Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Sleep Initiation and Maintenance Disorders: HELP
Articles from California
Based on 262 articles since 2006
||||

These are the 262 published articles about Sleep Initiation and Maintenance Disorders that originated from California during 2006-2015.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Editorial A step towards stepped care: delivery of CBT-I with reduced clinician time. 2015

Manber, Rachel / Simpson, Norah S / Bootzin, Richard R. ·Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94301-5597, USA. Electronic address: Rmanber@stanford.edu. · Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94301-5597, USA. · Department of Psychology, University of Arizona, USA. ·Sleep Med Rev · Pubmed #25454675.

ABSTRACT: -- No abstract --

2 Editorial Guest editorial: Overcoming barriers to care for returning veterans: expanding services to college campuses. 2013

McCaslin, Shannon E / Leach, Bridget / Herbst, Ellen / Armstrong, Keith. ·Mental Health Service, SFVAMC, San Francisco, CA. · ·J Rehabil Res Dev · Pubmed #24458904.

ABSTRACT: -- No abstract --

3 Review The value of mindfulness meditation in the treatment of insomnia. 2015

Martires, Joanne / Zeidler, Michelle. ·Greater Los Angeles VA Healthcare System, Los Angeles, California, USA. · ·Curr Opin Pulm Med · Pubmed #26390335.

ABSTRACT: PURPOSE OF REVIEW: Insomnia is the most common reported sleep disorder with limited treatment options including pharmacotherapy and cognitive behavioral therapy for insomnia. Pharmacotherapy can be complicated by tolerance and significant side-effects and cognitive behavioral therapy for insomnia providers are limited in number. This article reviews mindfulness meditation as an additional therapy for insomnia. RECENT FINDINGS: Both mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI) have been studied in the treatment of insomnia. Randomized controlled studies of MBSR and MBTI have shown overall reduction in sleep latency and total wake time and increase in total sleep time after mindfulness therapy using both patient reported outcome and quantitative measures of sleep. Mindfulness techniques have been shown to be well accepted by patients with long-lasting effects. A three-arm randomized study with MBSR, MBTI, and self-monitoring showed similar improvement in insomnia between the MBSR and MBTI groups, with possibly longer duration of efficacy in the MBTI group. Recent data show that MBTI is also an effective and accepted treatment for insomnia in older patients. SUMMARY: Increasing evidence shows that mindfulness meditation, delivered either via MBSR or MBTI, can be successfully used for the treatment of insomnia with good patient acceptance and durable results.

4 Review Sleep problems in the elderly. 2015

Rodriguez, Juan Carlos / Dzierzewski, Joseph M / Alessi, Cathy A. ·Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, 16111 Plummer Street (IE), North Hills, Los Angeles, CA, USA; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 405 Hilgard Avenue, CA 90095, USA; Department of Medicine, Pontificia Universidad Catolica de: Ave, Libertador Bernardo O'Higgins 340, Santiago, Chile. Electronic address: juan.rodrigueztapia@va.gov. · Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, 16111 Plummer Street (IE), North Hills, Los Angeles, CA, USA; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 405 Hilgard Avenue, CA 90095, USA. ·Med Clin North Am · Pubmed #25700593.

ABSTRACT: Epidemiologic studies have shown that approximately 50% of older adults have sleep problems, many of which carry deleterious consequences that affect physical and mental health and also social functioning. However, sleep problems in late life are often unrecognized, and are inadequately treated in clinical practice. This article focuses on the diagnosis and treatment of the 2 most common sleep problems in older patients: sleep apnea and insomnia.

5 Review Sleep disturbances as an evidence-based suicide risk factor. 2015

Bernert, Rebecca A / Kim, Joanne S / Iwata, Naomi G / Perlis, Michael L. ·Suicide Prevention Research Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA, rbernert@stanford.edu. · ·Curr Psychiatry Rep · Pubmed #25698339.

