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

Objective and subjective sleep and awakening quality was investigated in 11 drug-free patients (4 females, 7 males) aged 30-55 (mean: 44+/-9) years with nonorganic insomnia (F 51.0) related to panic disorder (F 41.0) as compared with 11 age- and sex-matched normal controls aged 30-58 (mean: 44+/-9) years, utilising polysomnography (PSG) and psychometry. PSG demonstrated decreased sleep efficiency (primary target variable), total sleep time (TST) and S2 as well as increased middle and late insomnia, S1, S3+S4, snoring and PLM in patients. There were no intergroup differences in REM variables. Subjective sleep quality deteriorated, as did drive and fine motor activity in the morning, while concentration increased. Blood pressure in the evening and morning and pulse rate in the evening were elevated. These differences as compared with normals were distinct from those observed in other sleep disorders. In a subsequent acute, placebo-controlled cross-over design study, patients received alprazolam 0.5 mg (Xanor((R));) and placebo. As compared with placebo, alprazolam induced an increase in sleep efficiency (primary target variable), TST and S2, a decrease in wakefulness during the total sleep period, S3+S4 and the oxygen desaturation and PLM indices, and improved subjective sleep quality, somatic complaints, drive, affectivity and drowsiness in the morning. There were no changes in REM variables. Thus, alprazolam induced changes that were opposite to the differences observed between patients and controls before treatment, thereby normalizing sleep and awakening quality. As observed in insomnia related to GAD and subsequent benzodiazepine therapy, the present study also points to a key-lock principle in the treatment of insomnia caused by anxiety disorders and neurophysiologically visualizes processes at the receptor level (e.g. benzodiazepine agonists versus inverse agonists). Copyright 2000 John Wiley & Sons, Ltd.
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PMID:Nonorganic insomnia in panic Disorder: comparative sleep laboratory studies with normal controls and placebo-controlled trials with alprazolam. 1240 19

Subjective health-related quality of life (HRQoL) was investigated in 100 patients with disturbed sleep (39 women aged 52 +/- 13 years and 61 men aged 53 +/- 10 years) referred to the sleep laboratory and compared with HRQoL in 100 normal healthy adults. Measurements included the Quality of Life Index (QLI) (Mezzich and Cohen), and objective (polysomnographic) and subjective (psychometric) quality of sleep and awakening. Statistical analysis (Mann-Whitney U-test) showed HRQoL to be significantly reduced in sleep disorders (SDs), with a more pronounced reduction in nonorganic than in organic SDs. Patients with nonorganic hypersomnia were more disturbed than those with nonorganic insomnia. Within organic SDs, patients with apnea were more disturbed than those with obstructive snoring. Out of ten elementary HRQoL components, seven were disturbed in SDs: physical well-being, psychological well-being, self-care and independent functioning, occupational functioning, interpersonal functioning, personal fulfillment, and overall quality of life. No differences between patients and normal healthy subjects where found in the components social support, community and services support or spiritual fulfillment. Patients suffering from nonorganic SDs had significantly worse scores in physical and psychological well-being and overall quality of life than those with organic SDs. Patients with both SDs and additional diagnoses of affective disorders had more profoundly reduced HRQoL than those with anxiety disorders. Follow-up of 51 patients (31 with nonorganic SDs and 20 with organic SDs) one year after sleep laboratory investigation and subsequent treatment found significantly improved HRQoL compared with pre-treatment. Moreover, patients diagnosed and treated in the sleep laboratory showed lower re-hospitalization rats.
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PMID:Quality of life in nonorganic and organic sleep disorders: I. Comparison with normative data. 1277 77

