-
Menopause (New York, N.Y.) Dec 2014The purpose of this study was to conduct a systematic review and meta-analysis of the relationship between menopausal stages and sleep disturbance reported using... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this study was to conduct a systematic review and meta-analysis of the relationship between menopausal stages and sleep disturbance reported using subjective methods. Secondary aims included examining the influence of culture/ethnicity on the relationship between menopausal stages and sleep disturbance.
METHODS
Multiple electronic databases were searched from the first available year to November 2013, and a manual search of the reference lists of review articles identified was also conducted. Twenty-four studies with a total of 63,542 midlife women were identified, coded, and analyzed.
RESULTS
The crude and adjusted odds of experiencing sleep disturbance were small but statistically significant for perimenopausal and postmenopausal women, using premenopause as the reference group. The ethnicity of the samples influenced effect sizes; Asian and white women both experienced an increased rate of sleep disturbance at the perimenopausal and postmenopausal stages compared with the premenopausal stage, whereas Hispanic women experienced no change in sleep disturbance across the menopausal transition.
CONCLUSIONS
The prevalence of sleep disturbance is higher in perimenopausal, postmenopausal, and surgical menopausal women than in premenopausal women. There is an independent relationship between menopausal stages and sleep disturbance beyond the effects of aging and other confounders, although the magnitude of the relationship is small. Culture, ethnicity, or both might affect the levels of sleep disturbance at various menopausal stages.
Topics: Aging; Asian People; Cross-Sectional Studies; Ethnicity; Female; Hispanic or Latino; Humans; Menopause; Middle Aged; Perimenopause; Postmenopause; Premenopause; Prevalence; Sleep Initiation and Maintenance Disorders; Vasomotor System; White People
PubMed: 24800878
DOI: 10.1097/GME.0000000000000240 -
Health Psychology Review Mar 2023This study examined the available literature concerning the association between sleep quality and quality of life (QoL) in autonomous older people with no sleep... (Meta-Analysis)
Meta-Analysis
This study examined the available literature concerning the association between sleep quality and quality of life (QoL) in autonomous older people with no sleep disorders. A systematic review and meta-analysis were conducted on studies identified in the PsycInfo, PubMed and Scopus databases that examined the associations between QoL and sleep quality in older adults. Our systematic literature search identified 23 studies concerning a total of 21,092 participants (range of mean ages: 58-79 years). The results showed that self-reported sleep quality, but not objective sleep quality, correlated positively with QoL with a moderate effect size (for self-reported sleep quality, the overall estimate of the average effect size was a Pearson's = .28 [95% CI: .34, .23]; for objective sleep quality, it was = .01 [.12, -.09]). This also applied to the main domains of QoL concerning physical and psychological health, social relationships and environmental aspects (the estimated average effect sizes ranged from Pearson's = .13 to = .35). These findings highlight the influence of sleep quality, and particularly of self-reported sleep quality, on QoL (as a whole and in its specific domains) in older adults with normal aging and no insomnia. This influence should therefore be investigated systematically when examining QoL.
Topics: Humans; Aged; Middle Aged; Quality of Life; Sleep Quality; Sleep Initiation and Maintenance Disorders; Mental Health; Aging
PubMed: 34459704
DOI: 10.1080/17437199.2021.1974309 -
Journal of Affective Disorders Oct 2022The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and meta-analysis of longitudinal studies to evaluate the global evolution of mental health problems during the pandemic.
METHODS
To conduct this systematic review, we searched for published articles from APA PsycInfo (Ovid), CINAHL (EBSCOhost), Embase (Ovid), MEDLINE (Ovid), and Web of Science. Longitudinal (at least 2 waves during the COVID-19 pandemic) and peer-reviewed articles on mental health problems conducted as from 2020 and after were included in the current study. Of 394 eligible full texts, 64 articles were included in the analysis. We computed random effects, standardized mean differences, and log odds ratio (LOR) with 95 % CIs. The meta-analysis protocol was registered with PROSPERO (CRD42021273624).
