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

This report represents the polysomnographic aspects of sleep and the psychological characteristics of a large series of patients with insomnia classified according to the diagnostic system of the Association of Sleep Disorders Centers. The findings for patients in the various diagnostic categories were compared to those of symptomatic patients with no objective findings. 9 specific diagnoses were made, but 4 diagnoses accounted for the majority of patients. The 4 most prevalent were psychophysiological disorders (15%), psychiatric disorders (17%), nocturnal myoclonus and restless legs (18%), and no objective findings (19%). Patients of a sleep disorders center are a select population and may not be representative of the general population of patients with insomnia complaints. The psychological characteristics of the different diagnostic groups were assessed by computing the number of elevations on the MMPI. Patients with a psychiatric diagnosis exhibited the highest number of MMPI elevations, as might be expected. Patients with nocturnal myoclonus had the lowest number of elevations. The other groups did not significantly differ from the group with no objective findings. Polysomnographic measures of sleep differed considerably among the diagnostic groups. The groups with medical disorders, respiratory impairment, atypical polysomnographic features, and nocturnal myoclonus had similar short sleep latencies to those of the group with no objective findings. With longer wake times before sleep and significantly different from patients with no objective findings were the psychophysiological disorder, psychiatric disorder and drug and alcohol groups. Patients with a circadian rhythm disturbance had the longest latencies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Polysomnographic and MMPI characteristics of patients with insomnia. 659 Nov 72

Data from three consecutive nights in the sleep laboratory and data from psychological questionnaires and interviews were cluster-analyzed. A total of 89 physician-referred insomniacs were included, together with 10 good sleepers. The goal was to develop a purely empirical classification scheme of insomnia and to compare it with the Association of Sleep Disorders Centers' current nosology, which is based on clinical experience. The categories of chronic psychophysiologic insomnia and of childhood-onset insomnia were clearly identified in the cluster analysis. The insomnias associated with psychiatric disorders were split into five subgroups that made some intuitive sense, but did not mesh exactly with DSM III (Diagnostic and Statistical Manual, 3rd edition, American Psychiatric Association) categories.
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PMID:A cluster analysis of insomnia. 666 95

Of 100 consecutive patients on a psychiatric consultation service, 80 had sleep disorders; 72 had insomnia. Disturbed sleep was not mentioned in the records of 54% of the 80 patients, indicating a need for more physician education in sleep disorders.
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PMID:Sleep disorders on a psychiatric consultation service. 670 41

Scales to assess nightmare recall frequency and recalled frequency of insomnia-related disorders (sleep onset, sleep-maintenance problems, unrefreshing sleep, and restless sleep) were administered, together with the Social Readjustment Rating Scale of Holmes and Rahe to 170 part-time undergraduate students (mean age 27.4 yr., 97 men, 73 women), and together with the Life Events Inventory of Tennant and Andrews to another sample of 91 part-time undergraduates (mean age 26 yr., 53 men, 37 women). The time span for which life events and sleep disorders were to be assessed was the previous 6 mo. Pearson rs suggested that the relationships of different types of scores for life events (scores for change, for distress, for amount of control over events, weighted and unweighted scores for negative and positive events) to reports of sleep disorders were mostly weak (the largest coefficient was .29) and nonsignificant. Of all life events measures, negative life events listed on the Readjustment Scale were the most closely associated with reports of sleep disorders; all 14 coefficients involving negative events were significant and in the clinically expected direction. Further research is needed to examine whether the size of correlations between events and sleep disorders is related to factors such as readiness to recall and report negative personal experiences.
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PMID:Life stress measures and reported frequency of sleep disorders. 671 1

The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent).
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PMID:Age-related sleep-wake disorders at a sleep disorder center. 685 47

Employment which requires frequent shift rotation may lead to the development of specific sleep disorders. Delayed sleep phase (DSP) insomnia, a syndrome identified recently, can greatly impair an individual's circadian rhythm-dependent functions; it can occur when shift work disrupts normal sleep-waking schedules. Disorders of excessive daytime sleepiness, such as narcolepsy, occur in some subjects after they have been subjected to frequently rotating shifts. Understanding the problems associated with circadian rhythm disturbances and their interaction with sleep disorders is particularly important in industrial medicine; any clinician whose patients are subjected to frequent shift rotations should consider the effects of disrupted sleep-waking schedules.
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PMID:Circadian rhythm disturbances and sleep disorders in shift workers. 696 57

To assess the usefulness of a sleep disorders center the authors sent follow-up questionnaires to patients and referring physicians 9 months after each diagnostic evaluation. Findings suggest that sleep disorders centers provide a useful diagnostic service, especially for patients suffering from excessive daytime sleepiness. This problem usually has a medical etiology, and sleep laboratory evaluations seemed crucial for about two-thirds of all such patients. Insomnia was more likely to involve behavioral/psychological factors; about 30% of the patients with long-term, serious insomnia seemed to benefit markedly from the sleep center evaluation.
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PMID:Effectiveness of a sleep disorders center: a 9-month follow-up. 707 57

This is a summary of research studies indicating a primary role of psychotherapy in the etiology of certain sleep disorders. Thus, chronic insomnia is associated with high levels of psychopathology and a personality profile characterized by internalization of emotions. Also, a greater number of stressful life events occurs at the year of onset of insomnia. Two additional sleep disorders (sleep-walking and night terrors in adults) are similarly associated with high levels of psychopathology. Although these two disorders share many common clinical and psychopathological characteristics, their psychological profiles and psychopathological correlates differ considerably. Sleepwalkers show a high incidence of personality disorders with generally active, outward behavioral patterns, whereas night terror sufferers are mostly anxious, depressed and phobic with an inhibition of outward expression of aggression. Based on these research findings a series of therapeutic recommendations is presented for the effective management of patients with insomnia, sleepwalking or night terrors.
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PMID:Sleep disorders: research in psychopathology and its practical implications. 712 21

Insomnia, daytime sleepiness, and nocturnal wandering, so common in the elderly, are caused largely by two specific pathophysiologic processes. Sleep apnea is a condition where respiration pauses during sleep, leading to arousal. Sleep apnea is due either to obstruction in the throat or failure of the central respiratory center. Periodic movements in sleep are characterized by frequent ankle and leg flexions, leading to arousal. Sleep apnea and periodic movements in sleep require specific diagnoses and treatments. Each process occurs in 20%-30% of people over 65, and perhaps the majority of older people have one or the other condition or both. Because of possible interactions with these sleep disorders, the widespread prescribing of sleeping pills to elderly patients is irrational and often dangerous. In the future, large-scale clinical trials will be needed to define effective long-term treatments for these conditions and to define when treatment is worthwhile.
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PMID:Sleep apnea and nocturnal myoclonus in the elderly. 717 50

The authors placed 84 patients who complained of insomnia into 10 diagnostic categories on the basis of medical, psychiatric, and polysomnographic evaluations. Only half the patients had objectively defined difficulty inducing or maintaining sleep when compared with 20 normal control subjects. However, all but 16 patients showed polysomnographic evidence of some sleep disorder. Diagnostic categories within the insomnia groups could be distinguished from one another by polysomnography. Patients in only 3 of the 10 diagnostic categories showed evidence of psychological distress on the MMPI; patients in the other 7 categories displayed few psychological symptoms. These results have implications for the treatment of insomnia.
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PMID:Evaluation and diagnosis of persistent insomnia. 724 6


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