep disturbance of the psychiatric patients was more severe than that of the chronic patients. Several chronic pain patients showed evidence of nocturnal myoclonus; several also showed alpha rhythm intrusions into their sleeping electroencephalograms. The study verifies that chronic pain patients do experience significant sleep disturbance and raises several questions concerning relationships among chronic pain, sleep disturbance, and psychiatric illness, particularly depression.
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PMID:Disturbed sleep in patients complaining of chronic pain. 708 3

Twenty-five adults with a deviated nasal septum, who complained about excessive daytime sleepiness, chronic fatigue, and nocturnal insomnia, were studied for one to two nights in a sleep laboratory. Recordings disclosed disordered breathing during sleep in the form of pronounced periodic breathing of alternating hypopneas and hyperpneas, isolated hypopneic episodes and central apneas and periodic sighs, all combined with electrophysiologic "microarousals," and a mixture of alpha and delta EEG wave activities. Surgical treatment of the deviated septum in 14 patients resulted in a subjective improvement in the level of diurnal alertness and in the quality of nocturnal sleep in 12 patients. Follow-up sleep recordings in seven of the patients who reported subjective improvement in sleep disclosed notably less waking and abnormal breathing during sleep. These results suggest that increased upper airway resistance can cause nonapneic breathing disorders in sleep and, consequently, sleep disturbances.
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PMID:Excessive daytime sleepiness and insomnia. 709 73

Of 22 patients on maintenance hemodialysis investigated during a period of 20 days for sleep disturbances by means of a semistructured questionnaire, 14 patients reported sleep disturbances. The patient group was found to be homogeneous with respect to factors influencing sleep behavior, such as age, personality and comedication. The sleep disturbances of the dialyzed patients was characterized by diminished sleep efficiency (time asleep/time in bed) and more fragmented sleep, while time of lying in bed awake was perceived as particularly disturbing. The sleep disturbance could be interpreted as a form of secondary metabolically induced insomnia. A single dialysis caused increased fatigue and diminution of well-being, but also an increase in the first fragment of sleep and of the total duration of sleep, i.e. it induced a modification toward a more physiologic sleep pattern. The retention of "middle molecules" could be of importance for the occurrence of uremic sleep disturbance. Patients who were underdialyzed relative to middle molecules were more numerous in the group with disturbed sleep, but the difference did not reach significance in the small number of subjects studied.
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PMID:[Sleep disorders in patients with chronic renal insufficiency in long-term hemodialysis treatment]. 710 Aug 78

The short-term hypnotic efficacy of 15 mg flurazepam was evaluated in nine patients (mean age 37.2 +/- 15.9 years) who complained of insomnia and had polysomnographic evidence of disturbed sleep. Patients slept in the laboratory 14 consecutive nights, and their sleep was monitored using standard polysomnographic procedures. Prior to bedtime, they received a placebo the first four nights, 15 mg flurazepam on nights 5 through 11, and a placebo again on nights 12 through 14. Flurazepam significantly increased total sleep time while reducing the latency to stage 1 sleep, the number of awakenings in the night, and the amount of wakefulness after sleep onset. Sleep stage patterns also were altered significantly with flurazepam: percentage stage 2 sleep increased, and percentages of 3-4 sleep and REM sleep (on drug night 1 and nights 1-3) decreased. With the exception of REM sleep, most of these drug effects were first detected on the second night of administration, did not diminish over the next six nights, and persisted during the three-day withdrawal period. Subjective evaluations of sleep generally corresponded with the polysomnographic data. It was concluded that 15 mg flurazepam has significant hypnotic properties with minimal adverse side effects.
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PMID:Flurazepam for short-term treatment of complaints of insomnia. 710 76

Polysomnographic studies of nocturnal sleep were performed on a 63-year-old women. Sleep-onset and sleep-maintenance insomnia dated back to a cerebral infarction at age 53, which resulted in bilateral cerebral injury. Two patterns of respiration were observed, and both were sleep-stage-dependent. Classic Cheyne-Stokes respiration predominated during slow-wave sleep and stages 1 and 2. REM sleep, in contrast, was associated almost exclusively with normal respiration. Recurrent brief arousals, temporally linked to the Cheyne-Stokes pattern of respiration, markedly disturbed sleep stages 1 and 2 and appeared related to the patient's subjective sleep complaints. During waking, REM, and NREM sleep, respiration is known to have different sensitivity to CNS and peripheral controls. The selective association of Cheyne-Stokes respiration with NREM sleep in this patient supports the view that anatomically separate CNS mechanisms regulate respiration in REM and NREM sleep.
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PMID:Sleep-stage-dependent Cheyne-Stokes respiration after cerebral infarct: a case study. 720 Nov 14


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