RESULTS
Results showed that anxiety (LOR = -0.33; 95 % CI, -0.54, -0.12) and depression symptoms (LOR = -0.12; 95 % CI, -0.21, -0.04) decreased from baseline to follow up. However, other mental health problems showed no change. Higher prevalence rates (40.9 %; 95 % CI, 16.1 %-65.8 %) of psychological distress were found in months after July 2020, respectively, while there were no significant month differences for the prevalence of other mental health problems. Higher means of anxiety (d = 3.63, 95 % CI, 1.66, 5.61), depression (d = 3.93; 95 % CI, 1.68, 6.17), and loneliness (d = 5.96; 95 % CI, 3.22, 8.70) were observed in May 2020. Higher prevalence of anxiety, depression, and PTSD and higher means of anxiety, depression and loneliness were observed in North America. The prevalence of psychological distress and insomnia was higher in Latin America and Europe, respectively.
LIMITATIONS
There is a lack of longitudinal studies in some parts of the world, such as Africa, the Caribbean, India, the Middle East, in Latin America, and Asia.
CONCLUSIONS
Results indicated that anxiety and depression symptoms decreased during the COVID-19 pandemic while other mental health problems showed no statistical change. The findings reveal that mental health problems peaked in April and May 2020. Prevalence of mental health problems remains high during the pandemic and mental health prevention, promotion and intervention programs should be implemented to mitigate the consequences of the COVID-19 pandemic on the global population.
Topics: Anxiety; Anxiety Disorders; COVID-19; Depression; Humans; Mental Health; Pandemics; Prevalence
PubMed: 35842064
DOI: 10.1016/j.jad.2022.07.011 -
Journal of Affective Disorders May 2015Mixed states have been a fundamental part of Kraepelin׳s conceptualization of the manic-depressive illness. However, after Kraepelin, the study of mixed states was not... (Review)
Review
BACKGROUND
Mixed states have been a fundamental part of Kraepelin׳s conceptualization of the manic-depressive illness. However, after Kraepelin, the study of mixed states was not of great interest, until the publication of the RDC criteria (1978) and then the DSM-III edition (1980), where criteria for mixed manic states were operationalized. The most notable victims of DSM nosology were depressive mixed states, in particular depression with flight of ideas and excited (agitated) depression.
METHODS
We briefly review the clinical work of Athanasios Koukopoulos on depressive mixed states (in particular agitated depression) pointing out the diagnostic and therapeutic contributions, especially in the lights of Koukopoulos׳ first description of depressive mixed syndrome in 1992.
RESULTS
The mixed depressive syndrome is not a transitory state but a state of long duration, which may last weeks or several months. The clinical picture is characterized by dysphoric mood, emotional lability, psychic and/or motor agitation, talkativeness, crowded and/or racing thoughts, rumination, initial or middle insomnia. Impulsive suicidal attempts may be frequent. The family observes incessant complaints, irritability, occasional verbal outbursts, occasional physical aggression, and occasional hypersexuality. Treatment with antipsychotics and ECT is very effective; antidepressants can worsen the clinical picture.
LIMITATIONS
Selective but not systematic review of the literature on depressive mixed states. Relatively little research data is currently available for validation of the criteria proposed by Koukopoulos.
CONCLUSIONS
Koukopoulos׳ proposal of mixed depression, besides its diagnostic implications, clearly identifying it as manifestations of bipolar disorder, allows for better clinical characterization of cases and improves treatment decisions.
Topics: Adult; Age of Onset; Antidepressive Agents; Bipolar Disorder; Depression; Depressive Disorder, Major; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Genetic Diseases, X-Linked; Humans; Irritable Mood; Psychomotor Agitation
PubMed: 25687279
DOI: 10.1016/j.jad.2015.01.053 -
The International Journal of Pharmacy... Apr 2023Sleep is an essential part of mental and physical well-being. Sleep disorders may lead to psychiatric and physical conditions that contribute to morbidity and mortality....
BACKGROUND
Sleep is an essential part of mental and physical well-being. Sleep disorders may lead to psychiatric and physical conditions that contribute to morbidity and mortality. They lead to severe health and economic consequences across high-, intermediate- and low-income countries. Little is known about how pharmacists manage sleep disorders for patients in high, intermediate and low-income countries.
METHOD
Four databases were systematically searched, and titles, abstracts, and full texts were screened to detect relevant studies. Data were extracted from literature and thematically synthesised to identify descriptive and analytical themes.
