Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Objective: To determine factors affecting sleep disturbances in children.Background: Factors affecting sleep disturbances have been studied extensively in adults, but relatively few studies have been done in children.Methods: As part of the twelfth survey of the Tucson Epidemiologic Study of Obstructive Airways Disease (TESOAD, 1991-1992), children, ages 3-14, of adult cohort members were administered a health questionnaire which contained items related to sleep problems as well as items related to respiratory diseases and symptoms. Participants were classified as having sleep disturbances if they reported disorders of initiating and maintaining sleep (DIMS), excessive daytime sleepiness (EDS) or snoring. Potential factors affecting sleep included age, gender, obesity, asthma, other bronchial problems, cough and sputum production, wheezing and rhinitis.Results: The overall prevalence rates were 16.8, 4 and 22.9% for DIMS, EDS, and snoring, respectively. We found a significantly higher prevalence of DIMS in 11-14-year-old girls (30.4%) and snoring (32.3%) in 3-6-year-old boys. Certain respiratory factors were more prevalent in children with sleep disturbances. Multivariate analysis revealed that risk factors for DIMS included female gender, age 11-14 and wheezing. The risk for EDS was increased in those children with cough and sputum production. Cough and sputum production also were risk factors for snoring as was rhinitis and age 3-6.Conclusions: We conclude that in children as in adults, respiratory symptoms are associated with sleep disturbances. Further, the increased insomnia seen in adult women may begin in early adolescence.
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PMID:Factors affecting sleep disturbances in children and adolescents. 1076 52

Since it was shown that numerous neurological, psychiatric and internal illnesses have characteristics manifested during, or influenced by sleep, somnology has been playing a clinically more and more important role. Among the 88 diagnoses listed by ICD, not only insomnia, but also sleep-related respiratory disorders, in particular the obstructive sleep apnea syndrome, are of special importance. Sleep apnea is associated with coronary heart disease, myocardial insufficiency and other pathological conditions. Already in the doctor's office, a carefully taken history (nocturnal apnea alternating with irregular snoring, and diurnal sleepiness) can arouse an appropriate suspicion. This can be confirmed by an ambulatory polygraphic exploration. The definitive diagnosis is then established with the aid of polysomnography in the sleep lab where specific treatment is also initiated.
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PMID:[Disturbed sleep caused by sleep apnea. To the sleep laboratory for diagnosis?]. 1080 16

Women living with heavy snorers were more frequently affected by symptoms of insomnia, morning headache, daytime sleepiness, and fatigue than women living with non-snorers. Questionnaire data were collected from 1,032 women 30 to 64 years of age residing in Dalarna county, in mid-Sweden. There were indications of a "dose-response relationship" between the conjectured sound exposure and reported symptoms, regardless of whether the female herself snored. Sleeping in separate bedrooms did not seem to give the women any alleviation. The results point to a possible contributory cause of disturbed sleep, morning headache, and daytime sleepiness among women living with a snoring spouse. The results also indicate that prevention and treatment of snoring are important issues for the couple as well as for the snorer.
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PMID:Adverse health effects among women living with heavy snorers. 1081 30

In order to investigate the occurrence and history of sleep problems in Japan, the 11-Centre Collaborative Study on Sleep Problems (COSP) project was carried out. Complaints of snoring are examined, and its prevalence, risk factors and screening reliability are discussed. The subjects who participated in the study were 6445 new outpatients from a general hospital. They were asked to answer a sleep questionnaire that consisted of 34 items with seven demographic items; each item was composed of four grades of frequency. In order to offset possible seasonal variations in sleep habits, data were collected across four seasons. Sleep patterns, insomnia, hypersomnia, parasomnia and circadian rhythm sleep disorders were covered. Habitual snoring was seen in 16.0% of males and 6.5% of females. Male predominance was noted. From these data, the relationship between habitual snoring and sleep complaints was statistically analyzed. Habitual snorers (HS) were observed to wake up more frequently during sleep (17.8% of males, 21.5% of females) than were non-habitual snorers (NHS; 6.6% of males, 9.7% of females). Mid-sleep awakening of HS was also more frequent than it was for NHS; however, there were no differences in difficulty in falling asleep and early morning awakening. Body mass index, cigarette smoking and alcohol consumption were also correlated with habitual snoring.
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PMID:Habitual snoring in an outpatient population in Japan. 1099 53

