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

Six hundred and ninety-seven medical specialists were surveyed to determine whether there is any consensus on the harmful effects of caffeine. More than 75% of the specialists recommended reduction in caffeine in patients with anxiety, arrhythmias, esophagitis/hiatal hernia, fibrocystic disease, insomnia, palpitations, and tachycardia.
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PMID:A survey of physician advice about caffeine. 248 81

New fluoroquinolones have generally been well tolerated. In a double-blind evaluation of oral fleroxacin, using 400, 600, or 800 mg once daily for 7 days in an ambulatory setting for treatment of uncomplicated genital infections, we encountered unexpectedly high rates of adverse reactions. The objective of this analysis was to determine whether any factors in addition to dose could be found to account for our observations. Adverse reactions developed in 66 (84%) of 79 individuals, and severe reactions arose in 38 (48%). Most frequent were central nervous system reactions (70%), with insomnia being especially frequent (49%); gastrointestinal reactions (39%) and photosensitivity reactions (10%) were also common. Development of any reaction (central nervous system reactions, insomnia, and severe intestinal reactions) was dose related. Development of photosensitivity reactions correlated with an outdoor occupation. No other factors, including usual daily caffeine use, correlated with the development of adverse reactions. In our study, fleroxacin taken as a single daily 600- or 800-mg dose was associated with an unacceptably high rate of adverse reactions. Other studies are required to determine whether this problem is unique to fleroxacin or will occur with higher doses of other fluoroquinolones possessing similar chemical modifications and/or good tissue penetration and very long half-lives.
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PMID:Adverse reactions in a dose-ranging study with a new long-acting fluoroquinolone, fleroxacin. 251 2

The safety profile of ofloxacin was evaluated on the basis of adverse reactions and abnormal laboratory values seen in United States clinical trials and phase I studies addressing specific issues. The most frequently reported adverse reactions occurring in 2,197 patients who received three to 10 days of ofloxacin in United States clinical trials were nausea (3.5 percent), insomnia (1.8 percent), headache (1.4 percent), and dizziness (1.2 percent). Adverse reactions were not serious and usually rapidly reversible. The incidence of adverse reactions did not increase with increasing age. There is no clinically significant interaction with methylxanthines (caffeine or theophylline). Crystalluria was not observed. Ofloxacin is a well-tolerated fluoroquinolone antimicrobial agent.
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PMID:The safety profile of ofloxacin. 269 Jun 23

In a cross-sectional study of 4558 Australians, it was found that the proportion of subjects reporting indigestion, palpitations, tremor, headache and insomnia increased significantly with mean caffeine intake. A multiple logistic regression model was used to show that the association between the prevalence of these symptoms and usual daily caffeine consumption remained significant in both males and females for palpitations, tremor, headache and insomnia after controlling for the potential confounding factors of age, adiposity, smoking, alcohol intake and occupation. Adiposity was strongly correlated with the prevalence of indigestion and the apparent association between caffeine and indigestion disappeared when adiposity was controlled for. According to the logistic model, the relative risk of experiencing symptoms for people consuming 240 mg of caffeine (approximately 4-5 cups of coffee or tea) per day (the population average) compared with caffeine abstainers is 1.6 for palpitations, 1.3 for tremor, 1.3 for headache, and 1.4 for insomnia in males and 1.7, 1.5, 1.2 and 1.4 respectively for females. Further logistic regression analysis indicated that the associations found between caffeine intake and symptoms did not depend on the source of caffeine. In general, coffee consumption has no significant effect over and above that attributable to its caffeine content. If these associations are causal, then approximately one quarter of the reported prevalence of palpitations, tremor, headache and insomnia is attributable to caffeine consumption in this study population.
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PMID:A study of caffeine consumption and symptoms; indigestion, palpitations, tremor, headache and insomnia. 387 38

Experimental sleep disturbances (model insomnia) were produced by the administration of methylphenidate (MPD) 10 mg and caffeine (CAF) 150 mg. The effect of temazepam (TEM), 15 mg or 30 mg, on the model was investigated. All-night polysomnography was performed on 8 normal young male subjects under each of the following 9 conditions: baseline, MPD 10 mg, CAF 150 mg, TEM 15 mg, TEM 30 mg, MPD + TEM 15 mg, MPD + TEM 30 mg, CAF + TEM 15 mg, CAF + TEM 30 mg. A reduction in total sleep time and total amount of stage REM (S-REM) sleep and an increase in the sleep latency and wake time (S-W) were observed in both the MPD and CAF nights. The sleep latency was significantly longer in the CAF night than in the MPD night. Administration of TEM 15 mg or TEM 30 mg alone caused very few modifications in the sleep parameters. These drugs in combination with MPD or CAF resulted in almost complete recovery of the sleep disturbance induced by MPD or CAF. The results indicate that CAF and MPD produced similar models of insomnia except for a greater sleep latency for CAF than for MPD. Both models were useful in the evaluation of hypnotic drugs such as temazepam.
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PMID:Model insomnia by methylphenidate and caffeine and use in the evaluation of temazepam. 612 91

