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 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The main mechanisms of the chronopathological forms of magnesium depletion associate a low Mg intake with various dysregulating biorhythms. The differentiation between forms with hyperfunction and forms with hypofunction of the biological clock is seminal and the main marker is the production of melatonin (MT). The clinical forms of the various patterns of the chronopathological forms of Mg depletion may be central or peripheral. The clinical forms with hyperfunction of the biological clock (marker: increase in MT) may associate diverse expressions of nervous hypoexcitability: depression (i.e. Seasonal affective disease); cephalalgias nocturnal, without photophobia (i.e. cluster headaches); dyssomnia LASPS (advanced sleep phase syndrome) particularly]; asthenia and myalgias (i.e. fibromyalgia, chronic fatigue syndrome). The main comorbidity is found with depressive states. The therapy relies on classical bright light phototherapy, sometimes associated with psychoanaleptics. The clinical forms with hypofunction of biological clock (marker: decrease in MT) may associate various signs of nervous hyperexcitability (HEN): anxiety (from generalized anxiety to panic attacks); cephalalgias diurnal with photophobia (mainly migraine); dyssomnia [DSPS (delayed sleep phase syndrome) particularly, jet lag, night work disorders, age related insomnia, sometimes with inappropriate behaviour; photogenic epilepsia, generalized or focal; some clinical forms of chronic fatigue syndrome and fibromyalgia. The main comorbidity is between migraine and epilepsia. The treatment relies on the diverse forms of darkness therapy, possibly with the help of some psycholeptics: anxiolytics and anticonvulsants. The indications of chromatotherapy remain to be validated.
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PMID:Chronopathological forms of magnesium depletion with hypofunction or with hyperfunction of the biological clock. 1263 82

Sleep problems have been observed during many of the space flights. The existence of poor quality of sleep, fatigue, insomnia or different alterations in sleep structure, organization and sleep cyclicity have been established. Nevertheless results obtained from investigations of human sleep on board manned space vehicles show that it is possible to keep sleep patterns related to the restorative and adaptive processes. For the first time in the frame of the "Intercosmos" program a multi-channel system for recording and analysis of sleep in space was constructed by scientists of the Bulgarian Academy of Sciences and was installed on board the manned Mir orbiting station. In 1988 during the joint Bulgarian-Russian space flight continues recording of electro-physiological parameters necessary to estimate the sleep stages and sleep organization was made. These investigations were continued in next space flights of different prolongation. The results were compared with the findings obtained under the conditions during the pre- and post-flight periods.
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PMID:How human sleep in space--investigations during space flights. 1297 17

Sleep disturbance is perhaps one of the most prevalent complaints of patients with chronically painful conditions. Experimental studies of healthy subjects and cross-sectional research in clinical populations suggest the possibility that the relationship between sleep disturbance and pain might be reciprocal, such that pain disturbs sleep continuity/quality and poor sleep further exacerbates pain. This suggests that aggressive management of sleep disturbance may be an important treatment objective with possible benefits beyond the improvement in sleep. Little is known, however, about how to effectively treat sleep disturbance associated with pain or whether such treatment might have beneficial effects on reducing pain. A small, but growing literature has applied cognitive-behavioral therapies (CBT) for either pain management or insomnia to patients with chronic pain. In this article, we review the longitudinal literature on sleep disturbance associated with chronic pain and clinical trial literatures of cognitive-behavior therapy for pain management and insomnia secondary to chronic pain with the aim of evaluating whether the relationship between clinical pain and insomnia is reciprocal. While methodological problems are common, the literature suggests that the relationship is reciprocal and CBT treatments for pain or insomnia hold promise in reducing pain severity and improving sleep quality. Directions for future research include the use of validated measures of sleep, longitudinal studies, and larger randomized clinical trials incorporating appropriate attentional controls and longer periods of follow-up.
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PMID:How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. 1503 51

Sleep problems become more common with age, affect quality of life for individuals and their families, and can increase healthcare costs. Older people are often prescribed a range of drugs for their health problems, many of which have side effects. Side effects are just one reason why there is an argument to be made for clinical use of non-pharmacological treatments. This review considers the effectiveness of three interventions, cognitive behavioural therapy (CBT), bright light, and physical exercise. It considers sleep quality, duration and efficiency as primary outcome measures. Randomised controlled trials were selected where 80% or more of participants were over 60 and had a diagnosis of primary insomnia and where investigators had taken care to screen participants for dementia and/or depression. The data suggest a mild effect of CBT for sleep problems in older adults, best demonstrated for sleep maintenance insomnia. It may be that the provisions of 'top-up' or 'refresher' sessions of CBT training to improve durability of effect are worthy of investigation. Evidence of the efficacy of bright light and exercise were so limited that no conclusions about them can be reached as yet; however, in view of the promising results of bright light therapy in other populations with problems of sleep timing, further research into its effectiveness with older adults would seem justifiable. Exercise, though not appropriate for all in this population, may enhance sleep. Research involving exercise programmes designed with the elderly in mind is needed.
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PMID:A systematic review of non-pharmacological therapies for sleep problems in later life. 1506 10

