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)

Under sleep-laboratory control, the efficacy of flurazepam hydrochloride (15 mg) was evaluated in 6 women (age range, 67-82 years) with objectively verified insomnia. A 15-night, single-blind, crossover procedure was followed. Sleep records obtained during 3 placebo-baseline nights, 7 consecutive flurazepam nights, and 3 placebo-withdrawal nights were evaluated by means of electroencephalographic, electro-oculographic, and electromyographic criteria. A statistically significant reduction in sleep latency and total awake time and a corresponding increase in total sleep time (P less than 0.05) were demonstrated during the active drug period. No evidence of diminishing effectiveness was observed during the 7 days of drug administration. For the rapid-eye-movement (REM) stage, a significant decrease (P less than 0.05) in mean REM percent was noted during the drug period despite an increase in mean absolute REM time. No REM rebound occurred upon drug withdrawal. There were no significant changes in mean percentages for stages 3 and 4 during the drug period and the withdrawal period. Adverse reactions were rare (chiefly some daytime drowsiness in 2 subjects).
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PMID:Insomnia in the elderly: treatment with flurazepam hydrochloride. 22 46

In recent years the effectiveness of hypnotic drugs has had to be assessed in terms of a greatly increased knowledge of the physiology and pathology of sleep. The normal pattern of sleep and wakefulness involves a cyclic alternation between three rather than two basically dissimilar states of the brain and body - alert wakefulness, rapid-eye-movement (REM) sleep and non-rapid-eye-movement (NREM) sleep. The pattern of this alternation in individual people results from the interaction of many influences - biological (including genetic, early developmental and later degenerative influences), psychological, social and environmental factors, various physical and psychiatric disorders, and most drugs which affect the central nervous system. The quality of sleep is not related in any simple or constant manner either to its duration or to the proprotions of time spent in each stage of sleep. Among the disorders of sleep, insomnia is a far more common problem of medical management than are enuresis, narcolepsy, somnambulism or nightmares. With a few exceptions, most hypnotic drugs now in widespread use cease to be effective in treating insomnia after the first few nights. However, the ineffective treatment is often continued because insomnia will be even worse during the initial period of drug withdrawal. These factors and the toxicity of hypnotic drugs when taken in overdose make the long-term treatment of insomnia more difficult than was previously supposed. Barbiturates should no longer be prescribed. Some of the non-barbiturates, such as glutethimide and methaqualone, have no advantage over the barbiturates. The benzodiazepine hypnotics, nitrazepam and flurazepam, are less toxic in overdose and are relatively effective in treating insomnia. Chloral hydrate and its derivates are useful alternative drugs for short-term use. Measures to improve sleep without drugs deserve greater emphasis than they have had in the past.
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PMID:Sleep and hypnotic drugs. 23 26

Flurazepam hydrochloride was experimented on 43 patients aged 33-83 yr with various forms of insomnia over a period of 4 to 23 days (mean 11.66). There were no changes in the laboratory data and gastroenteric tolerance was also excellent. Chi-square analysis showed that both the quantity and quality of sleep were significantly improved (P less than 0,001). There was no evidence of assuefaction or withdrawal symptoms.
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PMID:[Study of the tolerability and effectiveness of a new sleep-inducing preparation]. 24 Jan 41

The actions of flunitrazepam (Rohypnol) were assessed on the sleep cycle, heart and respiratory rates and skin potential fluctuations of normal volunteers and neurotic patients with insomnia by means of all night recordings. The most conspicuous effect of flunitrazepam (2 mg p.o.) in the healthy subject's sleep cycle was an increase of the latency for the appearance of the first REM period. In the insomniacs the compounds was effective in inducing and maintaining sleep. Flunitrazepam diminished heart rates during the REM phases and significantly decreased the variability indices, this effect being more prominent in the normal subjects. Skin potential fluctuations during stages 2 and REM sleep were also decreased although tolerance developed rapidly in this connection.
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PMID:The actions of flunitrazepam (Rohypnol) on heart and respiratory rates and skin potential fluctuations during the sleep cycle in normal volunteers and neurotic patients with insomnia. 24 31

