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Sleep Initiation and Maintenance Disorders: HELP
Articles from University of California Irvine
Based on 13 articles published since 2009
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These are the 13 published articles about Sleep Initiation and Maintenance Disorders that originated from University of California Irvine during 2009-2019.
 
+ Citations + Abstracts
1 Review Reconsidering Insomnia as a Disorder Rather Than Just a Symptom in Psychiatric Practice. 2018

Benca, Ruth M / Buysse, Daniel J. ·Department of Psychiatry and Human Behavior, University of California, Irvine, California, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. ·J Clin Psychiatry · Pubmed #29370483.

ABSTRACT: ​​ Insomnia is a common feature of many psychiatric disorders but can also be a comorbid disorder, often contributing to poor outcomes and treatment failure. For some patients who do respond to psychiatric treatment, their insomnia persists after their mood symptoms have remitted, indicating that their insomnia needs to be a separate focus of treatment. In this CME Academic Highlights, Drs Ruth Benca and Daniel Buysse discuss how to effectively evaluate patients with psychiatric disorders for comorbid insomnia, as well as how to safely and effectively implement both behavioral and pharmacologic treatments. ​​​​​​​.

2 Review Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA. 2017

McCall, W Vaughn / Benca, Ruth M / Rosenquist, Peter B / Riley, Mary Anne / McCloud, Laryssa / Newman, Jill C / Case, Doug / Rumble, Meredith / Krystal, Andrew D. ·From the Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta; the Department of Psychiatry and Human Behavior, University of California, Irvine; the Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, N.C.; the Department of Psychiatry, University of Wisconsin, Madison; and the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C. ·Am J Psychiatry · Pubmed #27609243.

ABSTRACT: OBJECTIVE: Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide. METHOD: This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System. RESULTS: Epidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be suicidal. On the other hand, ongoing research is testing whether treatment of insomnia may reduce suicidality in adults with depression. CONCLUSIONS: The review findings indicate that hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess whether increases in suicidality result from CNS impairments from a given hypnotic medication or whether such medication decreases suicidality because of improvements in insomnia.

3 Clinical Trial Suvorexant in Elderly Patients with Insomnia: Pooled Analyses of Data from Phase III Randomized Controlled Clinical Trials. 2017

Herring, W Joseph / Connor, Kathryn M / Snyder, Ellen / Snavely, Duane B / Zhang, Ying / Hutzelmann, Jill / Matzura-Wolfe, Deborah / Benca, Ruth M / Krystal, Andrew D / Walsh, James K / Lines, Christopher / Roth, Thomas / Michelson, David. ·Merck & Co., Inc., Kenilworth, NJ. Electronic address: william.herring@merck.com. · Merck & Co., Inc., Kenilworth, NJ. · Department of Psychiatry and Human Behavior, School of Medicine, University of California-Irvine, Irvine, CA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. · Sleep Medicine and Research Center, St. Luke's Hospital, St. Louis, MO. · Henry Ford Hospital Sleep Center, Detroit, MI. ·Am J Geriatr Psychiatry · Pubmed #28427826.

ABSTRACT: OBJECTIVE: Suvorexant is an orexin receptor antagonist approved for treating insomnia at doses of 10-20 mg. Previously reported phase III results showed that suvorexant was effective and well-tolerated in a combined-age population (elderly and nonelderly adults). The present analysis evaluated the clinical profile of suvorexant specifically in the elderly. METHODS: Prespecified subgroup analyses of pooled 3-month data from two (efficacy) and three (safety) randomized, double-blind, placebo-controlled, parallel-group trials. In each trial, elderly (≥65 years) patients with insomnia were randomized to suvorexant 30 mg, suvorexant 15 mg, and placebo. By design, fewer patients were randomized to 15 mg. Patient-reported and polysomnographic (subset of patients) sleep maintenance and onset endpoints were measured. RESULTS: Suvorexant 30 mg (N = 319) was effective compared with placebo (N = 318) on patient-reported and polysomnographic sleep maintenance, and onset endpoints at Night 1 (polysomnographic endpoints)/Week 1 (patient-reported endpoints), Month 1, and Month 3. Suvorexant 15 mg (N = 202 treated) was also effective across these measures, although the onset effect was less evident at later time points. The percentages of patients discontinuing because of adverse events over 3 months were 6.4% for 30 mg (N = 627 treated), 3.5% for 15 mg (N = 202 treated), and 5.5% for placebo (N = 469 treated). Somnolence was the most common adverse event (8.8% for 30 mg, 5.4% for 15 mg, 3.2% for placebo). CONCLUSION: Suvorexant generally improved sleep maintenance and onset over 3 months of nightly treatment and was well-tolerated in elderly patients with insomnia (clinicaltrials.gov; NCT01097616, NCT01097629, NCT01021813).

