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)

An analysis from the Finnish East and West Cohort of the Seven Countries Study tested the hypothesis that front line service during modern warfare is associated with depression later in life. World War Two-era Finnish combat veterans were compared to Finnish veterans who were non-combatants. Both groups were followed from 1959 to 1984. Dependent variables were the Zung depression scale and other measures of psychosocial adaptation and mental health. Analysis of variance of Zung scores by combat exposure was close to statistical significance (p = 0.0501). Even if statistical significance had been reached, it is felt that the absolute magnitude of the differences between the populations appear quite trivial. A significant association was found for those who had participated in over nine battles and when grouping depression, sleeplessness, paranoia, hallucinations, schizophrenia, and other mental illness into the general category of any mental illness (O.R. = 4.414; 95% C.I. = 1.113, 17.503). This seems to support the residual stress hypothesis pertaining to modern combat exposure.
Mil Med 1991 May
PMID:Depression late after combat: a follow-up of Finnish World War Two veterans from the seven countries east-west cohort. 205 71

Beginning in 1990, the Department of Psychiatry. Tripler Army Medical Center developed a formal treatment program for post-traumatic stress disorder (PTSD). Between 1990 and 1996, 632 patients, the vast majority of whom suffered from combat-related PTSD, were treated. Historically, many PTSD patients were treated with benzodiazepines, often in high dosages. The risks attendant to benzodiazepine management of PTSD, coupled with poor clinical outcome, prompted the staff to explore treatment alternatives. This paper describes the role of pharmacotherapy in the management of PTSD. The medications described in this paper have other primary uses in clinical practice (e.g., hypertension, insomnia, seizure control, depression, and anxiety). Medications were selected for use based on the putative modes of action and the degree of symptom relief. The therapeutic rationale was to decrease hyperarousal and sleep disturbance to permit the patients to engage in other psychotherapeutic efforts.
Mil Med 1997 Sep
PMID:Pharmacological management of post-traumatic stress disorder: clinical summary of a five-year retrospective study, 1990-1995. 929 Feb 98

A case is reported in which a patient experienced somnambulistic episodes only after taking zolpidem tartrate for insomnia. Previous to the patient's use of zolpidem tartrate he had never experienced sleepwalking, and once the medication was discontinued the sleepwalking stopped. A search of the literature revealed only two other cases of zolpidem-induced sleepwalking, both involving individuals with a previous history of somnambulism in their youth.
Mil Med 1999 Sep
PMID:Zolpidem tartrate and somnambulism. 1049 42

Persistent insomnia is one of the most common patient complaints reported in primary care settings. This paper reviews the behavioral assessment and treatment approaches for persistent insomnia and reports the results of 42 consecutively treated patients in the Wilford Hall Insomnia Program. Patients were treated in a six-session, multiple-component behavioral group treatment program consisting of sleep restriction, stimulus control, sleep hygiene, relaxation training, and cognitive therapy. In addition, patients were seen for two individual treatment sessions in conjunction with the program and for two individual post-group treatment sessions to assess treatment progress. The results indicated that sleep onset latency was improved by 53%, wake after sleep onset was decreased by 40%, and sleep efficiency was improved by 22%. A detailed description of the behavioral treatment program for insomnia is provided as well as recommendations for practitioners working in primary care settings.
Mil Med 2000 Mar
PMID:Behavioral treatment of insomnia: the Wilford Hall Insomnia Program. 1074 Oct 83

This preliminary investigation evaluated symptoms of sleep disturbance and insomnia in a group of 156 deployed military personnel. A 21-item Military Deployment Survey of Sleep was administered to provide self-reported estimates of a variety of sleep parameters. The results indicated that 74% of participants rated their quality of sleep as significantly worse in the deployed environment, 40% had a sleep efficiency of < 85%, and 42% had a sleep onset latency of > 30 minutes. Night-shift workers had significantly worse sleep efficiency and more problems getting to sleep and staying asleep as compared to day-shift workers. The results of the study indicate the need for programs to help deployed military members get more and better sleep.
Mil Med 2008 Mar
PMID:Sleep disturbance during military deployment. 1841 23

This study retrospectively reviewed records from current members of the U.S. military who had completed the PTSD Checklist (PCL) at 0 and 3-months after returning from deployments. Insomnia was the most commonly reported symptom of PTSD on the PCL and had the highest average severity scores. At initial screen, 41% of those who had been to Iraq or Afghanistan reported sleep problems. Those who had initially reported any insomnia had significantly higher overall scores for PTSD severity at follow-up than did service members without such a complaint. These results show that insomnia is a particularly frequent, severe, and persistent complaint in service members returning from deployment. Such complaints merit particular attention in relation to the possibility of PTSD.
Mil Med 2010 Oct
PMID:Insomnia is the most commonly reported symptom and predicts other symptoms of post-traumatic stress disorder in U.S. service members returning from military deployments. 2096 66

