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Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To study the features of the manifestation of insomnia and its impact on the condition and quality of life in patients with chronic tension-type headache.
OBJECTIVE
To study the features of the manifestation of insomnia and its impact on the condition and quality of life in patients with chronic tension-type headache.
MATERIAL AND METHODS
The study included 65 patients with chronic tension-type headache and insomnia. Patients filled out questionnaires on headache severity, sleep quality, emotional status and quality of life. Seventeen patients underwent polysomnography.
RESULTS
Patients with more severe insomnia had significantly more severe anxiety (<0.001) and depression (=0.025). Such patients assessed their quality of life worse according to the SF-12 questionnaire (<0.002) and the Subjective Well-Being Scale (<0.001), a higher level of central sensitization was observed in patients with more severe insomnia (<0.001).
CONCLUSION
The negative impact of insomnia on the condition of patients is not so much an increase in pain as such, but rather its influence on the quality of the emotional state and life in general, as well as an increase in the interdependence and mutual influence of other clinical and psychophysiological manifestations of the disease. Therefore, the clinical significance of insomnia is the deterioration of a person's ability to tolerate pain, which is the main prerequisite for a decrease in quality of life.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Female; Male; Quality of Life; Adult; Middle Aged; Surveys and Questionnaires; Tension-Type Headache; Depression; Anxiety; Polysomnography; Headache Disorders; Sleep Quality; Clinical Relevance
PubMed: 38934674
DOI: 10.17116/jnevro2024124052105 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To analyze complaints about sleep disorders and assess the incidence of various sleep disorders, using relevant scales, in patients with medication-overuse headache...
OBJECTIVE
To analyze complaints about sleep disorders and assess the incidence of various sleep disorders, using relevant scales, in patients with medication-overuse headache (MOH) in comparison with patients without MOH.
MATERIAL AND METHODS
The prospective case-control study included 171 patients, aged 18 years and older, with MOH (main group), and173 patients with primary headaches without MOH (control group). A neurologist conducted an initial examination and professional interview before the start of treatment. To diagnose sleep disorders, the International Classification of Sleep Disorders (3rd edition, 2014) was used. Additionally, an assessment was made using the Insomnia Severity Index Scale, the Epworth Sleepiness Scale (ESS) and the Lausanne Obstructive Sleep Apnea Syndrome Scale (NoSAS).
RESULTS
Statistically significant differences were revealed in the prevalence of the following complaints about sleep disorders in patients with MOH: lack of sleep (51.5%), frequent awakenings during sleep (43.3%), discomfort in legs before falling asleep or at rest in the evening (37.4%). Difficulties falling asleep occurred equally often in both patients with MOH (43.9%) and without MOH (37.0%), as well as daytime sleepiness (40.4% vs 36.4%) and the presence of snoring (13% of patients in each group). Patients with MOH were significantly more likely to suffer from chronic insomnia (60.2% and 47.4%, respectively, =0.02; OR 1.7; 95% CI 1.1-2.6) and restless legs syndrome (37.4% and 22.0%, respectively, =0.002; OR 2.1; 95% CI 1.3-3.4). The incidence of hypersomnia and obstructive sleep apnea syndrome did not have statistically significant differences.
CONCLUSION
Patients with MOH compared to patients without MOH have a significantly higher incidence of main complaints of sleep disorders, chronic insomnia and restless legs syndrome, which indicates the importance of sleep disorders in the pathogenesis of medication-overuse headaches and requires timely diagnosis and treatment to prevent the progression of both headaches and sleep disorders.
Topics: Humans; Male; Female; Middle Aged; Adult; Headache Disorders, Secondary; Prospective Studies; Case-Control Studies; Sleep Wake Disorders; Sleep Initiation and Maintenance Disorders; Incidence; Sleep Apnea, Obstructive; Prevalence; Aged
PubMed: 38934672
DOI: 10.17116/jnevro202412405293 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To determine the prevalence of insomnia and the effectiveness of its treatment in patients with a painful form of diabetic polyneuropathy (DPN). (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine the prevalence of insomnia and the effectiveness of its treatment in patients with a painful form of diabetic polyneuropathy (DPN).
