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Sleep Aug 1992To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual...
To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual polysomnograms (PSGs) were obtained as well as actigraphic assessments of their sleep. Patients also wore actigraphs for 7 days at home, were extensively interviewed and filled out psychometric tests. Based on all this information, the patients were then diagnosed according to the International Classification of Sleep Disorders. Averaged over the 3 nights for each insomniac, the mean discrepancy between actigram and PSG was 49 minutes per night. In three-fourths of the cases, actigram and PSG agreed to within 1 hour on the total amount of sleep per night. Discrepancies, however, were not random: In patients with psychophysiologic insomnia and in insomnia associated with psychiatric disease, the actigram typically overestimated sleep when compared with the PSG. In patients with sleep-state misperception, the actigram was either quite accurate or it underestimated sleep when compared with the PSG. Comparing laboratory with home sleep, one-third of all insomniacs slept better in the laboratory and two-thirds slept better at home. In addition, night-by-night variability was higher at home than in the laboratory. Based on our study, we now recommend actigraphy as an additional tool in the clinical evaluation of insomnia, but we believe that in complex cases it should be combined with 1 PSG night in the sleep disorders center.
Topics: Adult; Aged; Analysis of Variance; Clinical Laboratory Techniques; Female; Humans; Male; Middle Aged; Monitoring, Physiologic; Sleep; Sleep Initiation and Maintenance Disorders; Wrist
PubMed: 1519002
DOI: 10.1093/sleep/15.4.293 -
Canadian Journal of Psychiatry. Revue... Sep 2011To estimate the prevalence of insomnia and examine its correlates (for example, demographics and physical and mental health) and treatments. (Comparative Study)
Comparative Study
OBJECTIVES
To estimate the prevalence of insomnia and examine its correlates (for example, demographics and physical and mental health) and treatments.
METHODS
A sample of 2000 Canadians aged 18 years and older responded to a telephone survey about sleep, health, and the use of sleep-promoting products. Respondents with insomnia were identified using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and the International Classification of Diseases, Tenth Edition, criteria.
RESULTS
Among the sample, 40.2% presented at least 1 symptom of insomnia (that is, trouble falling or staying asleep, or early morning awakening) for a minimum of 3 nights per week in the previous month, 19.8% were dissatisfied with their sleep, and 13.4% met all criteria for insomnia (that is, presence of 1 insomnia symptom 3 nights or more per week for at least 1 month, accompanied by distress or daytime impairment). Insomnia was associated with female sex, older age, and poorer self-rated physical and mental health. Thirteen per cent of respondents had consulted a health care provider for sleep difficulties once in their lifetime. Moreover, 10% had used prescribed medications for sleep in the previous year, 9.0% used natural products, 5.7% used over-the-counter products, and 4.6% used alcohol. There were differences between French- and English-speaking adults, with the former group presenting lower rates of insomnia (9.5%, compared with 14.3%) and consultation (8.7%, compared with 14.4%), but higher rates of prescribed medications (12.9%, compared with 9.3%) and the use of natural products (15.6%, compared with 7.4%).
CONCLUSIONS
Insomnia is a prevalent condition, although few people seek professional consultation for this condition. Despite regional differences in the prevalence and treatments used to manage insomnia, prescribed medications remain the most widely used therapeutic option.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Canada; Comorbidity; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Prevalence; Referral and Consultation; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 21959029
DOI: 10.1177/070674371105600905 -
Journal of Clinical Psychology Oct 2013Vulnerability to transient insomnia is regarded as a predisposing factor for chronic insomnia. However, most individuals with transient insomnia do not develop chronic... (Comparative Study)
Comparative Study
OBJECTIVES
Vulnerability to transient insomnia is regarded as a predisposing factor for chronic insomnia. However, most individuals with transient insomnia do not develop chronic insomnia. The current study investigated the differential contributing factors for these two conditions to further the understanding of this phenomenon.
METHOD
Chronic insomnia patients and normal sleepers with high and low vulnerability to transient insomnia completed measures of pre-sleep arousal, dysfunctional sleep beliefs, and sleep-related safety behaviors.
RESULTS
Both cognitive and somatic pre-sleep arousals were identified as significant predictors for transient insomnia. Dysfunctional beliefs regarding worry about insomnia and cognitive arousal were predictors for chronic insomnia. Sleep-related safety behavior, although correlated with insomnia severity, was not a significant predictor for both conditions.
CONCLUSIONS
Dysfunctional beliefs associated with worry and losing control over sleep are the most critical factors in differentiating chronic insomnia from transient insomnia. These factors should be addressed to help prevent individuals with high sleep vulnerability from developing chronic sleep disturbance.