RESULTS
Thirty-four studies met the inclusion criteria. Most studies were from high-income countries (n = 33) and based in community pharmacy settings (n = 17). Four descriptive themes were identified: (1) how pharmacists manage sleep disorders, (2) the impact of pharmacists' interventions on sleep, (3) barriers to managing sleep by pharmacists and (4) inappropriate sleep disorders management by pharmacists. Three analytical themes were synthesised from extracted data that identified the pharmacists have roles as (1) de-prescribers, (2) collaborators and (3) educators in sleep management services.
CONCLUSION
Pharmacists have three clear roles in sleep disorder management; deprescribing, collaboration with other healthcare professionals and educators. However, most of the literature is from high-income countries; therefore, further work is needed to explore these roles in low and middle-income countries.
Topics: Humans; Pharmacists; Sleep; Professional Role; Community Pharmacy Services
PubMed: 36840950
DOI: 10.1093/ijpp/riac102 -
Clinical Psychology Review Aug 2020Insomnia disorder, defined by nocturnal and daytime symptoms, is highly prevalent worldwide and is associated with the onset of mental illness. Although daytime symptoms... (Meta-Analysis)
Meta-Analysis
Insomnia disorder, defined by nocturnal and daytime symptoms, is highly prevalent worldwide and is associated with the onset of mental illness. Although daytime symptoms are often the reason insomnia patients seek help, it is not clear whether recommended treatment is effective on daytime symptoms. We aimed to investigate the efficacy of cognitive and behavior therapies for insomnia (CBT-I) on all daytime symptoms explored in the literature using both direct and indirect data. 86 studies (15,578 participants) met inclusion criteria. Results showed significant effects of CBT-I administered face-to-face individually, in group and different self-help settings on depressive symptoms, anxiety, daytime sleepiness, fatigue, quality of life, daytime and social functioning and mental state, with Cohen's d's ranging from -0.52 and 0.81. Our results suggest that CBT-I is effective in the treatment of daytime symptoms, albeit with predominantly small to moderate effects compared to far stronger effects on the core symptoms of insomnia. Effects may be biased for depressive and anxiety symptoms, since many included studies excluded patients with severe levels of these complaints. Further, small to moderate effects may reflect that CBT-I, by improving nighttime symptoms, has a positive effect on daytime symptoms, but it does not target the daytime symptoms directly. Future studies may benefit from adding therapeutic techniques that address daytime symptoms more directly.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Cognition; Cognitive Behavioral Therapy; Depression; Fatigue; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Quality of Life; Sleep Initiation and Maintenance Disorders; Treatment Outcome; Young Adult
PubMed: 32777632
DOI: 10.1016/j.cpr.2020.101873 -
Sleep Medicine Oct 2019In this study, we performed a systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials to evaluate the efficacy and safety of... (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVE
In this study, we performed a systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials to evaluate the efficacy and safety of eszopiclone for the treatment of primary insomnia.
METHODS
We searched MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials and PubMed from inception to June 2018. Additionally, we searched the ClinicalTrials.gov trials register for other relevant trials. According to participants, intervention, comparison, outcome (PICO) criteria, studies were included that focused on: adults diagnosed with primary insomnia, aged 18-65 and > 65 years; eszopiclone for the treatment of primary insomnia; comparison were made between eszopiclone and placebo; as well as primary outcomes, secondary outcomes, and adverse effects.
RESULTS
A total of six randomized trials involving 2809 patients with primary insomnia were included in our analysis. Our analysis suggested that eszopiclone was associated with significant improvements in subjective sleep latency, wake after sleep onset, number of awakenings, total sleep time at one week, two weeks, one month, three months and six months. Meanwhile, eszopiclone was associated with increased quality of sleep, ability to function, daytime alertness and sense of physical well-being at one week, one month, three months and six months. Dizziness and unpleasant taste were the most common adverse effects in elderly subgroup. Alternately, non-elderly patients may be more prone to adverse effects such as infection, pharyngitis, somnolence, unpleasant taste and dry mouth.
CONCLUSION
This meta-analysis showed that eszopiclone is an effective and safe therapy option for patients with primary insomnia, especially in elderly patients. However, due to the high clinical heterogeneity in some outcomes, further standardized preparation, large-scale and rigorously designed trials are needed.
Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Double-Blind Method; Eszopiclone; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Placebos; Randomized Controlled Trials as Topic; Safety; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Latency; Treatment Outcome
PubMed: 31518944
DOI: 10.1016/j.sleep.2019.03.016 -
Frontiers in Neurology 2018Insomnia and obstructive sleep apnea (OSA) are often both present in patients with sleep-disordered-breathing (SDB). The coexistence of the two disorders shows an...