MATERIAL AND METHODS
Fifty patients with the painful form of DPN were randomly divided into 2 groups: the standard therapy group (ST) and the extended therapy group (ET). In the ST group, a single lesson on sleep hygiene was conducted, in the ET group there were 3-4 face-to-face individual sessions for the treatment of insomnia for two weeks. Both groups were interviewed at the time of hospitalization, after 3 and 6 months. The severity of polyneuropathy and the nature of neuropathic pain were assessed using the Neuropathic Neuropathy Impairment Score in the Lower Limbs (NIS-LL) and the Neuropathy Total Symptom Score - 9 (NTSS-9); the intensity of pain was assessed using a Visual Analog Scale (VAS). Sleep disorders were analyzed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI).
RESULTS
Sleep disorders of varying severity were observed in 82% of patients in the initial survey. In both groups, improvement in sleep quality was noted during treatment, but significantly better results were in the ET group, the ISI score after 6 months was 7.15±2.08 for the ST group and 3.07±2.49 for the ET group (<0.0001). In the ST group, there was no significant decrease in the intensity of pain and the severity of polyneuropathy in dynamics. In the ET group, a significant decrease in NTSS-9 and VAS scores was found during the initial survey and after 6 months (<0.0001). The intensity of pain also significantly decreased in the ET group compared with the ST group (<0.0001) at the end of follow-up, which indicates the importance of sleep normalization in the treatment of neuropathic pain.
CONCLUSION
Most patients with the painful form of DPN have insomnia. Treatment of insomnia has shown its effectiveness as part of a multimodal approach to the managing of neuropathic pain in DPN and improving the quality of life of patients.
Topics: Humans; Diabetic Neuropathies; Male; Female; Sleep Initiation and Maintenance Disorders; Middle Aged; Neuralgia; Severity of Illness Index; Aged; Pain Measurement; Adult; Treatment Outcome; Sleep Quality
PubMed: 38934671
DOI: 10.17116/jnevro202412405287 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2024To test the hypothesis of the difference between 3 means of sleep latency (SL) during falling asleep: accompanied by audio stimulus embedded with binaural beats (BB);...
OBJECTIVE
To test the hypothesis of the difference between 3 means of sleep latency (SL) during falling asleep: accompanied by audio stimulus embedded with binaural beats (BB); after listening to suggestive body relaxation instructions; accompanied by audio stimulus embedded with BB after listening to suggestive body relaxation instructions (that is the combination of 1 and 2).
MATERIAL AND METHODS
For the purpose of the study, a special Android application was developed and installed on the subjects' individual smartphones. The application assumed screen tapping test to control for fall-asleep process. The data of 63 subjects presented with the 3 types of sound stimuli mentioned above in a counterbalanced scheme were analyzed.
RESULTS
Statistical analysis confirmed the initial hypothesis about the dependence of LS on the type of sound stimulus (<0.05). Pairwise SL comparison showed reliable difference between stimuli (3) - 1149±113 s, and (1) - 1469±89 s (<0.01). SL for the stimulus (2) had an intermediate value of 1269±112 s (difference from (1) at a trend level).
CONCLUSION
The use of background sound embedded with BBs enhances the effect of suggestive instructions to improve sleep. But it is the suggestion as a psychotherapeutic technique that is determinant.
Topics: Humans; Male; Female; Adult; Acoustic Stimulation; Young Adult; Sleep Latency; Sleep; Sound; Middle Aged
PubMed: 38934662
DOI: 10.17116/jnevro202412405220 -
Nutrients Jun 2024Chronic sleep disturbance affects daily functioning, leading to decreased concentration, fatigue, and higher healthcare costs. Traditional insomnia medications are often...