Topics: Acute Disease; Adult; Arousal; Chronic Disease; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Severity of Illness Index; Sleep; Sleep Initiation and Maintenance Disorders; Young Adult
PubMed: 23797824
DOI: 10.1002/jclp.22000 -
Psychiatry Research Dec 2019Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the subjective and objective sleep differences amongst primary... (Comparative Study)
Comparative Study
Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the subjective and objective sleep differences amongst primary insomnia, major depression with insomnia and general anxiety disorder with insomnia. Subjective sleep and objective sleep of the participants were evaluated by using the Pittsburgh sleep quality index and polysomnography, respectively. We found that major depression with insomnia exhibited higher daytime dysfunction than primary insomnia; showed significantly higher values of rapid eye movement (REM) periods, time of REM sleep and percentage of REM stage; and presented lower percentage of non-rapid eye movement stage compared with primary insomnia and general anxiety disorder with insomnia (p < 0.05). General anxiety disorder with insomnia showed lower awakening number (AN) than primary insomnia, and other objective and subjective sleep values of general anxiety disorder with insomnia and primary insomnia showed no significant difference (p > 0.05). Our findings showed that major depression with insomnia increased active REM sleep and severe daytime function, which could alert clinicians to the risk of depression. Major depression with insomnia and primary insomnia may be categorically different. However, general anxiety disorder with insomnia and primary insomnia might be a continuum of a disease rather than be categorically distinct.
Topics: Adult; Anxiety Disorders; Depressive Disorder, Major; Female; Humans; Male; Middle Aged; Polysomnography; Sleep; Sleep Initiation and Maintenance Disorders; Sleep, REM
PubMed: 31474379
DOI: 10.1016/j.psychres.2019.112514 -
PharmacoEconomics 1996Insomnia is an extremely common symptom both de novo and in the context of other medical and psychiatric disorders. The impact of insomnia is often ignored both by the... (Review)
Review
Insomnia is an extremely common symptom both de novo and in the context of other medical and psychiatric disorders. The impact of insomnia is often ignored both by the individual and by society in terms of its clinical and socioeconomic ramifications. Insomnia is therefore under-appreciated and almost certainly under-treated, thus making it a serious health concern. It is estimated that more than 60 million Americans suffer from insomnia annually, and this figure is expected to grow to 100 million by the middle of the 21st century. Whether it be difficulty initiating or maintaining sleep, the disruption of nocturnal sleep will invariably impact on daytime activities and often results in daytime fatigue, performance deficits (including memory and other cognitive deficits), an increase in the number of sick days taken by an individual and accidents (some catastrophic). This review examines the costs directly related to insomnia in various sectors of healthcare, the indirect costs associated with accidents, sick days and decreased work productivity, and related costs resulting from insomnia but which meet neither the criteria of direct nor indirect cost categories. The total direct, indirect and related costs of insomnia are conservatively estimated at $US30 to 35 billion annually in the US (1994 dollars). Economic gains can be made by treating patients on an outpatient basis in sleep centres.
Topics: Absenteeism; Accidents, Occupational; Age Factors; Cost of Illness; Efficiency; Humans; Longevity; Prevalence; Sickness Impact Profile; Sleep Initiation and Maintenance Disorders
PubMed: 10163422
DOI: 10.2165/00019053-199600101-00003 -
CNS Spectrums Dec 2009
Topics: Female; Humans; Middle Aged; Sleep Initiation and Maintenance Disorders; United States
PubMed: 20448511
DOI: 10.1017/s1092852900003941 -
British Journal of Health Psychology Feb 2021To conduct a qualitative exploration of the lived experience of insomnia disorder and its management amongst a sample of mixed-diagnoses cancer survivors.
OBJECTIVES
To conduct a qualitative exploration of the lived experience of insomnia disorder and its management amongst a sample of mixed-diagnoses cancer survivors.
METHODS
Twenty-seven cancer survivors with persistent insomnia were recruited to this qualitative study following completion of treatment for breast (12), prostate (7), colorectal (7), and gynaecological (1) cancers. Eleven males and 16 females (mean age 62 years), who met DSM-5 criteria for insomnia disorder, contributed to one of four focus group discussions, designed to explore the lived experience of persistent insomnia and its management within cancer care services.
RESULTS
Poor sleep was a persistently troubling complaint for participants, long after the completion of active cancer treatment. The impact of insomnia was significant for all participants, with six key domains emerging as those most affected: temperament, sociability, physical well-being, cognitive functioning, relationships, and psychological well-being. In terms of insomnia management, participants frequently resorted to unfruitful self-management strategies, due to the lack of professional insomnia expertise within cancer care settings. Three main themes emerged in relation to insomnia management: self-management, seeking professional intervention, and a lack of focus on sleep. A lack of clinician understanding of the importance of sleep health and the poor availability of evidence-based insomnia interventions, such as cognitive behavioural therapy for insomnia (CBT-i), were highlighted as important gaps in cancer care.
