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

A representative sample of 5,622 subjects between 15 and 96 years of age from the noninstitutionalized general population of France were interviewed by telephone concerning their sleeping habits and sleep disorders. The interviews were conducted using the Sleep-Eval knowledge-based system, a nonmonotonic, level 2 expert system with a causal reasoning mode. Questions investigated nightmares, based on the Diagnostic and Statistical Manual, fourth edition (DSM-IV), definition, psychopathological traits, and included 12 other groups of information, including sociodemographics, sleep-wake schedule, daytime functioning, psychiatric and medical history, and drug intake. The data from 1,049 subjects suffering from insomnia were considered for this analysis. Bivariate analyses, logistic regression analysis using the method of indicator contrasts for the investigation of independent variables, and calculation of significant odds ratios were performed. Nightmares were reported in 18.3% of the surveyed insomniac population and were two times higher in women than in men. The following factors were found to be significantly associated with nightmares 1) sleep with many awakenings, 2) abnormally long sleep onset, 3) daytime memory impairment following poor nocturnal sleep, 4) daytime anxiety following poor nocturnal sleep, and 5) being a woman. There was a strong association between the report of nightmares in women and the presence of either a depressive disorder, anxiety disorder, or both disorders together. When the effects of major psychiatric disorders were controlled for, nightmares were significantly associated with being a woman, feeling depressed after a poor night's sleep, and complaining of a long sleep latency. Nightmares can lead to a negative conditioning toward sleep and to chronic sleep complaints. Considering the frequency of nightmares in an adult insomniac population and the significant relationship between nightmares and certain subgroups, nightmares should receive more attention in patients, especially women complaining of disrupted sleep, as high rates of psychiatric disorders were found in this specific group.
 ...
PMID:Prevalence of nightmares and their relationship to psychopathology and daytime functioning in insomnia subjects. 938 Oct 55

Insomnia is a frequent symptom in the general population; numerous studies have proven this. In the past years, classifications have gradually given more emphasis to daytime repercussions of insomnia and to their consequences on social and cognitive functioning. They are now integrated in the definition of insomnia and are used to quantify its severity. If the daytime consequences of insomnia are well known at the clinical level, there are few epidemiological data on this matter. The aim of this study was to assess the daytime repercussions of insomnia complaints in the general population of France. A representative sample (n=5,622) aged 15 or older was surveyed by telephone with the help of the sleep-EVAL expert system, a computer program specially designed to evaluate sleep disorders and to manage epidemiological investigations. Interviews have been completed for 80.8% of the solicited subjects (n=5,622). The variables considered comprised insomnia and its daytime repercussions on cognitive functioning, affective tone, daytime sleepiness and diurnal fatigue. Insomnia was found in 18.6% of the sample. The prevalence was higher in women (22.4%) than in men (14.5%, p<0.001) with a relative risk of 1.7 (95% confidence interval 1.5 to 2) and was twice more frequent for subjects 65 years of age or older compared to subjects younger than 45 years. Approximately 30% of subjects reporting insomnia had difficulties initiating sleep. Nearly 75% of insomnia complainers reported having a disrupted sleep or waking up too early in the morning and about 40% said they had a non-restorative sleep. Repercussions on daytime functioning were reported by most insomnia subjects (67%). Repercussions on cognitive functioning changed according age, number of insomnia symptoms and the use of a psychotropic medication. A decreased efficiency was more likely to be reported by subjects between 15 and 44 years of age (OR: 2.9), those using a psychotropic (OR: 1.5), those reporting at least three insomnia symptoms (OR: 1.4) and women (OR: 1.4). The highest probability of the appearance of concentration difficulties was found in subjects younger than 65 Years, having a depressive disorder and using a psychotropic (15-44 years: OR 19.1; 45-64 years: OR 46.6). Difficulties maintaining attention were 15 times higher in subjects aged between 45 and 64 who were using a psychotropic and had also a depressive disorder. Memory difficulties were three times more likely to be reported by subjects using a psychotropic. At the affective level, irritability was 10 times more likely to be reported by subjects younger than 65 Years who were also using a psychotropic and had a depressive disorder. Independent of the presence of a mental disorder and the use of a psychotropic, subjects between 15 and 44 Years were five times more likely to be irritable following a bad sleep. Feeling depressed after a bad night's sleep was 18 times more likely to occur in subjects aged between 45 and 64 who were using a psychotropic and had a depressive disorder. Feeling anxious after a bad night's sleep was seven times more likely to occur in subjects with a depressive disorder. Daytime sleepiness was reported by approximately 20% of insomnia subjects. This rate was relatively comparable among gender, age groups, presence/absence of a mental disorder and use or not of a psychotropic. However, taking into account the interaction between age, use of a psychotropic and the presence of a mental disorder, subjects younger than 65 years, using a psychotropic and having a depressive disorder were at least 10 times more likely to report daytime sleepiness. Subjects who were suffering the most diurnal symptoms of insomnia were those younger than 65 years. Several factors can be evoked to explain this fact. These subjects were, for the most part, likelier to have a stricter sleep/wake schedule because of constraints imposed by work, studies, child care, etc. Subjects older than 65 Years were generally retired and therefore less prone to sleepiness and to cognitive difficulties. Insomnia consequences were limited due to their inactivity. Complementary studies should be undertaken to describe the daytime repercussions of insomnia for this specific age group of the general population and to measure these repercussions.
 ...
PMID:[Daytime consequences of insomnia complaints in the French general population]. 1523 19