The introduction of a computerized medical information system as part of a project assessing quality in primary care required the coding of drugs prescribed. The development of a simple four-digit system is described, coding drug, therapeutic class, and route of administration. The system allows easy measurement of the use of combined preparations.The drugs used for insomnia and acute bronchitis have been analysed. The results show marked variation with the age of the patient.The potential for medical audit is discussed as it is now possible to link prescribing figures in routine primary care with relevant clinical information.
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PMID:Analysis of primary care prescribing--a "constructive" coding system for drugs. 31 Aug 81

The authors determined the prevalence of sleep disorders in a general population through a survey of 1,006 representative households in the Los Angeles metropolitan area. They found an overall prevalence of current or previous sleep disorders in adults of 52.1%. Specifically, they found a 42.5% prevalence of insomnia, 11.2% of nightmares, 7.1% of excessive sleep, 5.3% of sleeptalking, and 2.5% of sleepwalking. These conditions were often chronic and usually started early in life. Insomnia was more frequent in older people, particularly older women, and in people of lower educational socioeconomic status. Insomnia, nightmares, and hypersomnia were correlated with more frequent general physical and mental health problems.
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PMID:Prevalence of sleep disorders in the Los Angeles metropolitan area. 31 56

An open assessment of chlormezanone in the treatment of rheumatic sleep disturbances was carried out in general practice. Sixty-one patients received 400 mg chlormezanone (2 tablets) each night for 2 weeks. Patients' nightly sleep assessment showed a steady improvement over the 2-week period, and overall effectiveness was rated as good or excellent by 75% of patients. Only 1 patient stopped treatment because of side-effects. It was concluded that chlormezanone could prove a useful alternative to current therapy for treatment sleeplessness in rheumatic patients.
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PMID:Chlormezanone in the treatment of insomnia due to rheumatic stiffness. 31 73

The author states that the use of the amino acid L-tryptophan as a hypnotic might avoid the problems of nonspecificity in the currently used CNS depressants because L-tryptophan is chosen on the basis of the chemistry of normal sleep rather than on a purely empirical basis. He reviews nine studies from his laboratory dealing with the effects of L-tryptophan on sleep. Studies in rats, normal human subjects, and subjects with mild insomnia all demonstrate that L-tryptophan reduces sleep latency. Polygraphic studies demonstrate that L-tryptophan, unlike hypnotics, does not produce distortions of sleep physiology when first administered, on long-term administration, or after withdrawal.
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PMID:L-tryptophan: a rational hypnotic with clinical potential. 32 Aug 87

The effectiveness of nine hypnotic drugs was compared using a standard protocol in separate sleep laboratory drug evaluation studies. All of these drugs were relatively effective in improving sleep with initial and short-term use. However, with intermediate-term use (two weeks), most of the drugs showed a marked decrease in their effectiveness. Following withdrawal, sleep was similar to baseline with most of the drugs, continued to be improved with flurazepam (Dalmane), 30 mg, and worsened beyond baseline levels with triazolam (U33030), 0.5 mg. The determination of a drug's effectiveness with continued use is most important clinically in enabling the physician to rationally and effectively use hypnotic drugs in the adjunctive treatment of insomnia.
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PMID:Comparative effectiveness of nine hypnotic drugs: sleep laboratory studies. 32 88

69 patients hospitalized for chronic respiratory diseases and complaining of moderate to severe insomnia were treated with placebo for 2 days, 36 subjects (52.17%) were discarded for their placebo responsiveness. To the remaining patients who suffered from severe insomnia, 7-chloro-5-(2-chlorophenyl)-1,3-dihydro-2H-1,4-benzodiazepin-2-one (chlordesmethyldiazepam, 2 mg orally) was administered for 7 consecutive evenings. The onset, duration, quality of sleep and the state on awakening were scored on the basis of patient subjective measurements. High scores of the four considered parameters were obtained during chlordesmethyldiazepam administration. Three treated patients complained of diurnal drowsiness. Results are discussed with regard to methodological problems in the evaluation of hypnotics.
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PMID:Single-blind evaluation of hypnotic activity of chlordesmethyldiazepam in No-placebo-reactor medical patients. 32 71


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