Chronic sleep disturbance affects daily functioning, leading to decreased concentration, fatigue, and higher healthcare costs. Traditional insomnia medications are often associated with adverse side effects. This study investigated the efficacy of a novel compound derived from and extracts (named RNE) in improving sleep quality with fewer side effects. The study included individuals between the ages of 20 and 65 with subthreshold insomnia and evaluated the effects of RNE on sleep, fatigue, and quality of life. Participants took 750 mg of RNE daily at bed-time for two weeks. The study used the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), a sleep diary, the Fatigue Severity Scale (FSS), and the Short Form 36 Health Survey (SF-36) for assessments. Of the 20 participants, 13 completed the study and showed significant improvements in sleep quality. The results showed improvements in ISI and PSQI scores, a 57% reduction in wake-time after sleep onset, and improved sleep efficiency. Although FSS scores remained unchanged, significant improvements were seen in SF-36 physical and mental health scores. The results suggest that RNE is an effective, low-risk option for sleep disturbance, significantly improving sleep quality and overall wellbeing without significant side effects.
Topics: Humans; Rhodiola; Adult; Male; Female; Middle Aged; Plant Extracts; Sleep Quality; Quality of Life; Nelumbo; Sleep Initiation and Maintenance Disorders; Young Adult; Fatigue; Aged; Sleep Wake Disorders; Sleep
PubMed: 38931222
DOI: 10.3390/nu16121867 -
BMC Medicine Jun 2024To evaluate the neurological alterations induced by Omicron infection, to compare brain changes in chronic insomnia with those in exacerbated chronic insomnia in Omicron...
BACKGROUND
To evaluate the neurological alterations induced by Omicron infection, to compare brain changes in chronic insomnia with those in exacerbated chronic insomnia in Omicron patients, and to examine individuals without insomnia alongside those with new-onset insomnia.
METHODS
In this study, a total of 135 participants were recruited between January 11 and May 4, 2023, including 26 patients with chronic insomnia without exacerbation, 24 patients with chronic insomnia with exacerbation, 40 patients with no sleep disorder, and 30 patients with new-onset insomnia after infection with Omicron (a total of 120 participants with different sleep statuses after infection), as well as 15 healthy controls who were never infected with Omicron. Neuropsychiatric data, clinical symptoms, and multimodal magnetic resonance imaging data were collected. The gray matter thickness and T1, T2, proton density, and perivascular space values were analyzed. Associations between changes in multimodal magnetic resonance imaging findings and neuropsychiatric data were evaluated with correlation analyses.
RESULTS
Compared with healthy controls, gray matter thickness changes were similar in the patients who have and do not have a history of chronic insomnia groups after infection, including an increase in cortical thickness near the parietal lobe and a reduction in cortical thickness in the frontal, occipital, and medial brain regions. Analyses showed a reduced gray matter thickness in patients with chronic insomnia compared with those with an aggravation of chronic insomnia post-Omicron infection, and a reduction was found in the right medial orbitofrontal region (mean [SD], 2.38 [0.17] vs. 2.67 [0.29] mm; P < 0.001). In the subgroups of Omicron patients experiencing sleep deterioration, patients with a history of chronic insomnia whose insomnia symptoms worsened after infection displayed heightened medial orbitofrontal cortical thickness and increased proton density values in various brain regions. Conversely, patients with good sleep quality who experienced a new onset of insomnia after infection exhibited reduced cortical thickness in pericalcarine regions and decreased proton density values. In new-onset insomnia patients post-Omicron infection, the thickness in the right pericalcarine was negatively correlated with the Self-rating Anxiety Scale (r = - 0.538, P = 0.002, P = 0.004) and Self-rating Depression Scale (r = - 0.406, P = 0.026, P = 0.026) scores.
CONCLUSIONS
These findings help us understand the pathophysiological mechanisms involved when Omicron invades the nervous system and induces various forms of insomnia after infection. In the future, we will continue to pay attention to the dynamic changes in the brain related to insomnia caused by Omicron infection.