Patients with end-stage renal failure (ESRF) are reported to have a high prevalence of sleep disorders, such as daytime sleepiness, insomnia, restless legs syndrome (RLS), and obstructive sleep apnea syndrome (OSAS). However, there are few published data from Southeast Asia. A sleep questionnaire was administered to 201 patients (103 men) at the continuous ambulatory peritoneal dialysis (CAPD) outpatient clinic to assess sleep problems. Patients had a mean age of 56.7 +/- 12 (SD) years, with a mean body mass index (BMI) of 23.6 +/- 3.5 kg/m(2). Daytime sleepiness was the most frequent symptom (77.1%), and frequent awakening occurred in 69% of the patients. Sleep-onset insomnia and sleep-maintenance insomnia occurred in 73% and 60% of the patients, respectively. Sixty-two percent of the patients reported symptoms of RLS, which significantly correlated with sleep-onset insomnia (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.5 to 5.5; P = 0.001) and sleep-maintenance insomnia (OR, 2.1; 95% CI, 1.2 to 3.8; P = 0.014). The prevalence of OSAS was estimated by the frequency of the following symptoms: extremely loud snoring, 7 patients (3.5%); observed choking, 21 patients (10.5%); witnessed apnea, 11 patients (5.6%); snoring and witnessed apnea, 6 patients (3%); disruptive snoring, 29 patients (14.4%); and disruptive snoring and witnessed apnea, 3 patients (1.5%). This questionnaire survey confirmed a high prevalence of daytime sleepiness, insomnia, and RLS in patients with ESRF undergoing CAPD but showed a relatively low prevalence of OSAS of up to 14.4%, which may be related to the low BMI of these patients with ESRF compared with other populations. Whether this contributes to the overall better survival observed in some Asian patients with ESRF undergoing dialysis needs further investigation.
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PMID:Prevalence of sleep disturbances in chinese patients with end-stage renal failure on continuous ambulatory peritoneal dialysis. 1100 81

Between September 1996 and January 1999 we used polysomnography (PSG) to examine 473 patients (involving a total of 662 records). The diagnosis was a sleep-related breathing disorder in 256 patients, including sleep apnea syndrome (SAS) in 194 patients, sleep hypoxicemia in 18 and insomnia in the other four. The SAS consisted of three subtypes: central apnea (CA) in 56 patients, obstructive apnea (OA) in 124 and mixed apnea (MA) in eight. The ratio of central apnea was relatively higher than the national average. Among the 473 patients, the most common complication was heart disease (133 patients) while other complications included hypertension, and respiratory and cerebrovascular diseases. Concerning the therapy for these patients, continuous positive airway pressure therapy was the most commonly applied and was effective in each type of SAS (CA, OA, MA). Other therapies included prosthetic mandibular advancement, bilevel positive airway pressure, medication and ENT operations. In Koga Hospital, there are many patients with heart disease and/or respiratory disease. We examined those patients who presented with snoring and/or apnea using PSG. Among these patients, SAS was the most common sleep disorder. The relative ratio of CA was high and the average age was higher than those with OA.
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PMID:The Koga Hospital Center for studies on sleep: status report. 1118 86

The prevalence of sleep complaints in Northern Ireland is unknown. Sleep disruption can result in excessive daytime sleepiness (EDS), with significant socioeconomic consequences. The aim of this study was to assess the prevalence of sleep complaints and to determine risk factors for EDS in a Northern Irish community. From an urban and rural community of 499,111 people, a random sample of 3391 adult men were sent a questionnaire by mail. Questions were asked regarding sleep, EDS and medical history. There were 2364 completed questionnaires returned (response rate 70%). The mean age of respondents was 46.0 years (range 18--91 years). 26.7% of men were not satisfied with their usual night's sleep and 68% of men woke up at least once during the night. Based on pre-defined criteria, 24.6% of the population had insomnia and 19.8% had EDS. The strongest risk factor identified for EDS was a history of snoring loudly (odds ratio 2.62; 95% CI 1.82--3.77). Other risk factors included ankle swelling, feeling sad or depressed stopping sleep, experiencing vivid dreams while falling asleep, waking up feeling unrefreshed and age > 35 years. The prevalence rates of sleep complaints and EDS in this community-based study is high, although this does depend directly on the criteria used to define insomnia and EDS. Recognition of risk factors for EDS may help to identify and treat those affected.
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PMID:Sleep complaints and risk factors for excessive daytime sleepiness in adult males in Northern Ireland. 1128 57