Insomnia is increasingly common among the general population, even more so among veterans. Given the adverse impact of insomnia on both mental and physical health of veterans, it is important to provide effective treatments within the Veterans Health Administration (VHA) system. Group-based cognitive behavioral therapy for insomnia (CBT-I) provides a viable option for treatment. This study reports the feasibility, acceptability, initial effectiveness, and durability of group-based CBT-I in a clinical sample of veterans with comorbid medical and mental health diagnoses; the treatment was provided in a real-world VHA hospital setting using a manualized protocol that was explicitly adapted from the existing 1:1 CBT-I VHA protocol. Overall, we found the treatment to be feasible and acceptable to veterans, as well as effective. We found medium to large effect sizes for both questionnaire and sleep diary measures, including sleep onset latency, awakenings during the night, sleep efficiency, insomnia scores, and dysfunctional beliefs about sleep. Improvements in insomnia symptoms were maintained over 1 month.
Mil Med 2014 May
PMID:Feasibility and preliminary real-world promise of a manualized group-based cognitive behavioral therapy for insomnia protocol for veterans. 2480 97

Insomnia is common, but undertreated, among primary care patients. Within the Veterans Health Administration (VA), increasing attention has been given to the treatment of insomnia within primary care settings, but little research has examined Veterans' treatment preferences. We examined preferences for sleep treatment among VA primary care patients. Participants (N = 126: 98% male, 89% white; M age = 60 years) completed a brief survey. On the basis of Insomnia Severity Index scores, 22% reported subthreshold and 13% moderate insomnia. Fifty percent reported having issues with sleep (falling asleep, staying asleep, or sleeping too much) in the past 12 months; among these, only 44% reported any discussion of medication (34%) or other strategies (32%) to improve sleep with medical providers. The most preferred treatment approach was to work it out on one's own, followed by consulting the primary care provider (PCP). The most preferred modality was a one-on-one meeting with the PCP, followed by a one-on-one meeting with the behavioral health provider. In conclusion, VA primary care patients preferred handling sleep problems on their own, but if seeking help, they preferred working with PCPs over behavioral health providers. The majority of Veterans preferred individual treatment and strategies other than medication.
Mil Med 2014 Oct
PMID:Insomnia treatment experience and preferences among veterans affairs primary care patients. 2526 23

The purpose of this study was to examine the feasibility and acceptability of an auricular acupuncture (AA) insomnia regimen among Operation Iraqi Freedom and Operation Enduring Freedom veterans with post-traumatic stress disorder and sleep disturbance. Secondarily, this study examined the effect of an AA insomnia regimen on objective sleep times by wrist actigraphy, subjective sleep times by sleep diary, and sleep quality ratings utilizing the Pittsburg Sleep Quality Index. Veterans (n = 30) were randomized to receive a 3-week AA insomnia regimen. Veterans receiving the AA insomnia regimen reported it as a more acceptable treatment for sleep disturbance than subjects in the control group (AA group median = 5 vs. control group median = 3, p = 0.004). Significant differences between groups were found on the sleep quality and daytime dysfunction components of the Pittsburgh Sleep Quality Index (p = 0.003, p = 0.004). No other significant differences between groups were found for objective and subjective sleep measures. These results suggest that an AA insomnia regimen may improve sleep quality and daytime dysfunction among veterans with post-traumatic stress disorder. Future, large-scale, prospective clinical trials are needed to examine AA effects on sleep.
Mil Med 2015 May
PMID:Auricular acupuncture for sleep disturbance in veterans with post-traumatic stress disorder: a feasibility study. 2593 15

Excessive use of video games may be associated with sleep deprivation, resulting in poor job performance and atypical mood disorders. Three active duty service members in the U.S. Marine Corps were offered mental health evaluation for sleep disturbance and symptoms of blunted affect, low mood, poor concentration, inability to focus, irritability, and drowsiness. All three patients reported insomnia as their primary complaint. When asked about online video games and sleep hygiene practices, all three patients reported playing video games from 30 hours to more than 60 hours per week in addition to maintaining a 40-hour or more workweek. Our patients endorsed sacrificing sleep to maintain their video gaming schedules without insight into the subsequent sleep deprivation. During the initial interviews, they exhibited blunted affects and depressed moods, but appeared to be activated with enthusiasm and joy when discussing their video gaming with the clinical provider. Our article illustrates the importance of asking about online video gaming in patients presenting with sleep disturbances, poor work performance, and depressive symptoms. Because excessive video gaming is becoming more prevalent worldwide, military mental health providers should ask about video gaming when patients report problems with sleep.
Mil Med 2015 Jul
PMID:Excessive Video Game Use, Sleep Deprivation, and Poor Work Performance Among U.S. Marines Treated in a Military Mental Health Clinic: A Case Series. 2612 58


1 2 Next >>