Patients with dementias, such as Alzheimer's disease (AD), often have nocturnally disrupted sleep. Clinically, this may present as agitation during the nighttime hours, which may affect as many as a quarter of AD patients during some stage of their illness. Sleep disturbance in AD may be multifactorial and involve sleep-disordered breathing and disrupted chronobiology, both often characterized by excessive daytime napping. Polysomnographically, AD patients show decreased rapid eye movement (REM) sleep in proportion to the extent of their dementia; some evidence suggests that cholinesterase inhibitors, commonly used pharmacologic agents for cognitive loss in AD, may increase REM sleep measures. Unfortunately, such agents may also induce insomnia and vivid dreams. There have been no randomized clinical trials of sedative-hypnotic medications specifically targeted at AD patients with sleep problems. Evidence suggests that sedative-hypnotics, such as benzodiazepine site-specific agonists, may have a role in some cases, whereas atypical antipsychotics may be necessary in other cases. There are also reports of successful interventions with nonpharmacologic options (eg, exercise, illumination). The utility of melatonin as a hypnotic in this population appears equivocal.
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PMID:Sleep disorders in Alzheimer's disease and other dementias. 1525 36

Sleep problems tend to increase with age, so much so that insomnia can become entwined with other health issues among older people. This article looks at causes of sleep problems and explains how nurses can help assess their severity.
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PMID:Sleep in the older adult. 1561 2

Sleep problems and their consequences are a serious public health issue, imposing a substantial burden on the individual and society. Although sleep occupies one-third of our lives and can be considered to be an important subject, sleep medicine is a young speciality and problems are poorly investigated. Sleeping problems are frequently reported during the menopausal transition. Subjectively women find that hormone replacement therapy (HRT) significantly improves sleep quality. Thus, HRT can be considered as a first-line therapy for insomnia. However, in some cases insomnia coincides with the menopause transition and cannot be considered to result from ovarian failure. Depressive mood, stress and behavioural factors, as well as restless legs and periodic limb movement syndromes may be the underlying cause. Thus, if no relief with HRT has been achieved after a few months, other aetiologies should be explored.
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PMID:Sleep and the menopause. 1566 50

Sleep problems, day somnolence, and fatigue as a result of psychotropic drugs are very common. Psychiatrists usually consider these effects a result of insomnia and treat them by prescribing sleeping pills or other benzodiazepine agents. We describe here 10 cases of circadian rhythm sleep disorders (CRSD)--and not merely insomnia--as a possible side effect of fluvoxamine (FVA). Two other serotonin reuptake inhibitors, fluoxetine and clomipramine, did not induce CRSD in any of these 10 patients. We speculate that FVA-induced CRSD is caused by the effect of FVA on serotonin and melatonin levels in the central nervous system. CRSD as a side effect of FVA can be treated by replacing the suspected FVA or adding melatonin to a beneficial FVA treatment. Thus, it is important to be aware of possible iatrogenic CRSD in order to treat appropriately. Prospective studies are needed to confirm our observation and to study the influence of other psychotropic drugs on sleep-wake schedule.
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PMID:Circadian rhythm sleep disorders as a possible side effect of fluvoxamine. 1574 15

In order to study the therapeutic effects of the TCM drugs on senile dyssomnia, 121 such patients were randomly divided into a treatment group of 63 cases (given the TCM drugs) and a control group of 58 cases (given estazolam). The changes shown in the SDRS and HAMA scores and the other indexes were observed in both of the two groups to evaluate the therapeutic effects. The results showed that the effective rate was 76.3% in the treatment group, and it was 69.1% in the control group; and that the TCM drugs had better effects in improving such symptoms as lethargy, dry mouth, and rebound of insomnia. Therefore, it can be concluded that the effect of the TCM drugs isbetter for senile dyssomnia than that of the Western drug estazolam.
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PMID:TCM treatment for 63 cases of senile dyssomnia. 1588 23

Insomnia is a common and significant healthcare problem, and affects a large percentage of women seen by general practitioners, obstetrician-gynecologists and mental health professionals. Specific risk factors for insomnia may be gender-related, including higher prevalence rates of depression and anxiety among women, environmental and social factors, as well as reproductive-related factors (e.g., peri-menstrual difficulties and menopause-related symptoms). Sleep problems interfere significantly with daytime functioning and overall well-being, and may lead to serious clinical consequences. Treatment options include benzodiazepines, non-benzodiazepines, nonprescription sleep aids, and non-pharmacologic interventions such as sleep hygiene measures. This article reviews the existing literature on the prevalence, clinical characteristics of insomnia in women, and highlights some of the treatment options available. Healthcare providers should be aware of the variety of pharmacologic and non-pharmacologic options for treatment of insomnia and, in particular, be able to weigh their efficacy against the risks of side effects and next-day sedation.
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PMID:Insomnia in women: an overlooked epidemic? 1619 81


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