CONCLUSIONS
Insomnia was found to have a detrimental and pervasive impact on cancer survivors' quality of life, which persisted long into survivorship. There is an absence of professional attention to sleep throughout the cancer care trajectory, contributing to its prevalence, persistence, and impact. In order to break this cycle, sleep health should be integrated as a key aspect of cancer treatment and rehabilitation, much like maintaining a healthy diet and appropriate levels of physical activity.
Topics: Cancer Survivors; Cognitive Behavioral Therapy; Female; Humans; Male; Middle Aged; Neoplasms; Quality of Life; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 32558129
DOI: 10.1111/bjhp.12446 -
Hu Li Za Zhi the Journal of Nursing Oct 2008Sleep performs an essential function in humans. Insomnia is one of the common phenomena in a poor sleep pattern. Long-term suffering can result in somatic symptoms and...
Sleep performs an essential function in humans. Insomnia is one of the common phenomena in a poor sleep pattern. Long-term suffering can result in somatic symptoms and the development of diseases. It can even induce diseases with a mental dimension. Insomnia causes indications of poor health. No systematic analysis of insomnia has been performed, however. The purpose of this study, therefore, was to describe the concept of insomnia. In accordance with Walker and Avant's (2005) methodology of concept analysis, this paper presents a review of the conceptual definitions, characteristics, antecedents and consequences, constructing examples, and empirical references of insomnia. The results indicate that: (1) Insomnia's defining attributes are recognized as an insufficient of quality and quantity for sleep for more than one month. (2) Antecedents of insomnia include changes in life habits, physiological demands caused by sleep time changes, and the experience of uncomfortable sensations. (3) Consequences of insomnia include a poor condition, with physical, psychological, social, and global dimensions. (4) There are many instruments that can be used to inspect insomnia, including questionnaires and tools for physiological measurement. Insomnia is a serious problem with various facets. An understanding of the concept of insomnia will help nurses to perceive this problem in caring for subjects.
Topics: Adult; Female; Humans; Male; Middle Aged; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 18836979
DOI: No ID Found -
Sleep Sep 2011To estimate the prevalence and associations of broadly defined (i.e., meeting full ICD-10, DSM-IV, or RDC/ICSD-2 inclusion criteria) insomnia with work performance net...
STUDY OBJECTIVES
To estimate the prevalence and associations of broadly defined (i.e., meeting full ICD-10, DSM-IV, or RDC/ICSD-2 inclusion criteria) insomnia with work performance net of comorbid conditions in the America Insomnia Survey (AIS).
DESIGN/SETTING
Cross-sectional telephone survey.
PARTICIPANTS
National sample of 7,428 employed health plan subscribers (ages 18+).
INTERVENTIONS
None.
MEASUREMENTS AND RESULTS
Broadly defined insomnia was assessed with the Brief Insomnia Questionnaire (BIQ). Work absenteeism and presenteeism (low on-the-job work performance defined in the metric of lost workday equivalents) were assessed with the WHO Health and Work Performance Questionnaire (HPQ). Regression analysis examined associations between insomnia and HPQ scores controlling 26 comorbid conditions based on self-report and medical/pharmacy claims records. The estimated prevalence of insomnia was 23.2%. Insomnia was significantly associated with lost work performance due to presenteeism (χ² (1) = 39.5, P < 0.001) but not absenteeism (χ² (1) = 3.2, P = 0.07), with an annualized individual-level association of insomnia with presenteeism equivalent to 11.3 days of lost work performance. This estimate decreased to 7.8 days when controls were introduced for comorbid conditions. The individual-level human capital value of this net estimate was $2,280. If we provisionally assume these estimates generalize to the total US workforce, they are equivalent to annualized population-level estimates of 252.7 days and $63.2 billion.
CONCLUSIONS
Insomnia is associated with substantial workplace costs. Although experimental studies suggest some of these costs could be recovered with insomnia disease management programs, effectiveness trials are needed to obtain precise estimates of return-on-investment of such interventions from the employer perspective.
Topics: Absenteeism; Adult; Cost of Illness; Cross-Sectional Studies; Employee Performance Appraisal; Employment; Female; Health Surveys; Humans; Male; Middle Aged; Sleep Initiation and Maintenance Disorders; United States; Young Adult
PubMed: 21886353
DOI: 10.5665/SLEEP.1230 -
Acupuncture in Medicine : Journal of... Dec 2021
Topics: Acupuncture Points; Acupuncture Therapy; Female; Humans; Middle Aged; Perimenopause; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 34231419
DOI: 10.1177/09645284211026316