4 Clinical Trial Clinical profile of suvorexant for the treatment of insomnia over 3 months in women and men: subgroup analysis of pooled phase-3 data. 2017

Herring, W Joseph / Connor, Kathryn M / Snyder, Ellen / Snavely, Duane B / Zhang, Ying / Hutzelmann, Jill / Matzura-Wolfe, Deborah / Benca, Ruth M / Krystal, Andrew D / Walsh, James K / Lines, Christopher / Roth, Thomas / Michelson, David. ·Merck & Co., Inc., Kenilworth, NJ, USA. william_herring@merck.com. · Merck & Co., Inc., UG 4C-13, PO Box 1000, North Wales, PA, 19454-1099, USA. william_herring@merck.com. · Merck & Co., Inc., Kenilworth, NJ, USA. · Department of Psychiatry and Human Behavior, University of California-Irvine, Irvine, CA, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. · Sleep Medicine and Research Center, St., Luke's Hospital, St. Louis, MO, USA. · Henry Ford Hospital Sleep Center, Detroit, MI, USA. ·Psychopharmacology (Berl) · Pubmed #28265715.

ABSTRACT: RATIONALE: Sex-related differences in the clinical profiles of some insomnia medications have been previously reported. OBJECTIVE: To evaluate the clinical profile of suvorexant, a novel orexin receptor antagonist approved for treating insomnia at doses up to 20 mg, by sex subgroups. METHODS: Efficacy analyses by sex were based on pooled data from two similar phase 3, randomized, double-blind, placebo-controlled, 3-month trials in elderly (≥65 years) and non-elderly (18-64 years) insomnia patients. Two age-adjusted (non-elderly/elderly) dose regimes of 40/30 and 20/15 mg were evaluated, with fewer patients assigned to 20/15 mg. Efficacy was assessed by patient-reported outcomes (N = 1264 women, 707 men) and by polysomnography endpoints in ~75% of patients. Safety analyses by sex (N = 1744 women, 1065 men) included pooled data from the two 3-month trials plus 3-month data from a safety trial of 40/30 mg. RESULTS: The sex subgroup efficacy analyses mirrored the improvements seen for suvorexant 40/30 and 20/15 mg over placebo on patient-reported outcomes and polysomnography sleep maintenance and onset endpoints in the primary analyses; 95% CIs excluded zero in favor of suvorexant for most endpoints in both sexes, and similar efficacy was observed between sexes (95% CIs overlapped). Suvorexant was well-tolerated in women and men, although women in all treatment groups (including placebo) reported more adverse events than men. The most frequent adverse event was somnolence (women: 11.1% for 40/30 mg, 8.5% for 20/15 mg, 2.3% for placebo; men: 10.1% for 40/30 mg, 3.4% for 20/15 mg, 4.2% for placebo). CONCLUSION: Suvorexant was generally effective and well-tolerated in both women and men with insomnia. ClinicalTrials.gov trial registration numbers: NCT01097616, NCT01097629, NCT01021813.

