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BMJ (Clinical Research Ed.) Nov 2008
Topics: Humans; Male; Medical History Taking; Middle Aged; Sleep Initiation and Maintenance Disorders
PubMed: 19042934
DOI: 10.1136/bmj.a1245 -
Sleep Jan 2015We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither...
STUDY OBJECTIVES
We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither criterion (i.e., insomnia cases that do not meet quantitative thresholds for onset or maintenance problems). Insomnia cases that exhibited the same symptom profile over a 1-y period were considered to be phenotypes, and were compared in terms of clinical and demographic characteristics.
DESIGN
Longitudinal.
SETTING
Urban, community-based.
PARTICIPANTS
Nine hundred fifty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based current insomnia (46.6 ± 12.6 y; 69.4% female).
INTERVENTIONS
None.
MEASUREMENTS AND RESULTS
At baseline, participants were divided into four symptom profile groups based on quantitative criteria. Follow-up assessment 1 y later revealed that approximately 60% of participants retained the same symptom profile, and were hence judged to be phenotypes. Stability varied significantly by phenotype, such that sleep onset insomnia (SOI) was the least stable (42%), whereas combined insomnia (CI) was the most stable (69%). Baseline symptom groups (cross-sectionally defined) differed significantly across various clinical indices, including daytime impairment, depression, and anxiety. Importantly, however, a comparison of stable phenotypes (longitudinally defined) did not reveal any differences in impairment or comorbid psychopathology. Another interesting finding was that whereas all other insomnia phenotypes showed evidence of an elevated wake drive both at night and during the day, the 'neither criterion' phenotype did not; this latter phenotype exhibited significantly higher daytime sleepiness despite subthreshold onset and maintenance difficulties.
CONCLUSIONS
By adopting a stringent, stability-based definition, this study offers timely and important data on the longitudinal trajectory of specific insomnia phenotypes. With the exception of daytime sleepiness, few clinical differences are apparent across stable phenotypes.
Topics: Adult; Anxiety; Comorbidity; Cross-Sectional Studies; Demography; Depression; Diagnostic and Statistical Manual of Mental Disorders; Female; Follow-Up Studies; Humans; Male; Middle Aged; Phenotype; Sleep Initiation and Maintenance Disorders; Sleep Stages; Time Factors; Wakefulness
PubMed: 25325468
DOI: 10.5665/sleep.4338 -
Menopause (New York, N.Y.) Mar 2014Mindfulness has been defined as being intentionally aware of internal and external experiences that occur at the present moment, without judgment. Techniques that...
OBJECTIVE
Mindfulness has been defined as being intentionally aware of internal and external experiences that occur at the present moment, without judgment. Techniques that develop mindfulness, such as meditation, have positive effects on reducing insomnia, a sleep disorder that is common both during and after menopause. Our aim was to establish whether postmenopausal women with insomnia are less mindful than postmenopausal women without sleep disorders.
METHODS
Postmenopausal women aged 50 to 65 years who did not use hormone therapy were recruited for the study. The sample included 14 women with insomnia and 12 women without insomnia or any other sleep disorder. The groups were comparable in age, schooling, and anxiety level. To assess mindfulness, we used the validated Mindful Attention Awareness Scale and the attentiveness domain of the Positive and Negative Affect Schedule-Expanded Form.
RESULTS
Participants with insomnia were less mindful than healthy women. The level of mindfulness was able to discriminate the group with insomnia from the healthy group, with 71.4% accuracy.
CONCLUSIONS
Postmenopausal women with insomnia are less mindful than women without insomnia. Mindfulness-based interventions, such as meditation, may be beneficial for postmenopausal insomnia.
Topics: Aged; Female; Humans; Meditation; Middle Aged; Mindfulness; Postmenopause; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 23820599
DOI: 10.1097/GME.0b013e31829996fc -
The Primary Care Companion For CNS... 2016Pharmacotherapy for insomnia in primary care settings can be challenging. Frequently, there are multiple coexisting medical and psychiatric conditions, drug...