ABSTRACT: Increasing research indicates that sleep disturbances may confer increased risk for suicidal behaviors, including suicidal ideation, suicide attempts, and death by suicide. Despite increased investigation, a number of methodological problems present important limitations to the validity and generalizability of findings in this area, which warrant additional focus. To evaluate and delineate sleep disturbances as an evidence-based suicide risk factor, a systematic review of the extant literature was conducted with methodological considerations as a central focus. The following methodologic criteria were required for inclusion: the report (1) evaluated an index of sleep disturbance; (2) examined an outcome measure for suicidal behavior; (3) adjusted for presence of a depression diagnosis or depression severity, as a covariate; and (4) represented an original investigation as opposed to a chart review. Reports meeting inclusion criteria were further classified and reviewed according to: study design and timeframe; sample type and size; sleep disturbance, suicide risk, and depression covariate assessment measure(s); and presence of positive versus negative findings. Based on keyword search, the following search engines were used: PubMed and PsycINFO. Search criteria generated N = 82 articles representing original investigations focused on sleep disturbances and suicide outcomes. Of these, N = 18 met inclusion criteria for review based on systematic analysis. Of the reports identified, N = 18 evaluated insomnia or poor sleep quality symptoms, whereas N = 8 assessed nightmares in association with suicide risk. Despite considerable differences in study designs, samples, and assessment techniques, the comparison of such reports indicates preliminary, converging evidence for sleep disturbances as an empirical risk factor for suicidal behaviors, while highlighting important, future directions for increased investigation.

6 Review Pharmacological treatment of sleep disorders and its relationship with neuroplasticity. 2015

Abad, Vivien C / Guilleminault, Christian. ·Psychiatry and Behavioral Science-Division of Sleep Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. · ·Curr Top Behav Neurosci · Pubmed #25585962.

ABSTRACT: Sleep and wakefulness are regulated by complex brain circuits located in the brain stem, thalamus, subthalamus, hypothalamus, basal forebrain, and cerebral cortex. Wakefulness and NREM and REM sleep are modulated by the interactions between neurotransmitters that promote arousal and neurotransmitters that promote sleep. Various lines of evidence suggest that sleep disorders may negatively affect neuronal plasticity and cognitive function. Pharmacological treatments may alleviate these effects but may also have adverse side effects by themselves. This chapter discusses the relationship between sleep disorders, pharmacological treatments, and brain plasticity, including the treatment of insomnia, hypersomnias such as narcolepsy, restless legs syndrome (RLS), obstructive sleep apnea (OSA), and parasomnias.

7 Review An evidence-based review of insomnia treatment in early recovery. 2014

Kaplan, Katherine A / McQuaid, John / Primich, Charles / Rosenlicht, Nicholas. ·From the Department of Psychiatry (KAK), Stanford University School of Medicine, Stanford, CA; Department of Psychiatry (JM, NR), University of California, San Francisco; and San Francisco VA Medical Center (JM, CP, NR), San Francisco, CA. · ·J Addict Med · Pubmed #25369938.

ABSTRACT: Accruing evidence indicates that insomnia is prevalent and persistent in early recovery from substance use disorders and may predict relapse. As such, insomnia treatment after abstinence represents an important area for intervention. This article reviews the literature on insomnia predicting new-onset alcohol and substance use disorders, along with evidence for insomnia predicting relapse in recovering populations. Pharmacological and psychological treatment options are presented, and cognitive-behavioral therapy for insomnia applied to recovering populations is described in detail.

8 Review Managing the risks of ADHD treatments. 2014

Schneider, Benjamin N / Enenbach, Michael. ·Division of Child & Adolescent Psychiatry, UCLA Semel Institute for Neuroscience & Human Behavior, 760 Westwood Plaza, Suite 68-251A, Los Angeles, CA, 90024, USA, bschneider@mednet.ucla.edu. · ·Curr Psychiatry Rep · Pubmed #25135779.