5 Article Effects of Brief Cognitive Behavioral Therapy for Insomnia on Improving Depression Among Community-Dwelling Older Adults: A Randomized Controlled Comparative Study. 2019

Tanaka, Mika / Kusaga, Mari / Nyamathi, Adey M / Tanaka, Katsutoshi. ·School of Nursing, Kitasato University, Kanagawa, Japan. · Department of Nursing Science, University of Nagasaki, Nagasaki, Japan. · Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA. · Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan. ·Worldviews Evid Based Nurs · Pubmed #30714310.

ABSTRACT: BACKGROUND: Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve depressive symptoms in older adults with comorbid insomnia and depression. However, it remains unclear whether brief CBT-I is effective for improving depressive symptoms in community-dwelling older adults with insomnia symptoms of varying severity. AIM: This study sought to examine the effectiveness of a brief CBT-I intervention delivered by public health nurses to improve depressive symptoms among older adults recruited from a community setting. METHODS: This randomized controlled study compared sleep status and depression at baseline and a 3-month follow-up using a wait-list control design. Depression was evaluated using the Geriatric Depression Scale short form (GDS-SF). RESULTS: The GDS-SF scores in the CBT-I group improved over time (p < .01), with an effect size (Cohen's d) of 0.34 (95% CI [0.16, 0.58]). The results demonstrated the effectiveness of a brief CBT-I intervention for depression, although the effect size was small. LINKING EVIDENCE TO ACTION: A brief CBT-I intervention consisting of sleep hygiene education, stimulus control, sleep restriction, cognitive restructuring, and relaxation is effective for improving depressive symptoms among older adults in the community.

6 Article Patients presenting to a Men's Health clinic are at higher risk for depression, insomnia, and sleep apnea. 2019

Walia, Arman S / Lomeli, Luis de Jesus Martinez / Jiang, Pengbo / Benca, Ruth / Yafi, Faysal A. ·Department of Urology, University of California-Irvine, Irvine, CA, USA. · Center for Complex Biological Systems, University of California-Irvine, Irvine, CA, USA. · Department of Psychiatry & Human Behavior, University of California-Irvine, Irvine, CA, USA. · Department of Urology, University of California-Irvine, Irvine, CA, USA. faysalyafi@gmail.com. ·Int J Impot Res · Pubmed #30171191.

ABSTRACT: Depression and sleep problems are highly prevalent disorders that are often comorbid with other medical disorders. We evaluated the prevalence and associations of these conditions in patients presenting to a Men's Health clinic. In this retrospective study, 124 patients presenting to a Men's Health clinic completed three urological questionnaires (International Index of Erectile Function [IIEF-5], International Prostate Symptom Score [IPSS], and Androgen Deficiency in Aging Males [ADAM]); and four non-urological questionnaires (Patient Health Questionnaire for depression [PHQ-9], STOP-BANG Sleep Apnea [OSA STOP-BANG], Insomnia Severity Index [ISI], and Epworth Sleepiness Scale [ESS]). Questionnaire results were evaluated in conjunction with patient clinical history and associated laboratory values via univariate and multivariate analysis. The mean age of the study participants was 54.1 years (SD 16). Comorbidities included hypertension (22.5%), vascular disease (15%), and diabetes mellitus (13.3%). Body Mass Index (BMI) was >25 in 77.3%. IIEF-5 scores were moderate-severe in 47.9%, ADAM questionnaire was positive in 79%, and IPSS scores were moderate-severe in 42.9% of patients. PHQ-9 demonstrated mild-severe depression in 38.6%, STOP-BANG showed intermediate-high risk for sleep apnea in 55.2%, ISI indicated moderate-severe insomnia in 18.1%, and ESS revealed mild-severe sleepiness in 16.6% of participants. On univariate analysis, BMI was associated with scores on the PHQ-9 (p = 0.035), STOP-BANG (p < 0.001), and ESS (p < 0.006). On multivariate analysis, positive ADAM questionnaire was associated with STOP-BANG (OR 3.29, 95% CI: 1.012-10.69), and IPSS with PHQ-9 (OR 4.64, 95% CI: 1.40-15.43) and ISI (OR 3.27, 95% CI: 1.06-10.1). Overall, patients presenting to a Men's Health Clinic were found to have high prevalence rates for risk of depression, insomnia and sleep apnea. Risks were elevated in older subjects, and those with increased BMI, hypogonadism, and lower urinary tract symptoms. Appropriate screening and referral to appropriate specialists are encouraged.