Pharmacotherapy for insomnia in primary care settings can be challenging. Frequently, there are multiple coexisting medical and psychiatric conditions, drug interactions, concern regarding use of habit-forming sleep aids, and paucity of time in office visits to discuss management of sleep difficulties. This article reports the results of a literature search related to pharmacotherapy for insomnia and presents 4 clinical vignettes with corresponding treatment options.
Topics: Adult; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Primary Health Care; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 27486547
DOI: 10.4088/PCC.16br01930 -
BMC Public Health Jul 2014Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study...
BACKGROUND
Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study was to examine the effect of insomnia in middle age on all-cause mortality.
METHODS
Using a cohort design with 13-15 years follow-up, mortality registry data were linked to health information obtained during 1997-99, as part of the community-based Hordaland Health Study (HUSK), in Western Norway. 6,236 participants aged 40-45 provided baseline information on self- reported insomnia using the Karolinska Sleep Questionnaire Scale (defined according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), sociodemographic factors, health behaviors, shift/night-work, obstructive sleep apnea symptoms, sleep duration, sleep medication use, anxiety, depression, as well as a range of somatic diagnoses and symptoms. Height, weight and blood pressure were measured. Information on mortality was obtained from the Norwegian Cause of Death Registry.
RESULTS
Insomnia was reported by 5.6% (349/6236) at baseline and a significant predictor of all-cause-mortality (hazard ratio [HR] = 2.74 [95% CI:1.75-4.30]). Adjusting for all confounders did not attenuate the effect (HR = 3.34 [95% CI:1.67-6.69]). Stratifying by gender, the effect was especially strong in men (HR = 4.72 [95% CI:2.48-9.03]); but also significant in women (adjusted HR = 1.96 [95% CI:1.04-3.67]). The mortality risk among participants with both insomnia and short sleep duration (<6.5 hours) was particularly high, whereas insomnia in combination with normal/greater sleep duration was not associated with mortality.
CONCLUSIONS
Insomnia was associated with a three-fold risk of mortality over 13-15 years follow-up. The risk appeared even higher in males or when insomnia was combined with short sleep duration, although such unadjusted subgroup analyses should be interpreted with caution. Establishing prevention strategies and low-threshold interventions should consequently be a prioritized task for public health policy.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Norway; Registries; Risk Assessment; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 25024049
DOI: 10.1186/1471-2458-14-720 -
Circulation Journal : Official Journal... Jun 2016Insomnia is associated with incident heart failure (HF), but the clinical significance and impact of insomnia on HF remain unclear. (Clinical Trial)
Clinical Trial Observational Study
BACKGROUND
Insomnia is associated with incident heart failure (HF), but the clinical significance and impact of insomnia on HF remain unclear.
METHODS AND RESULTS
Consecutive 1,011 patients admitted for HF were divided into 2 groups according to the presence of insomnia: HF with insomnia (insomnia group, n=519) and HF without insomnia (non-insomnia group, n=492). We compared (1) cardiac event rates including cardiac death and worsening HF; and (2) underlying clinical background including laboratory data, echocardiographic data, and cardiopulmonary exercise test between the 2 groups. On Kaplan-Meier analysis, cardiac event rate was significantly higher in the insomnia group than in the non-insomnia group (39.1 vs. 23.4%, P<0.001). The insomnia group, as compared with the non-insomnia group, had (1) higher plasma renin activity (P=0.042), renin concentration (P=0.007), and aldosterone (P=0.047); (2) lower peak V̇O2(14.9 vs. 16.3 ml/kg/min, P=0.002) and higher V̇E/V̇CO2slope (36.0 vs. 33.5, P=0.001); and (3) similar B-type natriuretic peptide and left ventricular ejection fraction. Importantly, on multivariate Cox proportional hazard analysis after adjusting for potential confounding factors, insomnia was an independent predictor of cardiac events in HF patients (hazard ratio, 1.899; P<0.001).
CONCLUSIONS
Insomnia is an independent predictor of cardiac events in HF patients. HF patients with insomnia have activated renin-angiotensin-aldosterone system and lower exercise capacity. (Circ J 2016; 80: 1571-1577).
