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Schizophrenia Research Mar 2009Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are...
Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services. Assessments of insomnia, persecutory ideation, anxiety, and depression were completed by 300 individuals from the general population and 30 individuals with persecutory delusions and a diagnosis of non-affective psychosis. Insomnia symptoms were clearly associated with higher levels of persecutory ideation. Consistent with the theoretical understanding of paranoia, the association was partly explained by the presence of anxiety and depression. Moderate or severe insomnia was present in more than 50% of the delusions group. The study provides the first direct evidence that insomnia is common in individuals with high levels of paranoia. It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia.
Topics: Adult; Anxiety; Depression; Female; Humans; Male; Middle Aged; Paranoid Disorders; Psychiatric Status Rating Scales; Residence Characteristics; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 19097752
DOI: 10.1016/j.schres.2008.12.001 -
Health Psychology : Official Journal of... Jan 2006Meta-analyses support the effectiveness of behavioral interventions for the treatment of insomnia, although few have systematically evaluated the relative efficacy of... (Comparative Study)
Comparative Study Meta-Analysis Review
Meta-analyses support the effectiveness of behavioral interventions for the treatment of insomnia, although few have systematically evaluated the relative efficacy of different treatment modalities or the relation of old age to sleep outcomes. In this meta-analysis of randomized controlled trials (k = 23), moderate to large effects of behavioral treatments on subjective sleep outcomes were found. Evaluation of the moderating effects of behavioral intervention type (i.e., cognitive-behavioral treatment, relaxation, behavioral only) revealed similar effects for the 3 treatment modalities. Both middle-aged adults and persons older than 55 years of age showed similar robust improvements in sleep quality, sleep latency, and wakening after sleep onset. A research agenda is recommended to examine the mechanisms of action of behavioral treatments on sleep with increased attention to the high prevalence of insomnia in older individuals.
Topics: Behavior Therapy; Female; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 16448292
DOI: 10.1037/0278-6133.25.1.3 -
Annual Review of Clinical Psychology 2011Sleep disturbance is intricately entwined with our sense of well-being, health, emotion regulation, performance and productivity, memory and cognitive functioning, and... (Review)
Review
Sleep disturbance is intricately entwined with our sense of well-being, health, emotion regulation, performance and productivity, memory and cognitive functioning, and social interaction. A longitudinal perspective underscores the conclusion that persistent sleep disturbance, insomnia, at any time during the life span from infancy to old age has a lasting impact. We examine how insomnia develops, the evidence for competing explanations for understanding insomnia, and the evidence about psychological and behavioral treatments that are used to reduce insomnia and change daytime consequences. There are new directions to expand access to treatment for those who have insomnia, and thus a critical analysis of pathways for dissemination is becoming increasingly important.
Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Cognitive Behavioral Therapy; Female; Humans; Hypnotics and Sedatives; Infant; Male; Meditation; Middle Aged; Patient Education as Topic; Relaxation Therapy; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 17716026
DOI: 10.1146/annurev.clinpsy.3.022806.091516 -
British Medical Journal (Clinical... Oct 1981
Topics: Female; Humans; Male; Middle Aged; Sleep Initiation and Maintenance Disorders
PubMed: 6793154
DOI: 10.1136/bmj.283.6296.874 -
Clinical Cornerstone 2003Insomnia in the geriatric patient is unique and complex, requiring a comprehensive and careful evaluation. Insomnia is the most common sleep complaint reported by... (Review)
Review
Insomnia in the geriatric patient is unique and complex, requiring a comprehensive and careful evaluation. Insomnia is the most common sleep complaint reported by persons > 60 years. It is defined as the inability to initiate or maintain sleep, and the etiology can be multifactorial. Insomnia in the geriatric patient may be due to a primary sleep disorder, such as obstructive sleep apnea, periodic limb movements in sleep, circadian rhythm disorders, or restless legs syndrome, or it may be secondary to underlying medical or psychiatric conditions, medication effects, or psychosocial factors. When insomnia becomes chronic, it may exacerbate medical and psychiatric illnesses. Insomnia can lead to excessive daytime sleepiness, which may result in disturbed intellect, impaired cognition, confusion, psychomotor retardation, or increased risk of injury, any of which can compromise the patient's quality of life and create social and economic burdens for caregivers. This article discusses the recommended diagnostic and treatment approaches that may be used by the clinician in treating the geriatric patient. Case studies are presented to illustrate diagnoses of insomnia and therapeutic interventions.
Topics: Age Factors; Aged; Circadian Rhythm; Diagnosis, Differential; Dyssomnias; Female; Humans; Male; Middle Aged; Sleep Initiation and Maintenance Disorders
PubMed: 14626541
DOI: 10.1016/s1098-3597(03)90035-4 -
Climacteric : the Journal of the... Aug 2016Many middle-aged women are affected by sleep disturbance. We investigated how subjective insomnia is associated with objective sleep parameters and other background...
OBJECTIVES
Many middle-aged women are affected by sleep disturbance. We investigated how subjective insomnia is associated with objective sleep parameters and other background characteristics.
METHODS
This cross-sectional study used baseline data obtained from 95 women aged 40-59 years who participated in another study assessing the effects of a dietary supplement. Participants wore an actigraph unit for 3 days to collect information concerning physical activities and objective sleep parameters and were then evaluated for body composition, cardiovascular parameters, and menopausal symptoms including insomnia and fatigue, and lifestyle factors. Stratifying Athens Insomnia Scale scores as low (0-5 points, control group) and high (≥ 6 points, subjective insomnia group), we sought to identify the parameters that are independently associated with subjective insomnia.