Recent recognition of daytime sleepiness in Parkinson's disease (PD) has prompted a search for its causes. Sleepy patients may be more susceptible to sleep attacks after the use of dopamine agonists and the recognition of sleep disturbances in PD may influence important therapeutic decisions. To identify clinical factors influencing excessive daytime sleepiness (EDS) and sleep complaints in PD, we studied 86 consecutive patients with clinical diagnosis of PD using a sleep questionnaire, the Epworth Sleepiness Scale, the Unified Parkinson's Disease Rating Scale and the Montgomery and Asberg Depression Rating Scale. Patients with cognitive dysfunction were not included in the study. We found that 49 patients (53.3%) had insomnia, 45 (49.9%) restless legs syndrome (RLS), 51 (55.4%) vivid dreams, 61 (71.8%) snoring and 29 (31.5%) had EDS. RLS was more frequent in patients with longer duration of illness. Snoring was the most important risk factor associated with EDS (OR=3.64, 95% CI=1.11-11.9, P=0.03) and a marginal association between motor dysfunction and EDS was observed (OR=1.06, 95% CI=1.00-1.12, P=0.05).
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PMID:Snoring and excessive daytime sleepiness in Parkinson's disease. 1467 8

In Don Quijote de la Mancha, Miguel de Cervantes presents Don Quixote as an amazing character of the 17th century who suffers from delusions and illusions, believing himself to be a medieval knight errant. Besides this neuropsychiatric condition, Cervantes included masterful descriptions of several sleep disorders such as insomnia, sleep deprivation, disruptive loud snoring and rapid eye movement sleep behaviour disorder. In addition, he described the occurrence of physiological, vivid dreams and habitual, post-prandial sleepiness--the siesta. Cervantes' concept of sleep as a passive state where all cerebral activities are almost absent is in conflict with his description of abnormal behaviours during sleep and vivid, fantastic dreams. His concept of sleep was shared by his contemporary, Shakespeare, and could have been influenced by the reading of the classical Spanish book of psychiatry Examen de Ingenios (1575).
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PMID:Sleep and sleep disorders in Don Quixote. 1472 36

Sleep and sleep disorders are different in several important ways between men and women. Because of pregnancy and menopause, women experience changes in sleep that may present as clinical problems. In clinical populations, women are more likely to present with insomnia than are men, although their sleep may be better preserved. The presentation of sleep apnea in women is distinct from that of men and is less likely to include a "classic" history of witnessed ap-nea or heavy snoring. More likely it presents with nonspecific symptoms, such as fatigue or mood disturbance. There are little data on the effects of different treatments for OSA between men and women. OHS is a syndrome that may be as common in women as in men. The role of hormones in its pathophysiology is not well-defined.
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PMID:Gender differences in sleep and sleep-disordered breathing. 1509 87

Sleep in elderly people shows progressive changes caused by general aging processes. Several alterations are described in medical literature: changes of sleep/wake rhythm and modifications both in sleep duration and in sleep architecture. The aim of our study was to evaluate sleep disturbances in elderly people, with and without cognitive impairment,through a sleep questionnaire. Our population included 1000 subjects, over 65 years of age, stratified by sex and age. The first 600 interviews were included in this report. All patients underwent a mini mental state examination (MMSE) and a questionnaire concerning excessive daytime sleepiness. In our total sample, we found a high prevalence of excessive daytime sleepiness, insomnia, nighttime awakenings, snoring, restlessness and periodic leg movements during sleep. Patients with cognitive dysfunctions showed less difficulty in falling asleep and fewer nighttime awakenings; they snored less frequently and were the only ones to present enuresis and to fall off the bed. Moreover, patients with cognitive impairment presented excessive daytime sleepiness with variable intensity and frequency. In conclusion, our results indicate significant differences in sleep disorders between healthy subjects and patients cognitively impaired. Besides, our subjective evaluation seems to be a useful method to perform an assessment of sleep disturbances in elderly people.
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PMID:Sleep disturbances in elderly: a subjective evaluation over 65. 1520 30

Although the physiological mechanisms that underlie sleep disorders in children differ little from those seen in adults, the clinical manifestations may differ considerably between the two. For example, sleep apnea in adults affects men more than women, is more prevalent in the obese, and presents with symptoms of snoring and excessive somnolence. In preadolescent children, sleep apnea affects both sexes equally, is more closely correlated with adenotonsillar enlargement than obesity, and may be more likely to present with daytime inattention and learning problems rather than frank somnolence. Likewise, the insomnia and associated bedtime struggles of a 3-year-old bear little resemblance to the insomnia of a mature adult apart from the fact that both individuals are unable to easily fall asleep. Sleep disorders in children are reviewed with particular focus on age-related changes in normal sleep and on sleep disorders that primarily or exclusively affect children. Pediatric aspects of other sleep disorders will be reviewed in more limited detail, with examination of how age, developmental level, and comorbid conditions cause clinical presentation and treatment to differ from that of adults.
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PMID:Sleep and its disorders in children. 1544 25