7 Article Association of Chronic Insomnia With Mortality and Adverse Renal Outcomes. 2018

Lu, Jun Ling / Freire, Amado X / Molnar, Miklos Z / Kalantar-Zadeh, Kamyar / Kovesdy, Csaba P. ·Division of Nephrology, University of Tennessee Health Science Center, Memphis. · Division of Pulmonary, Critical Care and Sleep Medicine, University of Tennessee Health Science Center, Memphis; Pulmonary Section, Memphis VA Medical Center, Memphis, TN. · Division of Nephrology, University of Tennessee Health Science Center, Memphis; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis; Division of Transplant Surgery, Methodist University Hospital Transplant Institute, Memphis, TN; Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary. · Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine Medical Center, Orange. · Division of Nephrology, University of Tennessee Health Science Center, Memphis; Nephrology Section, Memphis VA Medical Center, Memphis, TN. Electronic address: ckovesdy@uthsc.edu. ·Mayo Clin Proc · Pubmed #30392541.

ABSTRACT: OBJECTIVE: To examine whether chronic insomnia is associated with an increased risk of adverse renal outcomes and all-cause mortality. PATIENTS AND METHODS: We examined associations of chronic insomnia (defined as the presence of both International Classification of Diseases, Ninth Revision codes 307.42, 307.49, and 780.52 and long-term use of insomnia medications) with adverse renal outcomes (end-stage renal disease, incidence of estimated glomerular filtration rate [eGFR] ≤45 mL/min per 1.73 m RESULTS: A total of 36,741 patients (2.24%) had chronic insomnia; 32,985 (89.8%) were male and 28,090 (76.5%) were white, with a mean baseline eGFR of 84.1±16.4 mL/min per 1.73 m CONCLUSION: Chronic insomnia is associated with a higher risk of development and progression of chronic kidney disease, but not ESRD. Further studies are needed to establish the underlying mechanisms of action and to determine whether treatment of insomnia could be beneficial to prevent deteriorating kidney function.

8 Article Sleep quality moderates the association between physical activity frequency and feelings of energy and fatigue in adolescents. 2018

Herring, Matthew P / Monroe, Derek C / Kline, Christopher E / O'Connor, Patrick J / MacDonncha, Ciaran. ·Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland. matthew.herring@ul.ie. · Health Research Institute, University of Limerick, Limerick, Ireland. matthew.herring@ul.ie. · School of Medicine, University of California-Irvine, Irvine, CA, 92617, USA. · Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA. · Department of Kinesiology, The University of Georgia, Athens, GA, 30602, USA. · Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland. ·Eur Child Adolesc Psychiatry · Pubmed #29508054.

ABSTRACT: Physical activity (PA) can improve sleep quality, low energy, and fatigue. Though poor sleep quality may induce feelings of low energy and fatigue, the potential moderating effect of sleep quality on associations between PA and feelings of energy and fatigue among adolescents is unknown. Thus, this study examined the moderating effect of sleep quality on associations between PA frequency and feelings of energy and fatigue among adolescents in Ireland. Adolescents (N = 481; 281 males, 200 females) aged 15.1 ± 1.7 years self-reported PA frequency, feelings of energy and fatigue, and sleep quality (September to December 2015). Two-way ANCOVAs examined variation in feelings of energy and fatigue according to the interaction of PA and sleep quality. Standardized mean difference (d) quantified the magnitude of differences. Poor sleepers with low PA reported greater feelings of fatigue compared to normal sleepers with low PA (d = 1.02; 95% CI 0.60, 1.44), and poor sleepers with moderate PA reported greater feelings of fatigue compared to normal sleepers with moderate PA (d = 0.50; 0.17, 0.82). Poor sleepers with low PA reported greater feelings of fatigue compared to both poor sleepers with moderate PA (d = 0.44; 0.05, 0.83) and poor sleepers with high PA (d = 0.87; 0.46, 1.28). Poor sleepers with moderate PA reported greater feelings of fatigue compared to poor sleepers with high PA (d = 0.52; 0.14, 0.91). Poor sleep did not moderate the association between PA and feelings of energy. Sleep quality moderates the association between PA frequency and feelings of fatigue. Fatigue symptoms improve as PA frequency increases among adolescents with poor sleep quality.