Topics: Humans; COVID-19; Male; Female; Middle Aged; Adult; Magnetic Resonance Imaging; Sleep Initiation and Maintenance Disorders; Sleep Quality; SARS-CoV-2; Neuroimaging; Brain; Multimodal Imaging; Gray Matter; Aged
PubMed: 38926881
DOI: 10.1186/s12916-024-03487-9 -
BMJ Open Jun 2024Insomnia is a common health problem and cognitive-behavioural therapy (CBT) is recommended as a treatment. As there is a critical shortage of CBT-trained therapists, we... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
Insomnia is a common health problem and cognitive-behavioural therapy (CBT) is recommended as a treatment. As there is a critical shortage of CBT-trained therapists, we developed a digital CBT application (IIIP MED: Sleepy Med) as Software as a Medical Device for insomnia. This paper describes the study protocol for an exploratory randomised controlled trial (RCT) to evaluate effectiveness and safety of our developed digital CBT (dCBT) for 5 weeks compared with zolpidem tartrate for patients with insomnia disorder.
METHODS AND ANALYSIS
This proposed multicentre exploratory RCT will be conducted at the outpatient clinic of Chiba University Hospital, Akita University Hospital and Yoyogi Sleep Disorder Center, Japan. The study population comprises two parallel groups (dCBT and zolpidem) consisting of 15 participants each (n=30 in total) diagnosed with insomnia disorder who remain symptomatic at 4 weeks after sleep hygiene education. We will evaluate the effectiveness at baseline, week 5 (post-intervention) and week 10 (follow-up). The primary outcome will be the change of subjective sleep onset latency at week 5 from baseline. Secondary outcomes include sleep-related outcomes, such as objective sleep onset latency measured by mobile electroencephalography, functional improvement during the daytime and quality of life.
ETHICS AND DISSEMINATION
Ethics approval was granted by the Institutional Review Board of Chiba University Hospital (K2023001). All participants will be required to provide written informed consent. Results will be published in international journals.
TRIAL REGISTRATION NUMBER
jRCT2032230353.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Zolpidem; Cognitive Behavioral Therapy; Hypnotics and Sedatives; Adult; Randomized Controlled Trials as Topic; Female; Male; Treatment Outcome; Japan; Middle Aged
PubMed: 38925698
DOI: 10.1136/bmjopen-2023-081205 -
BMC Medicine Jun 2024To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer.
BACKGROUND
To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer.
METHODS
Data of 356,894 participants without cancer at baseline in the UK Biobank were analyzed. Sleep score was evaluated using five sleep traits (sleep duration, chronotype, insomnia, snoring, and excessive daytime sleepiness) and dichotomized into healthy or unhealthy sleep. Circulating liver function biomarkers were measured. Cox proportional hazard model was performed to investigate the independent and joint associations of sleep and liver function biomarkers with liver cancer incidence.
RESULTS
After a median follow-up time of 13.1 years, 394 cases of incident liver cancer were documented. The multivariable-adjusted hazard ratio (HR) for liver cancer was 1.46 (95% confidence interval: 1.15-1.85) associated with unhealthy sleep (vs. healthy sleep), and was 1.17 (1.15-1.20), 1.20 (1.18-1.22), 1.69 (1.47-1.93), 1.06 (1.06-1.07), 1.08 (1.07-1.09), 1.81 (1.37-2.39), or 0.29 (0.18-0.46) associated with each 10-unit increase in alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), or albumin (ALB), respectively. Individuals with unhealthy sleep and high (≥ median) ALT, AST, TBIL, GGT, ALP, or TP or low (< median) ALB level had the highest HR of 3.65 (2.43-5.48), 4.03 (2.69-6.03), 1.97 (1.40-2.77), 4.69 (2.98-7.37), 2.51 (1.75-3.59), 2.09 (1.51-2.89), or 2.22 (1.55-3.17) for liver cancer, respectively. Significant additive interaction of unhealthy sleep with high TP level on liver cancer was observed with relative excess risk due to an interaction of 0.80 (0.19-1.41).
CONCLUSIONS
Unhealthy sleep was associated with an increased risk of liver cancer, especially in participants with lower ALB levels or higher levels of ALT, AST, TBIL, GGT, ALP, or particularly TP.
