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

The literature describing nondyskinetic antipsychotic withdrawal symptoms is reviewed. The withdrawal of antipsychotic agents can result in nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. Psychotic relapse is often presaged by increased anxiety, agitation, restlessness, and insomnia. However, the temporal relationship of these prodromal symptoms to reduction in the dosage or discontinuation of neuroleptics distinguishes them from the effects of abrupt withdrawal.
Gen Hosp Psychiatry 1988 Nov
PMID:Antipsychotic withdrawal phenomena in the medical-surgical setting. 290 18

Electroencephalographic (EEG) sleep patterns were examined in 27 psychotic and 79 nonpsychotic subjects with major depression to evaluate the validity of the psychotic-nonpsychotic subtype dichotomy. Sleep in psychotic depression was characterized by increased wakefulness, decreased rapid eye movement (REM) sleep percentage, and decreased REM activity even after controlling for clinical differences in age, severity, and agitation. Psychotic depressive subjects also were more likely to have extremely short sleep-onset REM latencies. In psychotic depression EEG sleep varied as a function of total illness duration. Patients with recent-onset syndromes had profiles characterized by marked initial insomnia, increased stage 1 sleep percentage, and long REM latency; patients with illnesses of longer duration had extremely short REM latencies. Demonstration of selected EEG sleep variables discriminating between psychotic and nonpsychotic depression further supports psychotic depression as a distinct subtype of major affective disorder.
Arch Gen Psychiatry 1986 Sep
PMID:Electroencephalographic sleep in psychotic depression. A valid subtype? 375 66

To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by DSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation.
Arch Gen Psychiatry 1986 Mar
PMID:Signs and symptoms of tobacco withdrawal. 395 51

This article discusses the causes of sleeplessness and its long-term management. Sleep may be repeatedly disturbed by pain, dyspnoea, micturition, or restlessness. The sleep patterns of the diseases which produce these symptoms are given, with an explanation in physiological terms of why they disturb sleep. A knowledge of these sleep patterns provides a valuable aid to diagnosis. It is concluded that there is only one condition, senility leading to senile dementia, for which long-term night sedation is justified.
J R Coll Gen Pract 1974 Aug
PMID:The clinical significance of disturbed sleep and the use of hypnotics. 437 78

A study of benzodiazepine prescribing in a single-handed general practice was carried out over a period of three months. It seemed that the existing pattern of prescribing was indiscriminate and ineffective, and that repeat prescriptions were poorly controlled. A programme of controlled withdrawal was instituted for patients whose consumption of benzodiazepines was felt to be no longer appropriate. Of 103 patients identified who had been taking benzodiazepines for longer than three months, 78 were entered into the programme. On completion, 45 patients (58 per cent) had discontinued benzodiazepines completely, and a further 13 (17 per cent) were taking less than half their original dose. Four patients had failed to reduce consumption at all and two were lost to follow-up. At follow-up between three and five months later, 49 patients (63 per cent) had discontinued benzodiazepines completely and only two had restarted treatment. The median time taken to complete the programme was 3.2 weeks, with 95 per cent of patients completing within six weeks. Withdrawal was generally well tolerated, with a temporary increase in insomnia as the main symptom. Two patients experienced severe symptoms, but both had stopped treatment abruptly.
J R Coll Gen Pract 1982 Dec
PMID:Benzodiazepine withdrawal in general practice. 613 Jan 50

We describe a new syndrome called "delayed sleep phase insomnia." Thirty of 450 patients seen for a primary insomniac complaint had the following characteristics: (1) chronic inability to fall asleep at a desired clock time; (2) when not on a strict schedule, the patients have a normal sleep pattern and after a sleep of normal length awaken spontaneously and feel refreshed; and (3) a long history of unsuccessful attempts to treat the problem. These patients were younger than the general insomniac population and as a group did not have a specific psychiatric disorder. Six patients' histories are described in detail, including the successful nonpharmacological chronotherapy regimen (resetting the patients' biological clock by progressive phase delay). Delayed sleep phase insomnia is proposed to be a disorder of the circadian sleep-wake rhythm in which the "advance" portion of the phase response curve is small.
Arch Gen Psychiatry 1981 Jul
PMID:Delayed sleep phase syndrome. A chronobiological disorder with sleep-onset insomnia. 724 37

After evaluating 165 insomniacs, 48 psychophysiologic insomniacs were randomly assigned to one of the following four groups: electromyographic (EMG) feedback, combined EMG and theta feedback, sensorimotor rhythm (SMR) feedback, and no treatment (control). Sleep evaluations by home logs and in the laboratory were done before and after biofeedback and nine months later. No feedback group showed improved sleep significantly more than did the controls. The amount of feedback learning correlated significantly with sleep improvement for the SMR group but not for the other groups. Initial tension of the insomniacs correlated positively with sleep improvement for the EMG group, but negatively with sleep improvement for the SMR group. Those treated with the biofeedback that seemed appropriate for their specific deficiencies showed significant sleep improvements, while those who received inappropriate feedback did not. Appropriate biofeedback methods may be effective for specific types of insomnia, but these procedures offer no panacea for all poor sleep.
Arch Gen Psychiatry 1981 Jul
PMID:Treating psychophysiologic insomnia with biofeedback. 724 38

Clonidine hydrochloride was found to be effective in the treatment of methadone hydrochloride withdrawal. Under controlled inpatient conditions established to assess dosage guidelines and to examine specific signs and symptoms of withdrawal, 20 of 25 (80%) patients were able to withdraw completely from methadone by the end of a two-week period. In most patients, ten to 11 days of clonidine administration, with a peak mean dose of 16 micro g /kg/day, resulted in a perceived reduction in symptoms compared with previous attempts to become opiate free. At these doses clonidine significantly reduced standing blood pressure without producing clinical problems. The withdrawal symptoms of anxiety, restlessness, insomnia, and muscular aching were most resistant to clonidine treatment and were reported by the majority of patients.
Arch Gen Psychiatry 1981 Nov
PMID:The clinical use of clonidine in abrupt withdrawal from methadone. Effects on blood pressure and specific signs and symptoms. 730 8

We compared sleep variables in 14 drug-free endogenous depressives and in 14 age- and insomnia-matched, nondepressed controls before and after brief rapid eye movement (REM) sleep deprivation by awakenings. Before REM sleep deprivation, compared with controls, depressives had lower REM latency, higher REM frequency, and--a new finding--an abnormal temporal distribution of REM sleep. Depression improvement by REM sleep deprivation correlated with the ameliorative effect of brief REM sleep deprivation on on indicator of the abnormal temporal distribution of REM sleep. Several findings suggest that the depressive abnormalities represent a "damaged," weakened sleep cycle "oscillator" and its correlate, a circadian rhythm disturbance, and that REM sleep deprivation improved depression to the extent that it stimulated the oscillator and corrected one manifestation of the circadian rhythm disturbance.
Arch Gen Psychiatry 1980 Mar
PMID:Improvement of depression by REM sleep deprivation. New findings and a theory. 736 14

A sleep clinic was founded within a general hospital psychiatry service. A practical approach toward sleep problems included: flexible diagnostic investigations; descriptive, imprecise diagnostic categories; and symptomatic treatment measures. A summary of 100 consecutive patients with chronic insomnia is presented to illustrate this approach. Of 36 treatment failures, most were due to incomplete treatment rather than irremediable problems. The general psychiatry service may provide a favorable base for a sleep clinic.
Gen Hosp Psychiatry 1980 Jun
PMID:A sleep clinic within a general hospital psychiatry service. 739 Jan 46


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