The objective of this study was to compare the frequency of some sociocultural, clinical, and anthropometric data between men and women in a sample of 1745 patients referred to a Sleep Unit for symptoms of obstructive sleep apnea (OSA). A standardized questionnaire was administered and anthropometric data were measured. Patients underwent a polysomnography (during a night or a nap) or an overnight home cardiorespiratory polygraphy. A total of 1166 patients (male/female ratio 4.9:1) fulfilled criteria of OSA (apnea-hypopnea index > or = 10). Women were employed, habitual drivers or workers at risk occupations in a lower percentage than men. Women came to the clinical interview accompanied by their partner less frequently than men. The frequency of snoring and daytime hypersomnolence was similar in both genders, although witnessed apneas were more frequent in males. Fatigue, morning headaches, insomnia, depression and use of sedatives were more frequent in women than in men. Women were older than men, more obese (although with an obesity pattern less centrally distributed), and referred hypertension more frequently. It is concluded that it is likely that women with OSA may be underdiagnosed due to circumstances related to the family lifestyle and sociocultural factors in addition to different OSA clinical expression.
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PMID:Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. 1548 Dec 75

The prevalence of sleep-related disorders (SRD) in adults in Turkey is unknown. The main objective of our study was to assess the prevalence of SRD in Sivas, Turkey. Adults living in Sivas, a city of Turkey from the central region of Anatolia at 20-107 years of age, in both genders, of the 5339 persons, who attended the survey 2638 (49.4%) were male and 2701 (50.6%) were female. The prevalence of insomnia, habitual snoring, obstructive sleep apnea (OSA) and day time hyper somnolence was 40.3%, 37.0%, 6.4%, 24.0% respectively. The prevalence rates of narcolepsy and nocturnal myoclonus was 30.6%, 40.1% respectively. There was a statistical significance between the persons of above 60 years old and another age groups (p< 0.05). But we did not find any significant difference between smokers and non-smokers, also between males and females about SRD prevalence (p> 0.05). However, sleep apnea prevalence was about 9 times higher in the persons suffering from hypertension than without hypertension. Also sleep apnea prevalence was 12 times higher in the persons suffering from overweight. This study has shown that sleep-disordered breathing (SDB) prevalence in Turkey is as high as in other countries and may be more common.
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PMID:The prevalence of sleep related disorders in Sivas, Turkey. 1700 51

We used a self-report questionnaire to identify outpatients with chronic symptoms of sleep disorders and/or high pretest probability for sleep apnea as well as for restless legs syndrome (RLS), insomnia, and narcolepsy. Surveys were presented to patients waiting for an appointment in Veterans Administration (VA) Medical Center clinics in Northeast Ohio, USA. Items addressed the frequency of snoring behavior; wake time sleepiness or fatigue and history of obesity/hypertension for high risk for sleep apnea (Netzer et al. 1999), along with other symptoms, were scored as positive vs negative risk for insomnia, narcolepsy, and RLS. Of the patients offered the surveys, 886 (59.2%) provided timely responses to the questionnaire. Mean age was 62.5 years (range, 19 to 85 years); 95% were males; mean body mass index was 29.3 kg/cm(2) (range, 15.1 to 57.5 kg/cm(2)); and mean Epworth Sleepiness Scale score was 8.3 (range, 1 to 22) with 4.6% having a score >17. Of the respondents, 47.4% met high-risk criteria for sleep apnea, 41.7% for insomnia, 19% for restless leg syndrome, and 4.7% for narcolepsy. Twenty-four percent reported use of sleeping pills or bedtime alcohol. Drowsy driving >3-4 days a week or every day was reported in 5.7%. VA primary care patients have high prevalence for pretest probability for sleep apnea. This population also reports chronic symptoms for other sleep disorders and for drowsy driving.
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PMID:Sleep problems and the risk for sleep disorders in an outpatient veteran population. 1587 29


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