Insomnia and obstructive sleep apnea (OSA) are often both present in patients with sleep-disordered-breathing (SDB). The coexistence of the two disorders shows an increase in cumulative morbidity and an overall greater illness severity. There is still considerable controversy regarding management decisions in this group of patients. This systematic review focused on more recent evidence regarding treatment of patients presenting with both clinical entities of comorbid insomnia and OSA (COMISA) in terms of their management, especially using combinations of positive airway pressure [PAP, namely aPAP, cPAP, adaptive servo-ventilation (ASV)] and CBTi as well as each one of these two modalities alone. As a conclusion it is necessary to specifically target distinct combinations of both insomnia (initial, middle, late) and OSA (mild, moderate, severe) phenotypes. The present review gives reason to assume that both CBTi and PAP-therapy are necessary. However, it appears that distinct treatment patterns may suit different COMISA phenotypes.
PubMed: 30420826
DOI: 10.3389/fneur.2018.00804 -
Sleep Medicine Reviews Jun 2019Recent investigations have established that patients with obstructive sleep apnea (OSA) and insomnia have greater daytime impairments and reduced quality of life... (Meta-Analysis)
Meta-Analysis
Recent investigations have established that patients with obstructive sleep apnea (OSA) and insomnia have greater daytime impairments and reduced quality of life compared to those with either disorder alone. The present study reviewed current data on the co-occurrence prevalence of insomnia and insomnia symptoms with OSA and assessed its worldwide and regional prevalence based on World Health Organization (WHO) regions. A total of 37 studies were included in the analysis. The overall prevalence rates of insomnia, any insomnia complaints, difficulty falling asleep (DFA), difficulty maintaining sleep (DMS) and early morning awakening (EMA) found in OSA patients were 38%, 36%, 18%, 42%, and 21%, respectively. According to the regional classification of the WHO, the rates of DFA, DMS and EMA in OSA patients in the Western Pacific Region were lower than those in the European Region and the Region of the Americas. We also analyzed the pooled prevalence rates of OSA based on different apnea-hypopnea index (AHI) criteria in insomnia patients. The rates were 35% (AHI≥5) and 29% (AHI≥15), respectively. Regional differences of DFA, DMS and EMA in OSA patients may be related to sex, age and body mass index.
Topics: Adult; Comorbidity; Disorders of Excessive Somnolence; Female; Humans; Male; Middle Aged; Prevalence; Severity of Illness Index; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Sleep Initiation and Maintenance Disorders
PubMed: 30844624
DOI: 10.1016/j.smrv.2019.01.004 -
Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials.Integrative Cancer Therapies Jun 2017Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug...
BACKGROUND
Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug approaches have a low rate of success in alleviating those suffering insomnia. The aim of this systematic review was to assess the efficacy of acupuncture in the management of cancer-related insomnia.
METHODS
A total of 12 databases were searched from their inception through January 2016 without language restriction. Randomized controlled trials (RCTs) and quasi-RCTs were included if acupuncture was used as the sole intervention or as an adjunct to another standard treatment for any cancer-related insomnia. The data extraction and the risk of bias assessments were performed by 2 independent reviewers.
RESULTS
Of the 90 studies screened, 6 RCTs were included. The risk of bias was generally unclear or low. Three RCTs showed equivalent effects on the Pittsburgh Sleep Quality Index and 2 RCTs showed the similar effects on response rate to those of conventional drugs at the end of treatment. The other RCT showed acupuncture was better than hormone therapy in the numbers of hours slept each night and number of times woken up each night. The 3 weeks of follow-up in 2 RCTs showed superior effects of acupuncture compared with conventional drugs, and a meta-analysis showed significant effects of acupuncture. Two RCTs tested the effects of acupuncture on cancer-related insomnia compared with sham acupuncture. One RCT showed favourable effects, while the other trial failed to do so.
CONCLUSION
There is a low level of evidence that acupuncture may be superior to sham acupuncture, drugs or hormones therapy. However, the number of studies and effect size are small for clinical significance. Further clinical trials are warranted.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Acupuncture Therapy; Neoplasms; Quality of Life; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders
PubMed: 27531549
DOI: 10.1177/1534735416664172