9 Article Assessing and Treating Insomnia in Patients With Psychiatric Disorders, Part 2. 2018

Benca, Ruth M / Buysse, Daniel J. ·Department of Psychiatry and Human Behavior, University of California, Irvine, California, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. ·J Clin Psychiatry · Pubmed #29505189.

ABSTRACT: Tune in to this podcast as experts discuss 2 patient cases-one involving co-occurring insomnia and depression and another comprising PTSD, substance abuse, insomnia, and nightmares. Drs Benca and Buysse explain how to effectively diagnose and manage these complex cases based on the latest diagnostic criteria and evidence from clinical trials.

10 Article Assessing and Treating Insomnia in Patients With Psychiatric Disorders, Part 1. 2018

Benca, Ruth M / Buysse, Daniel J. ·Department of Psychiatry and Human Behavior, University of California, Irvine, California, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. ·J Clin Psychiatry · Pubmed #29505188.

ABSTRACT: Listen to this podcast as experts discuss 2 patient cases focusing on diagnosing and treating co-occurring insomnia and mental illness. The first case features a 32-year-old man with bipolar disorder who is experiencing psychiatric symptoms and poor sleep, and the second case involves a 27-year-old man with schizophrenia who is having auditory hallucinations as well as chronic issues with insomnia.

11 Article Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes. 2017

Facco, Francesca L / Grobman, William A / Reid, Kathryn J / Parker, Corette B / Hunter, Shannon M / Silver, Robert M / Basner, Robert C / Saade, George R / Pien, Grace W / Manchanda, Shalini / Louis, Judette M / Nhan-Chang, Chia-Ling / Chung, Judith H / Wing, Deborah A / Simhan, Hyagriv N / Haas, David M / Iams, Jay / Parry, Samuel / Zee, Phyllis C. ·Department of Obstetrics and Gynecology, Magee-Womens Research Institute and Foundation, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: faccof@upmc.edu. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. · Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. · RTI International, Research Triangle Park, NC. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, UT. · Department of Clinical Medicine, College of Physicians and Surgeons, Columbia University, New York, NY. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX. · Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. · Department of Medicine, Section of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Cleveland, OH. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Irvine, CA. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Irvine, CA; Miller Children's Hospital/Long Beach Memorial Center, Long Beach, CA. · Department of Obstetrics and Gynecology, Magee-Womens Research Institute and Foundation, University of Pittsburgh School of Medicine, Pittsburgh, PA. · Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN. · Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA. ·Am J Obstet Gynecol · Pubmed #28599896.