Objective: To elucidate the predictive role of age and other pre-treatment, putative confounding factors on compliance with nasal continuous positive airway pressure (nCPAP) therapy.Patients and methods: This study was designed as a prospective cohort study in the setting of a sleep laboratory in a teaching hospital at Saint Antoine, Paris. One hundred and sixty-three patients referred to the sleep laboratory with complaints of snoring and excessive daytime sleepiness for whom nCPAP had been prescribed for obstructive sleep apnea syndrome (OSAS; defined as an apnea-hypopnea index (AHI) of >15/h of sleep during a polysomnographic recording) were followed for a median period of 887 days. The main outcome measure was the risk ratio for elderly patients associated with nCPAP compliance.Results: Four patients, who remained under treatment, died before the end of the study, and 50 patients stopped their nCPAP therapy for reasons other than death (insomnia, equipment too noisy, etc.). When compliance curves were compared by univariate analysis (log-rank test), the oldest group (57/163 patients, >60 years old) was significantly less compliant with nCPAP than the youngest (P=0.01). However, in the Cox's proportional hazards model, age did not exert any independent effect on compliance with nCPAP after controlling for confounding factors (adjusted relative risk, 1.09, 0.5-2; P=0.70). On the other hand, female sex (adjusted relative risk, 2.8, 1.4-5.4; P=0.002), a body mass index (BMI) of </=30 kg/m(2) (adjusted relative risk, 2.2, 1.2-4; P=0.006), an Epworth sleepiness scale (ESS) score of </=15 (adjusted relative risk, 3.2, 1.1-8.9; P=0.025), an AHI of </=30/h (adjusted relative risk, 2.2, 1.2-4; P=0.01) and a nCPAP of >/=12 cmH(2)O (adjusted relative risk, 2.3, 1.2-4.4; P=0.011) were predictive factors for non-compliance.Conclusion: This study suggests that there is no independent effect of age on compliance with nCPAP therapy.
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PMID:The age and other factors in the evaluation of compliance with nasal continuous positive airway pressure for obstructive sleep apnea syndrome. A Cox's proportional hazard analysis. 1131 85

Despite the complex influences of normal sleep physiology and sleep disorders on the development or presentation of headache, it is important to recognize and understand these relationships. Successful outcomes depend on the provision of treatment interventions specifically directed toward each condition. Nocturnal or early morning headaches that are associated with OSA are often eradicated after the sleep disorder is successfully managed with CPAP, oral appliances, or surgery. Substantial improvement in headache can also result from the successful management of other sleep disorders that may incite headaches such as heavy snoring, PLMS, or the various forms of insomnia. To improve headache patterns associated with bruxism and TMD, it is often necessary to formulate a multidisciplinary treatment approach that combines oral appliance therapy, stress management, biofeedback, oromandibular physical therapy, and, at times, pharmacologic treatment (i.e., tricyclic antidepressant, intramuscular botulinum toxin injections). There are still many gaps in the understanding of the interrelationships of sleep physiology and headache pathophysiology. More well-designed clinical trials are needed so that enough data can be amassed for the formulation of evidence-based guidelines or consensus statements that can better delineate the identification, diagnostic evaluation, and treatment of sleep-related headache disorders and headaches that develop as a consequence of disordered sleep.
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PMID:Headaches and their relationship to sleep. 1169 36

A middle-aged female patient with chronic insomnia showed rapid eye movement (REM)- localized obstructive sleep apnea. She visited the Sleep Disorders Clinic and complained of insomnia with loud snoring. Once, in the past, her sleep complaints had disappeared after weight reduction but, 6 months later, she complained of excessive daytime sleepiness. Overnight polysomnography revealed REM-localized apnea. Careful follow up is strongly recommended for a female patient with chronic insomnia who shows REM-localized apnea.
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PMID:Rapid eye movement-localized apnea in a female patient with chronic insomnia. 1204 15


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