Topics: Humans; Male; Female; Middle Aged; Liver Neoplasms; Prospective Studies; Sleep; Biomarkers; Aged; United Kingdom; Adult; Incidence; Liver Function Tests; Risk Factors; Liver
PubMed: 38915009
DOI: 10.1186/s12916-024-03440-w -
BMJ Open Jun 2024To investigate the knowledge, attitude and practice (KAP) towards insomnia and sleep hygiene among patients with chronic insomnia.
OBJECTIVES
To investigate the knowledge, attitude and practice (KAP) towards insomnia and sleep hygiene among patients with chronic insomnia.
DESIGN
Web-based cross-sectional survey.
SETTING
Shaanxi Provincial People's Hospital (northwest China) between January 2023 and May 2023.
PARTICIPANTS
Patients with chronic insomnia.
PRIMARY AND SECONDARY OUTCOME MEASURES
Demographic characteristics and KAP towards insomnia and sleep hygiene were collected by distributing a questionnaire developed by the authors.
RESULTS
A total of 613 people participated in this study, with a Mean Knowledge Score of 7.63±2.56 (total score of 12), a Mean Attitude Score of 48.39±6.643 (total score of 70) and a Mean Practice Score of 42.37±8.592 (total score of 70). Knowledge was significantly correlated with attitude (r=0.447, p<0.001) and practice (r=0.327, p<0.001), and attitude was significantly correlated with practice (r=0.486, p<0.001). Multivariable logistic regression showed that higher knowledge (OR=1.181 (1.062-1.314), p=0.002) and better attitude (OR=1.171 (1.124-1.221), p<0.001) were independently associated with good practice. According to the structural equation modelling analysis, knowledge directly influenced practice (β=0.457, p=<0.001) and attitude (β=1.160, p=<0.001), while attitude influenced practice (β=0.550, p=<0.001).
CONCLUSION
The KAP towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023 was moderate, with better practice showing signs of being influenced by better knowledge and more positive attitudes.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Cross-Sectional Studies; Female; Male; Health Knowledge, Attitudes, Practice; China; Sleep Hygiene; Middle Aged; Adult; Surveys and Questionnaires; Chronic Disease; Logistic Models; Aged; Young Adult
PubMed: 38910008
DOI: 10.1136/bmjopen-2023-083100 -
BMC Medical Informatics and Decision... Jun 2024Patient-reported outcome (PRO) is a distinct and indispensable dimension of clinical characteristics and recent advances have made remote PRO measurement possible. Sex...
BACKGROUND
Patient-reported outcome (PRO) is a distinct and indispensable dimension of clinical characteristics and recent advances have made remote PRO measurement possible. Sex difference in PRO of Parkinson's disease (PD) is hardly extensively researched.
METHODS
A smartphone-based self-management platform, offering remote PRO measurement for PD patients, has been developed. A total of 1828 PD patients, including 1001 male patients and 827 female patients, were enrolled and completed their PRO submission through this platform.
RESULTS
Sex differences in PROs have been identified. The female group had a significantly lower height, weight, and body mass index (BMI) than the male group (P < 0.001). For motor symptoms, a higher proportion of patients reporting dyskinesia was observed in the female group. For non-motor symptoms, there is a higher percentage (P < 0.001) as well as severity (P = 0.016) of depression in the female group. More male patients reported hyposmia, lisp, drooling, dysuria, frequent urination, hypersexuality, impotence, daytime sleepiness, and apathy than females (P < 0.05). In contrast, more female patients reported headache, palpation, body pain, anorexia, nausea, urinal incontinence, anxiety, insomnia (P < 0.05) than males.
CONCLUSIONS
We provide evidence for sex differences in PD through the data collected from our platform. These results highlighted the importance of gender in clinical decision-making, and also support the feasibility of remote PRO measurement through a smartphone-based self-management platform in patients with PD.
Topics: Humans; Parkinson Disease; Male; Female; Smartphone; Pilot Projects; Self-Management; Cross-Sectional Studies; Middle Aged; Aged; Patient Reported Outcome Measures; Sex Factors; Mobile Applications
PubMed: 38907208
DOI: 10.1186/s12911-024-02569-1