RESULTS
Women with subjective insomnia (n = 30) had lower sleep efficiency than did the controls. They were also older; had more live births, lower height, higher body mass index, lower ankle brachial index, and more severe menopausal symptoms including fatigue; took more naps; smoked more cigarettes; and more of them were full-time workers. Multivariate logistic regression analysis revealed that low sleep efficiency (adjusted odds ratio, 1.44 per 1% decrease in sleep efficiency; 95% confidence interval 1.06-2.05) and fatigue assessed with Brief Fatigue Inventory (BFI) (adjusted odds ratio, 1.57 per 1-point increase in BFI score; 95% confidence interval 1.19-2.13) were independent contributors to subjective insomnia.
CONCLUSIONS
Low sleep efficiency and feeling of fatigue were found to be independently associated with subjective insomnia in middle-aged women.
Topics: Actigraphy; Adult; Cross-Sectional Studies; Fatigue; Female; Humans; Logistic Models; Menopause; Middle Aged; Multivariate Analysis; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 27175855
DOI: 10.1080/13697137.2016.1186160 -
Chest Feb 2013Chronic insomnia (symptoms for ≥ 6 months) is the most common sleep disorder, affecting 6% to 10% of adults in the general population, with even higher rates in... (Review)
Review
Chronic insomnia (symptoms for ≥ 6 months) is the most common sleep disorder, affecting 6% to 10% of adults in the general population, with even higher rates in patients with comorbid conditions (eg, hypertension, 44%; cardiac disease, 44.1%; breathing problems, 41.5%). Traditionally, chronic insomnia occurring with another condition has been considered secondary and rarely received direct treatment because treatment of the primary condition was expected to improve the insomnia. However, this approach often failed because chronic insomnia is maintained by behaviors, cognitions, and associations that patients adopt as they attempt to cope with poor sleep but that end up backfiring (eg, increasing caffeine, spending more time in bed, trying harder to sleep). Cognitive behavioral treatment of insomnia (CBTi) targets those behaviors, cognitions, and associations and is effective across a variety of populations, including those with medical and psychologic comorbidities. Thus, in 2005, a National Institutes of Health expert consensus panel on chronic insomnia recommended dropping the term "secondary insomnia" in favor of the term "comorbid insomnia." Because CBTi does not carry the risks associated with some sleep medications (eg, dependency, polypharmacy, cognitive and psychomotor impairment), it is an attractive option for patients with other conditions. Through the Society of Behavioral Sleep Medicine (www.behavioralsleep.org) and the American Board of Sleep Medicine (www.absm.org), it is possible to find practitioners with expertise in CBTi (as well as other aspects of behavioral sleep medicine) and other behavioral sleep resources. Given the currently limited number of trained practitioners, exploration of alternative delivery methods (eg, briefer protocols, self-help, Internet) to improve access to this highly effective treatment and expanded training in these treatments are warranted.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cognitive Behavioral Therapy; Comorbidity; Female; Heart Diseases; Humans; Hypertension; Lung Diseases; Male; Middle Aged; Sleep Initiation and Maintenance Disorders; Treatment Outcome; Young Adult
PubMed: 23381322
DOI: 10.1378/chest.12-0731 -
Progress in Brain Research 2007Sleep problems are common in individuals with tinnitus but it is not known if they can be seen as a reaction to the acoustic percept of tinnitus disturbing normal sleep,...
Sleep problems are common in individuals with tinnitus but it is not known if they can be seen as a reaction to the acoustic percept of tinnitus disturbing normal sleep, or if there are common causes. Sleep problems further impair the quality of life of individuals with tinnitus and the impairment correlates with the severity of the tinnitus. However the nature of the relationship between tinnitus and disturbed sleep in individuals with tinnitus is not clearly understood. Preliminary studies suggest that chronically disturbed sleep (insomnia) in individuals with tinnitus that is not caused by organic disorders exists unrelated to the tinnitus. We studied the relationship between tinnitus and insomnia in a retrospective sleep study of 13 hospitalized patients with insomnia and tinnitus. Patients with sleep apnea, periodic leg movements, or a severe psychiatric disorder were excluded. We collected physiologic sleep measures (EEG, EOG, EMG, and respiration) and subjective sleep information from a morning protocol during two nights. We also obtained information about performance in sustained attention tasks and the scores of self-rated depression scale and self-rated daytime-tiredness scale. Thirteen age- and sex-matched inpatients with primary insomnia who did not have tinnitus served as controls. There were no significant differences between the physiologic data obtained in patients with tinnitus and in the controls. Both groups had low sleep efficiency but the patients with both insomnia and tinnitus had longer subjective sleep latencies than insomnia patients without tinnitus (controls). No differences were found in sustained attention tasks, subjective daytime tiredness, and depression rating scores between the two groups. Similarities between the results from these two groups suggest that sleep specific psychotherapeutic methods, which are established for treating insomnia, should be further developed for the use in patients with insomnia and tinnitus.
Topics: Adult; Female; Humans; Male; Middle Aged; Polysomnography; Psychotherapy; Retrospective Studies; Sleep Initiation and Maintenance Disorders; Tinnitus
PubMed: 17956787
DOI: 10.1016/S0079-6123(07)66021-X -
Praxis Jun 2017
Review
Topics: Adult; Age Factors; Aged; Health Status; Humans; Middle Aged; Patient Education as Topic; Polysomnography; Risk Factors; Sex Factors; Sleep Initiation and Maintenance Disorders; Sleep Stages; Switzerland
PubMed: 28635393
DOI: 10.1024/1661-8157/a002707 -
Journal of Consulting and Clinical... Dec 2007Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of...
Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were found to have a significant relationship with both psychological and subjective well-being but a stronger relationship to subjective well-being. These data suggest that insomnia symptoms have a stronger relationship to enjoying life than to the perception that one has a meaningful life.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Prevalence; Quality of Life; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 18085910
DOI: 10.1037/0022-006X.75.6.939