The study investigates the relative crash involvement risk associated with diagnosed medical conditions, subjective symptoms and the use of some medicines based on self-report questionnaires from 4448 crash-involved drivers. Whereas many previous studies of medical conditions and crash risk have focussed exclusively on elderly drivers, this study included drivers of all ages. Relative risk for each health condition was estimated by comparing drivers with and without the condition, regarding the odds of being at fault for the crash. Statistical significance was tested by a logistic regression analysis for each condition with crash culpability as the dependent variable. Relative risks were expressed as odds ratios (OR) adjusted for age and annual driving distance. The analyses identified the following significant risk factors: non-medicated diabetes (OR=3.08), a history of myocardial infarction (OR=1.77), using glasses when driving (OR=1.26), myopia (OR=1.22), sleep onset insomnia (OR=1.87), frequent tiredness (OR=1.36), anxiety (OR=3.15), feeling depressed (OR=2.43) and taking antidepressants (OR=1.70). In addition, there was a relatively large and nearly significant relative risk for drivers who had suffered a stroke (OR=1.93). For some additional conditions the crude odds ratios were significant, but failed to reach significance after correction for age and annual driving distance.
 ...
PMID:Driver health and crash involvement: a case-control study. 1605 4

This study aimed to determine the prevalence and pattern of insomnia in a Malaysian population aged 30 to 70 years. The sample consisted of 1611 subjects, recruited by stratified random sampling and interviewed using a semistructured questionnaire conducted in 2004. This was a community-based survey in 4 Malaysian states. The prevalence of insomnia symptom was 33.8%, and 12.2% of the subjects had chronic insomnia. Insomnia was more common among elderly; those who were separated, divorced, or widowed; and those who smoked at bedtime. Subjects with insomnia had a higher prevalence of feeling depressed (12.7), loss of concentration (19.1%), exhaustion (17.2%), poor memory (9.2%), decreased work productivity (6.4%), and perceived poor health status (40.9%; all, P < .05). A total of 22.2% of those with insomnia had excessive daytime sleepiness based on their Epworth Sleepiness Score (P = <.001). Those with insomnia used more sedatives (9.9%) compared with those without insomnia (2.6%; P < .001). About one-third of the population had insomnia associated with impaired daily function. This study concluded that insomnia is common in Malaysian adult population, and it has significant impact on psychological well being and daily functioning.
 ...
PMID:Epidemiology of insomnia in Malaysian adults: a community-based survey in 4 urban areas. 1912 16