ABSTRACT: BACKGROUND: Experimental and epidemiologic data suggest that among nonpregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly report poor sleep, few studies objectively evaluated the quality of sleep in pregnancy or explored the relationship between sleep disturbances and maternal and perinatal outcomes. OBJECTIVE: Our objective was to examine the relationship between objectively assessed sleep duration, timing, and continuity (measured via wrist actigraphy) and maternal cardiovascular and metabolic morbidity specific to pregnancy. STUDY DESIGN: This was a prospective cohort study of nulliparous women. Women were recruited between 16 0/7 and 21 6/7 weeks' gestation. They were asked to wear a wrist actigraphy monitor and complete a daily sleep log for a period of 7 consecutive days. The primary sleep exposure variables were the averages of the following over the total valid nights (minimum 5, maximum 7 nights): short sleep duration during the primary sleep period (<7 h/night), late sleep midpoint (midpoint between sleep onset and sleep offset >5 am), and top quartile of minutes of wake time after sleep onset and sleep fragmentation index. The primary outcomes of interest were a composite of hypertensive disorders of pregnancy (mild, severe, or superimposed preeclampsia; eclampsia; or antepartum gestational hypertension) and gestational diabetes mellitus. We used χ RESULTS: In all, 901 eligible women consented to participate; 782 submitted valid actigraphy studies. Short sleep duration and a later sleep midpoint were associated with an increased risk of gestational diabetes (odds ratio, 2.24; 95% confidence interval, 1.11-4.53; and odds ratio, 2.58; 95% confidence interval, 1.24-5.36, respectively) but not of hypertensive disorders. A model with both sleep duration and sleep midpoint as well as their interaction term revealed that while there was no significant interaction between these exposures, the main effects of both short sleep duration and later sleep midpoint with gestational diabetes remained significant (adjusted odds ratio, 2.06; 95% confidence interval, 1.01-4.19; and adjusted odds ratio, 2.37; 95% confidence interval, 1.13-4.97, respectively). Additionally, after adjusting separately for age, body mass index, and race/ethnicity, both short sleep duration and later sleep midpoint remained associated with gestational diabetes. No associations were demonstrated between the sleep quality measures (wake after sleep onset, sleep fragmentation) and hypertensive disorders or gestational diabetes. CONCLUSION: Our results demonstrate a relationship between short sleep duration and later sleep midpoint with gestational diabetes. Our data suggest independent contributions of these 2 sleep characteristics to the risk for gestational diabetes in nulliparous women.

12 Article Two Cases of Anti-NMDA Receptor Encephalitis. 2016

Baker, Jessa / Jeziorkowski, Chris / Siebe, Cory / Osborn, Megan Boysen. ·University of California, Irvine School of Medicine, Irvine, California. · Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois. · Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado. · University of California, Irvine School of Medicine, Department of Emergency Medicine, Irvine, California. ·West J Emerg Med · Pubmed #27625730.

ABSTRACT: -- No abstract --

13 Article Rumination predicts longer sleep onset latency after an acute psychosocial stressor. 2009

Zoccola, Peggy M / Dickerson, Sally S / Lam, Suman. ·Department of Psychology and Social Behavior, 3340 Social Ecology II, University of California, Irvine, Irvine, CA 92697-7085, USA. p.m.zoccola@uci.edu ·Psychosom Med · Pubmed #19622710.

ABSTRACT: OBJECTIVES: Rumination has been linked to self-reported sleep quality. However, whether rumination is related to an objective sleep parameter has not been tested. This study examined whether rumination predicts sleep onset latency (SOL) on the night after an acute psychosocial stressor. We hypothesized that those who ruminate (assessed with both trait and stressor-specific measures) would have longer SOL (assessed with objective and subjective methods). METHODS: Seventy participants delivered a 5-minute speech in front of an evaluative panel during an afternoon laboratory session. Trait rumination was assessed before the stressor. Stressor-specific rumination was captured with the frequency of task-related thoughts participants experienced during a 10-minute rest period after the stressor. Participants wore actigraphs on their wrists on the night after the laboratory session to measure objective sleep onset latency (SOL-O). Subjective sleep onset latency was estimated by participants on the subsequent morning. RESULTS: Consistent with hypotheses, trait and stressor-specific rumination predicted longer SOL-O and subjective sleep onset latency, respectively. In addition, trait and stressor-specific rumination interacted to predict longer SOL-O. SOL-O was longest among those who engaged in more stressor-specific rumination and had greater trait rumination scores. Neither rumination measure was related to sleep duration or wakefulness after sleep onset. CONCLUSIONS: The findings from this study are consistent with previous research linking rumination to subjective sleep quality. The results also suggest that post-stressor ruminative thought may predict delayed sleep onset for those with a propensity for rumination.