ABSTRACT: Pharmacotherapy of attention deficit-hyperactivity disorder (ADHD) is a well-established and effective treatment modality. However, ADHD medications are not without side effects. Understanding the prevalence of adverse events and effective management of risks associated with stimulants and other medications used to treat ADHD is central to broad applicability and effective treatment. This review discusses the literature on the prevalence of adverse events and management strategies employed. We searched online MEDLINE/PubMed and Cochrane databases for articles using several keywords relating to adverse events associated with ADHD medication management. We discuss the relevant data on the significance and prevalence of side effects and adverse events, highlight recent updates in the field, and suggest approaches to clinical management.

9 Review Insomnia as a transdiagnostic process in psychiatric disorders. 2014

Dolsen, Michael R / Asarnow, Lauren D / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, 2205 Tolman Hall #1650, Berkeley, CA, 94720-1650, USA. · ·Curr Psychiatry Rep · Pubmed #25030972.

ABSTRACT: Insomnia is a major public health concern, and is highly comorbid with a broad range of psychiatric disorders. Although insomnia has historically been considered a symptom of other disorders, this perspective has shifted. Epidemiological and experimental studies suggest that insomnia is related to the onset and course of several psychiatric disorders. Furthermore, several randomized controlled trials show that cognitive behavioral therapy for insomnia delivered to individuals who meet diagnostic criteria for insomnia and another psychiatric disorder improves the insomnia as well as the symptoms of the comorbid psychiatric disorder. Taken together, these results encompassing a range of methodologies have provided encouraging evidence and point toward insomnia as a transdiagnostic process in psychiatric disorders.

10 Review Sleep disruption in hematopoietic cell transplantation recipients: prevalence, severity, and clinical management. 2014

Jim, Heather S L / Evans, Bryan / Jeong, Jiyeon M / Gonzalez, Brian D / Johnston, Laura / Nelson, Ashley M / Kesler, Shelli / Phillips, Kristin M / Barata, Anna / Pidala, Joseph / Palesh, Oxana. ·Moffitt Cancer Center, Tampa, Florida. Electronic address: heather.jim@moffitt.org. · Department of Psychology, University of South Florida, Tampa, Florida. · Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. · Moffitt Cancer Center, Tampa, Florida. · Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California. · Moffitt Cancer Center, Tampa, Florida; Psychiatry and Legal Medicine PhD Program, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida. ·Biol Blood Marrow Transplant · Pubmed #24747335.

ABSTRACT: Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of recipients experiencing sleep disruption pre-transplant, with up to 82% of patients experiencing moderate to severe sleep disruption during hospitalization for transplant and up to 43% after transplant. These rates of sleep disruption are substantially higher than what we see in the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption and disorders (ie, insomnia, obstructive sleep apnea, restless legs syndrome) as a clinical problem in HCT in order to facilitate patient education, intervention, and research. We identified 35 observational studies published in the past decade that examined sleep disruption or disorders in HCT. Most studies utilized a single item measure of sleep, had small sample size, and included heterogeneous samples of patients. Six studies of the effects of psychosocial and exercise interventions on sleep in HCT have reported no significant improvements. These results highlight the need for rigorous observational and interventional studies of sleep disruption and disorders in HCT recipients..

11 Review The evidence base of sleep restriction therapy for treating insomnia disorder. 2014

Miller, Christopher B / Espie, Colin A / Epstein, Dana R / Friedman, Leah / Morin, Charles M / Pigeon, Wilfred R / Spielman, Arthur J / Kyle, Simon D. ·Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Australia; Institute of Neuroscience & Psychology, University of Glasgow, UK. Electronic address: chris.miller@sydney.edu.au. · Nuffield Department of Clinical Neurosciences and Sleep & Circadian Neuroscience Institute, University of Oxford, UK. · Phoenix Veterans Affairs Health Care System, USA; Arizona State University College of Nursing and Health Innovation, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. · Université Laval, Québec City, Québec, Canada. · Sleep & Neurophysiology Research Lab, University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, USA. · Cognitive Neuroscience Doctoral Program, The City College of the City University of New York, USA; Weill Cornell Medical College, Center for Sleep Medicine, NY, USA. · School of Psychological Sciences, University of Manchester, UK. ·Sleep Med Rev · Pubmed #24629826.

