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

An epidemiologic approach to the involutive general population was made to detect patients and risk group of insomnia. The survey was carried out in one health area of Oviedo, during the winter of 1990. A total of 329 elderly persons were interviewed, and three questionnaires were used: the G.H.Q., MMSE and a questionnaire "ad hoc". In the study, sleep disorders were correlated with level of general health (Golberg) and cognitive impairment (MMSE).
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PMID:[Sleep, organic deterioration and general health in the aging population. Study in a basic health zone of Oviedo]. 195 11

Sleep disorders related to depressive illness are now well documented. However, sleep disturbances associated with anxiety have only been explored in recent time. All types of anxiety (generalized anxiety, obsessive-compulsive disorders, panic attack) are associated with sleep disorders such as early insomnia, sleep interruption and low efficiency of sleep. The EEG approach gives different results according to the type of anxiety. Generalized anxiety is associated with total sleep time reduction and low efficiency of sleep. Sleep is unstable with numerous awakenings. Longer periods of stage 1 and 2 sleep are observed and slow wave sleeps as well as REM sleep time is reduced. REM sleep latency may be reduced in obsessive compulsive disorders. Although sleep abnormalities observed in anxiety disorders differ from those observed in depressive disorders, none of these features can be considered specific of anxiety.
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PMID:[Sleep disorders related to anxiety]. 198 13

An electroencephalographic (EEG) study on the rhesus monkey, primate model of human sleep, showed the significant wakening effect of a new psychostimulant, Modafinil. The first experiment, with single administration of three increasing doses of Modafinil (3, 6, and 12 mg/kg), was to determine the efficient threshold dose; the second experiment, with repeated administration of 22.5 mg/kg during 4 days, was to determine whether continuous wakefulness could be obtained without apparent behavioral disorders. Results of the first experiment showed a wakening effect above 6 mg/kg, but 12 mg/kg induced a sharp wakening effect with a significant decrease in all sleep stages. The second experiment induced important insomnia in all subjects for 4 days and 4 nights. No behavioral disorder was observed. Modafinil has a wakening effect at the dose of 6 mg/kg in rhesus monkeys and induces quasicontinuous wakefulness for 4 total days and nights with daily administration of 22.5 mg/kg, with no behavioral disorders. Modafinil should therefore find interesting applications in sleep disorder treatments.
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PMID:Electroencephalographic effects of modafinil, an alpha-1-adrenergic psychostimulant, on the sleep of rhesus monkeys. 198 Nov 2

Disturbed sleep is a common problem particularly among depressed patients. Diagnostic and treatment considerations are reviewed for two of the more common insomnia problems, psychophysiological insomnia and insomnia associated with depression. Studies of the actual sleep patterns of patients with these disorders reveal reliable differences that are important to understand for optimized treatment outcome. As the differentiation of sleep disorders becomes more precise and the pharmacologic armamentarium becomes greater, emphasis needs to be placed on both understanding the etiology of the sleep complaint and selecting a drug that is best matched to correct the underlying problem.
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PMID:Diagnosis and treatment of insomnia and depression. 205 Jun 50

Insomnia and anxiety are frequently experienced not only by healthy persons, but in their more intense expressions, by patients suffering from a variety of medical and psychiatric disorders. The International Classification of Sleep Disorders (1990) lists 88 types of sleep disorders. Thirty-three of these are related to insomnia and belong to the categories of intrinsic sleep disorders, extrinsic sleep disorders, circadian rhythm sleep disorders, and sleep disorders associated with medical or psychiatric disorders. Benzodiazepines are frequently used for the treatment of insomnia. For optimal treatment of insomnia, exact diagnosis, correct understanding of the biology, and appropriate use of the drugs are essential.
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PMID:Appropriate use of benzodiazepines in insomnia: clinical update. 207 65

The National Institutes of Health Consensus Development Conference on the Treatment of Sleep Disorders of Older People brought together clinical specialists in pulmonology, psychiatry, psychology, geriatrics, internal medicine, other health care providers, and the public to address the cause, diagnosis, assessment, and specific treatments of sleep disorders of older people. Following 1 1/2 days of presentations by experts and discussion by the audience, a consensus panel weighed the scientific evidence and prepared a consensus statement. Among their findings, the panel concluded that although sleep patterns change during the aging process most older people with sleep disturbances suffer from any of a variety of medical and psychosocial disorders. The panel recommended that the diagnostic evaluation of sleep disorders begin with a careful clinical evaluation performed by an informed primary care physician. When necessary, referrals should be made to individuals or centers with specialized skills and tools for therapy. The panel recognized two types of disorders for which treatment may be beneficial: obstructive sleep apnea and insomnia. The mainstay for treatment for sleep apnea is the use of nasal continuous positive airway pressure. A thorough medical evaluation is essential prior to initiating treatment for insomnia, as its causes may be of psychiatric, pharmacological, or medical origin. The panel recommended that hypnotic medications not be the mainstay of treatment for insomnia as they may have habit forming potential if overused. The full text of the consensus panel's statement follows.
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PMID:The treatment of sleep disorders of older people. 209 80

Because sleep needs vary from person to person, insomnia is defined as the chronic inability to obtain the amount of sleep needed for optimal functioning and well-being. Insomnia, which is a symptom rather than a disease, can be classified into three main etiologic groups: insomnias related to other mental disorders (for example, depression and anxiety), insomnias related to known organic factors (for example, sleep apnea and "nonrestorative" sleep), and primary insomnia (for example, learned psychophysiologic insomnias and insomnia complaints without objective findings). The treatment for insomnia often involves a combination of pharmacotherapy, behavioral and short-term psychotherapy, and sleep hygiene guidelines. Sleep disorders centers can provide specialized knowledge and techniques for patients with severe chronic insomnia.
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PMID:Insomnia. 219 48

Two common sleep disorders of the infant and toddler stages of development are sleeplessness and arousal disorders. Effective methods are available to reduce the impact of these problems upon the family.
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PMID:Sleep disturbances of the infant and toddler. 221 67

One hundred seven chronic insomniacs (41 men, 66 women; mean age, 37.9 years) with a history of use of benzodiazepines were recruited for a multicenter study testing the relative efficacy of flurazepam 15 mg or 30 mg, midazolam 15 mg, or placebo during a 14-day treatment period. Average duration of the complaint of insomnia was 13.5 years. Most (74%) of the patients met criteria for a diagnosis of persistent psychophysiological sleep disorder for both initiating and maintaining sleep.
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PMID:Characteristics of chronic insomniacs examined in a multicenter 14-day study of flurazepam and midazolam. 222 59

While insomnia is a familiar management problem for most doctors, disorders of hypersomnolence are much less familiar. The evolution of sleep monitoring at a major South African teaching hospital is described and the classification of sleep disorders reviewed. Analysis of the first 5 years' experience revealed that 27 of 46 patients had sleep apnoea (all obstructive, but 13 with a central component), while 3 had narcolepsy. Contributing causes of sleep apnoea included obesity (25 patients), tonsillar enlargement (3), acromegaly (3), rheumatoid cervical spondylosis (1), Hunter's syndrome (1) and haemangioma of the throat (1). Death from sleep apnoea occurred in 3 cases. Treatment of specific causes was effective in abolishing sleep apnoea, although attempts at weight loss were effective in a minority only. Nasal continuous positive airway pressure was effective in achieving symptomatic relief. Sleep monitoring was found to be valuable, provided all-night study facilities are available, and provided that patients who simply snore are excluded by prior clinical evaluation.
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PMID:The diagnosis and management of respiratory sleep disorders--the first 5 years at Groote Schuur Hospital. 225 27


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