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

What role do the media play in the medicalization of sleep problems? This article, based on a British Academy funded project, uses qualitative textual analysis to examine representations of insomnia and snoring in a large representative sample of newspaper articles taken from the UK national press from the mid-1980s to the present day. Constructed as 'common problems' in the population at large, insomnia and snoring we show are differentially located in terms of medicalizing-healthicizing discourses and debates. Our findings also suggest important differences in the gendered construction of these problems and in terms of tabloid and 'broadsheet' newspaper coverage of these issues. Newspaper constructions of sleep, it is concluded, are complex, depending on both the 'problem' and the paper in question.
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PMID:Medicalization and beyond: the social construction of insomnia and snoring in the news. 1840 Aug 32

Sleep has long been recognized to both provoke and relieve headache. Epidemiologic research has associated sleep disorders with more frequent and severe headaches. Chronic daily, awakening, and morning headache patterns are particularly suggestive of sleep disorders, including sleep-related breathing disorders, insomnia, circadian rhythm disorders, and parasomnias. Snoring and other indicators of sleep-disordered breathing are the most commonly studied and are particularly salient because of the potential for headache to improve or resolve with treatment of sleep. In addition to sleep disorders, clinical research correlates specific headache diagnoses (eg, migraine, tension-type, and cluster) with chronobiologic patterns and sleep processes, implicating common anatomic structures and neurochemical processes involved in the regulation of sleep and headache. Evidence strongly supports screening for sleep disorders by headache practitioners. Headache management should identify and treat sleep disorders that may improve or resolve headache.
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PMID:Sleep and headaches. 1846 Feb 87

The aims of this study were to investigate the prevalence of sleep disorders in patients with end-stage renal disease (ESRD), and to assess the effect of dialysis schedule on sleep quality and the presence of daytime symptoms. We prospectively selected 150 long-term hemodialysis (HD) patients in three groups (morning, afternoon, and evening dialysis) and gave them a sleep questionnaire, the Epworth sleepiness scale and the Pittsburgh sleep quality index. Snoring was the most common complaint (56%), followed by insomnia (38%) and restless legs syndrome (22.7%). The evening dialysis group experienced more sleep time in bed (P = 0.02), required less hypnotic medication (P = 0.049), had fewer daytime symptoms (P < 0.01), and experienced less daytime sleepiness (P = 0.034). Our study confirms the high prevalence of sleep disorders in ESRD patients, and indicates a beneficial effect of evening HD on sleep quality and reduction of daytime symptoms.
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PMID:Better sleep quality and less daytime symptoms in patients on evening hemodialysis: a questionnaire-based study. 1868 8

Sleep disorders are both common and consequential, but too often remain undiagnosed. The insidious, chronic course of most sleep disorders and lack of patient awareness of signs and symptoms during sleep can complicate the clinical evaluation. Typical chief complaints include snoring, excessive daytime sleepiness, insomnia, and behaviors during sleep. Sleep disorders can be primary or secondary to medical, neurologic, or psychiatric conditions, so a multidisciplinary approach is often desirable. Family members can be a critical source of information as they may have observed nocturnal or daytime symptoms unrecognized by the patient. Objective testing plays an important role in assessment for obstructive sleep apnea, parasomnias, and other specific sleep disorders, and can be used most effectively in combination with a thorough clinical evaluation. Nonsleep specialists should consider obtaining assistance from sleep clinicians for more challenging presentations or management of sleep disorders unfamiliar to them.
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PMID:Approach to the patient with sleep complaints. 1974 7

Although sleep disorders such as insomnia and obstructive sleep apnea are common in both children and adults, the clinical features and treatments for these conditions differ considerably between these two populations. Whereas an adult with obstructive sleep apnea typically presents with a history of obesity, snoring, and prominent daytime somnolence, a child with the condition is more likely to present with normal body weight, tonsillar hypertrophy, and inattentiveness during school classes. The adult with suspected sleep apnea almost always undergoes a baseline polysomnogram and proceeds to treatment only if this test confirms the diagnosis, while many children with suspected sleep apnea are treated empirically with adenotonsillectomy without ever receiving a sleep study to verify the diagnosis. This article reviews sleep disorders in children, with a particular focus on age-related changes in sleep, conditions that primarily affect children, and disorders for which clinical manifestations and treatment differ substantially from the adult population.
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PMID:Sleep disorders in children. 2014 88

The prevalence of sleep disorders is higher in patients with kidney failure than the general population. We studied the prevalence of sleep disorders in 88 (mean age; 41.59 +/- 16.3 years) chronic hemodialysis (HD) patients at the Urology and Nephrology Center, Mansoura University, Egypt over 4-month period. The investigated sleep disorders included insomnia, restless leg syndrome (RLS), obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness (EDS), narcolepsy and sleep walking, and we used a questionnaire in accordance with those of the International Restless Legs Syndrome Study Group, the Berlin questionnaire, Italian version of Epworth Sleepiness Scale, International Classification of Sleep Disorders, and the specific questions of Hatoum's sleep questionnaire. The prevalence of sleep disorders was 79.5% in our patients, and the most common sleep abnormality was insomnia (65.9%), followed by RLS (42%), OSAS (31.8%), snoring (27.3%), EDS (27.3%), narcolepsy (15.9%), and sleep walking (3.4%). Insomnia correlated with anemia (r=0.31, P= 0.003), anxiety (r=0.279, P= 0.042), depression (r=0.298, P= 0.24) and RLS (r=0.327, P= 0.002). Also, RLS correlated with hypoalbuminemia (r=0.41, P= < 0.0001), anemia (r=0.301 and P= 0.046), hyperphosphatemia (r=0.343 and P= 0.001). EDS correlated with OSAS (r=0.5, P= < 0.0001), snoring (r=0.341, P= 0.001), and social worry (r=0.27, P= 0.011). Sleep disorders are quite common in the HD patients, especially those who are anemic and hypoalbuminemic. Assessment of sleep quality, preferably with polysomnography, is necessary to confirm our results. Interventional studies for management of sleep disorders in HD patients are warranted.
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PMID:Sleep disorders in hemodialysis patients. 2022 17