In six healthy subjects with a history of caffeine-induced wakefulness caffeine kinetics were compared to with those in six subjects not affected by caffeine. The data indicated that the former have a longer plasma t 1/2 (mean 7.4 and 4.2 hr) and slower plasma clearance (mean 1.2 and 1.7 ml . min-1 . kg-1) of caffeine. Plasma caffeine concentration at midnight, 8 hr after afternoon coffee, is higher in those with caffeine-attributed insomnia. Those reporting "coffee wakefulness" also tend to drink less coffee. We conclude that the rate of caffeine metabolism is a determinant of individual variation in the effect of drinking coffee on sleep.
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PMID:Caffeine metabolism and coffee-attributed sleep disturbances. 685 8

Caffeine affects most physiological systems. Few studies, however, have attempted to document which somatic symptoms are commonly associated with caffeinism. To answer this question, the authors evaluated 124 general hospital patients, and compared reported somatic symptoms among low, moderate and high caffeine users. Diuresis, insomnia, withdrawal headache, diarrhea, anxiety, tachycardia and tremulousness were most commonly reported, in descending order of frequency. Differences among high, moderate and low users were common, and some dose-response associations were apparent. Most symptoms were explainable by caffeine's known CNS neuropharmacological effects or peripheral pharmacological actions.
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PMID:Somatic manifestations of caffeinism. 721 21

Sleep complaints, habits, and medical history were surveyed in 81 patients chronically receiving continuous ambulatory peritoneal dialysis. Seventy-three percent of the sample reported insomnia, and 52% reported unintentional napping during the day. Behavioral factors (such as caffeine or alcohol use) or the severity of concurrent medical disease did not account for the sleep problems. Eighteen of these patients subsequently underwent polysomnography and objective measurement of daytime sleepiness. Clinically significant sleep apnea syndrome was present in 11. The presence of sleep apnea was associated with increased levels of psychological distress and daytime sleepiness. Periodic leg movements during sleep were also frequently observed but had minimal effect on sleep quality. Implications of these findings for clinical practice are discussed.
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PMID:Sleep disorders in patients on continuous ambulatory peritoneal dialysis. 757 84

Healthy sleeping habits is a complex balance between behaviour, environment and circadian rhythm. The quality of sleep can be improved by behaviour, e.g. eating tryptophan and carbohydrate rich foods, physical exercise in the afternoon or a cold shower just before going to bed. Total sleep time is maximal in thermoneutrality and decreases above and below the thermoneutrality zone. Thermoneutrality is reached for an environmental temperature of 30-32 degrees C without night clothing or of 16-19 degrees with a pyjama and at least one sheet. Noise also modifies sleep structure and above 50dB shortens total sleeping time. Although subjects do become subjectively accustomed to noise, vegetative cardiovascular reactivity to environmental noise remains unchanged. The spontaneous circadian awake/sleep cycle is 25 hours, slightly longer than the body temperature cycle, but when subjects are exposed to environmental synchronization, the two cycles coincide. In individuals undergoing temporal isolation, the two rhythms become independent often leading to subjective discomfort and fatigue. Certain factors including age can favour internal desynchronization. Other factors may include social contact, stress due to mental work load, and constant lighting which could lengthen the awake/sleep cycle. Caffeine blocks the receptors of adenosine, and thus its effects of inhibiting neurotransmission. Intake 30 to 60 minutes before sleeping shortens total sleep time and increases the duration of stage 2 and shortens stage 3 and 4. Alcohol may act as a relaxing, sedative agent when consumed just before sleeping but can also lead to night-time awakening due to sympathetic activation which does not return to baseline levels until the blood alcohol levels have returned to 0. Nicotine has a biphasic effect on sleep: at low concentrations, it leads to relaxation and sedation and at high concentrations inhibits sleep. A careful study of sleeping habits is the first step in evaluating complains of insomnia or hypersomnia. Before relying on drugs, treatment should start with attention to the sleep environment and personal habits.
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PMID:[Prevention and treatment of sleep disorders through regulation] of sleeping habits]. 802 26

Subjective insomnia is more prevalent in elderly than in young populations. In order to examine the relationship between caffeine and sleep quality we studied 181 community-dwelling subjects over a wide age range and 53 elderly patients receiving continuing hospital care. Subjects completed a sleep questionnaire and data concerning smoking, alcohol, use of hypnotics and caffeine-containing substances were recorded. Late afternoon plasma caffeine concentrations were measured in a sub-group of 87 of the community-dwelling subjects and in the hospitalized patients. For the group as a whole, there was a significant negative correlation between age and coffee but not tea consumption (p < 0.001). A global score of sleep quality was significantly inversely related to age (p < 0.001). For the community-dwelling population, the median plasma caffeine concentration was 1.71 micrograms/ml (range 0.10-6.74) and showed a significant correlation with sleep quality (p < 0.05). In contrast, for the hospital dwelling population, median caffeine concentration was higher in patients reporting sleep problems than in those without (p < 0.05). Self-reported consumption of coffee and tea did not correlate with plasma caffeine concentrations. It is possible that people with poor sleep quality, residing in the community, are aware of the stimulatory effects of caffeine and lower their intake accordingly, whereas hospitalized elderly patients, who have less control over their environment, do not.
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PMID:Is caffeine a factor in subjective insomnia of elderly people? 843 65


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