Topics: Aged; Aged, 80 and over; Disease-Free Survival; Female; Heart Failure; Humans; Male; Middle Aged; Prospective Studies; Renin-Angiotensin System; Sleep Initiation and Maintenance Disorders; Survival Rate
PubMed: 27194467
DOI: 10.1253/circj.CJ-16-0205 -
The Journal of Family Practice Oct 2019
Review
Topics: Aged; Alzheimer Disease; Female; Humans; Male; Middle Aged; Sleep Initiation and Maintenance Disorders
PubMed: 31697798
DOI: No ID Found -
Nursing & Health Sciences Sep 2019No evidence exists in the literature concerning the prevalence of insomnia and its associated risk factors among prison inmates in Taiwan. The aim of the present study...
No evidence exists in the literature concerning the prevalence of insomnia and its associated risk factors among prison inmates in Taiwan. The aim of the present study was to determine the prevalence and factors associated with insomnia among inmates in a large prison in Taiwan. A cross-sectional anonymous questionnaire survey was conducted at a prison. The participants were 1490 male inmates. Participants completed the self-reported Insomnia Severity Index-Chinese version questionnaire, and the sociodemographic and psychological distress questionnaires for the study. Multivariate logistic regression was used to analyze and compare the differences between inmates with and without insomnia. The prevalence of insomnia was 26.9%. The study determined that anxiety, self-rated health status, and religious beliefs were independent predictors of insomnia in male inmates. Given the adverse effect of insomnia and its social consequences, it is crucial to develop prevention programs to mitigate insomnia in inmates.
Topics: Adult; Aged; Anxiety; Cross-Sectional Studies; Depression; Female; Health Status; Humans; Logistic Models; Male; Middle Aged; Prevalence; Prisoners; Psychometrics; Risk Factors; Self Report; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires; Taiwan
PubMed: 30776859
DOI: 10.1111/nhs.12600 -
Journal of Clinical Psychology Jul 2015Insomnia has been shown to have profound negative consequences on multiple aspects of daily functioning. Despite increased interest in the association between insomnia...
OBJECTIVE
Insomnia has been shown to have profound negative consequences on multiple aspects of daily functioning. Despite increased interest in the association between insomnia and psychopathology, no research has examined the relationships between insomnia and hoarding. The aim of the current investigation was to examine the associations between insomnia and hoarding severity.
METHODS
Participants consisted of patients with hoarding disorder (n = 24).
RESULTS
Results revealed that insomnia was a significant predictor of increased hoarding severity. In addition, when examining the relationships among insomnia and specific hoarding symptoms, sleep difficulties were associated with increased acquiring and difficulty discarding behaviors.
CONCLUSIONS
These findings add to a growing body of literature on insomnia and various forms of psychopathology, as well as research on symptoms related to hoarding. Reducing insomnia symptoms among hoarders may help to reduce hoarding-related behaviors and increase treatment efficacy.
Topics: Adolescent; Adult; Comorbidity; Female; Hoarding Disorder; Humans; Male; Middle Aged; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 25760757
DOI: 10.1002/jclp.22161 -
Clinical Psychology Review Jul 2005Insomnia outcome studies from the last 15 years show consistent success for behavioral treatment with older adults. The present review of evaluation and treatment covers... (Review)
Review
Insomnia outcome studies from the last 15 years show consistent success for behavioral treatment with older adults. The present review of evaluation and treatment covers the effects of aging on ability to sleep, the insomnia classification system, the treatment efficacy database, and critical outcome research methodology. Clinical trial methodology with older adults includes familiar challenges; for example, the need for placebo controls, and frequent failures to document the adequacy of treatment implementation. Recommendations for improving methodology are offered. A new review of treatment for primary insomnia in older adults shows strong improvement and consistent results for popular behavioral treatments. Older adult clinical trials show proven efficacy of behavioral treatment for primary insomnia, efficacy for secondary insomnia, and efficacy for insomnia associated with hypnotic dependency.
Topics: Aged; Aging; Chronic Disease; Humans; Hypnotics and Sedatives; Incidence; Middle Aged; Placebos; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders
PubMed: 15961205
DOI: 10.1016/j.cpr.2005.04.008