This study aimed to investigate the association between attention-deficit hyperactivity disorder (ADHD) symptoms and subtypes, and sleep schedules, daytime inadvertent napping, and sleep problems/disorders in children and adolescents with and without ADHD. The sample included 325 patients with ADHD, aged 10-17 years [male: 81.5%; combined type (ADHD-C): 174; predominantly inattentive type (ADHD-I): 130; predominantly hyperactive-impulsive type (ADHD-HI): 21], and 257 children and adolescents without lifetime ADHD (non-ADHD). We conducted psychiatric interviews with the participants and their mothers before making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD symptoms. Multi-level models were used for data analyses controlling for sex, age, psychiatric comorbidities, and treatment with methylphenidate. The ADHD-C and ADHD-I groups had more daytime inadvertent napping. In general, the three subtypes were associated with increased rates of sleep problems/disorders. Specifically, ADHD-C rather than ADHD-I was associated with circadian rhythm problems, sleep-talking, nightmares (also ADHD-HI), and ADHD-I was associated with hypersomnia. The most-related sleep schedules and problems for inattention and hyperactivity-impulsivity were earlier bedtime, later rise time, longer nocturnal sleep, more frequent daytime napping, insomnia, sleep terrors, sleep-talking, snoring, and bruxism across informants. The findings imply that in addition to the dichotomous approach of ADHD and considering the psychiatric comorbid conditions, ADHD subtypes and symptom dimensions need to be considered in clinical practice and in the research regarding the association between ADHD and sleep problems/disorders.
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PMID:Association between symptoms and subtypes of attention-deficit hyperactivity disorder and sleep problems/disorders. 2040 26

Background. MSA (Multiple System Atrophy) may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype). It is considered a rare disease, but many patients are misdiagnosed as suffering from idiopathic Parkinson's disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due to MSA-c. Case Report. A 79-year-old Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure needing noninvasive ventilation. She had orthostatic blood pressure decline, constipation, insomnia, daytime sleepiness, and snoring. The neurologic examination revealed cerebellar ataxia. A laryngoscopy revealed vocal cord paralysis in midline position and tracheostomy was performed. The Brain Magnetic Resonance Imaging revealed atrophy of middle cerebellar peduncles and pons with the "hot cross bun sign." Conclusion. Although Multiple-system atrophy is a rare disease, unexplained respiratory failure, bilateral vocal cord paralysis, or stridor should lead to consider MSA as diagnosis.
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PMID:Multiple-system atrophy with cerebellar predominance presenting as respiratory insufficiency and vocal cords paralysis. 2086 40

Sleep disorders are becoming more prevalent. There is an overlap of symptoms related to obstructive sleep apnea syndrome (OSAS) and many psychiatric conditions. Complaints of excessive sleepiness, insomnia, cognitive dysfunction, and depressive symptoms can be related to both disease states. Obstructive sleep apnea syndrome is characterized by repetitive disruption of sleep by cessation of breathing and was first described in the 19th century by bedside observation during sleep. Physicians observed this cessation of breathing while the patient slept and postulated that these episodes were responsible for subsequent complaints of sleepiness. OSAS can coexist with major depressive disorder, exacerbate depressive symptoms, or be responsible for a large part of the symptom complex of depression. Additionally, in schizophrenia, sleep apnea may develop as a result of chronic neuroleptic treatment and its effect on gains in body weight, a major risk factor for the development of OSAS.It is important to recognize the signs and symptoms of sleep apnea, namely excessive daytime sleepiness, snoring, and witnessed apneas. Recognition of the existence of sleep apnea, prompt referral to a sleep specialist, and ultimately treatment of an underlying sleep disorder, such as OSAS, can ameliorate symptoms of psychiatric disease.
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PMID:Sleep-disordered breathing: in depression and schizophrenia. 2097 18

The timing and continuity of sleep in healthy individuals is regulated by the synchronous function of the sleep homeostasis and the endogenous circadian rhythms. Multiple factors affect these two processes and the way they interact. Sleep disorders may manifest differently in men and women and these differences are particularly notable during pregnancy, lactation, and menopause. Insomnia may occur relatively commonly during pregnancy and in the postpartum, and may be the result of either a primary sleep disorder, such as obstructive sleep apnea (OSA), movement disorders such as restless legs syndrome (RLS), or sometimes depression, especially in the postpartum period. Obstructive sleep apnea may contribute to a higher risk of hypertension during pregnancy and doubles the risk for preeclampsia and preterm birth. Snoring, a frequent symptom of OSA, increases in frequency during pregnancy. Restless legs syndrome is more common in pregnant women, is more frequent in the third trimester of pregnancy, and tends to improve dramatically after delivery. Factors associated with increased RLS in pregnancy may be related to iron and folate metabolism. Risk for OSA increases after menopause and presentation with insomnia can delay the diagnosis of OSA. Various treatment options for sleep disorders in women are discussed.
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PMID:Sleep in women. 2211 12


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