ABSTRACT: Sleep restriction therapy is routinely used within cognitive behavioral therapy to treat chronic insomnia. However, the efficacy for sleep restriction therapy as a standalone intervention has yet to be comprehensively reviewed. This review evaluates the evidence for the use of sleep restriction therapy in the treatment of chronic insomnia. The literature was searched using web-based databases, finding 1344 studies. Twenty-one were accessed in full (1323 were deemed irrelevant to this review). Nine were considered relevant and evaluated in relation to study design using a standardized study checklist and levels of evidence. Four trials met adequate methodological strength to examine the efficacy of therapy for chronic insomnia. Weighted effect sizes for self-reported sleep diary measures of sleep onset latency, wake time after sleep onset, and sleep efficiency were moderate-to-large after therapy. Total sleep time indicated a small improvement. Standalone sleep restriction therapy is efficacious for the treatment of chronic insomnia for sleep diary continuity variables. Studies are insufficient to evaluate the full impact on objective sleep variables. Measures of daytime functioning in response to therapy are lacking. Variability in the sleep restriction therapy implementation methods precludes any strong conclusions regarding the true impact of therapy. A future research agenda is outlined.

12 Review Acupuncture in the treatment of cancer-related psychological symptoms. 2014

Haddad, Nadia Elisabeth / Palesh, Oxana. ·Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA nhaddad@stanford.edu. · Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. ·Integr Cancer Ther · Pubmed #24501113.

ABSTRACT: Acupuncture is being adopted by cancer patients for a wide range of cancer-related symptoms including highly prevalent psychological symptoms like depression, anxiety, insomnia, and impairment in quality of life. Pharmacological treatment of prevalent symptoms like anxiety, depression, and sleep disturbance can contribute to the high chemical burden already carried by cancer patients, creating additional side effects. As a result, patients and providers alike are interested in evidence-based nonpharmacologic alternatives like acupuncture for these symptoms. This article reviews the current literature (January 2000 through April 2013) for acupuncture in cancer-related psychological symptoms with attention to both efficacy and acupuncture-specific methodology. All published studies that met our review criteria demonstrate a positive signal for acupuncture for the treatment of depression, anxiety, sleep disturbance, and for improving quality of life with most results showing statistical significance. However, there are only a handful of acupuncture studies that were specifically designed to evaluate depression, sleep disturbance, and quality of life as primary outcomes, and no studies were found that looked at anxiety as a primary outcome in this population. Published studies in cancer patients and survivors show that acupuncture treatment is not only safe but also more acceptable with fewer side effects than standard of care pharmacological treatments like antidepressants. Finally, there is wide variability in both the implementation and reporting of acupuncture methods in the literature, with only 2 of 12 studies reporting full details of acupuncture methods as outlined in the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines, published in 2010 and providing an essential framework for the reporting of acupuncture methodology. This lack of methodological detail affects outcomes, generalizability, and validity of research involving acupuncture. Reasons for ongoing challenges in the development of high-quality acupuncture trials are discussed. In conclusion, results are encouraging for the development of randomized trials to directly evaluate the therapeutic impact of acupuncture in cancer-related psychological symptoms, including depression, anxiety, sleep disturbance, and quality of life, but attention to acupuncture methodological specific challenges in the development of high-quality research is necessary.

13 Review Depression and insomnia in cancer: prevalence, risk factors, and effects on cancer outcomes. 2013

Irwin, Michael R. ·Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Gefffen School of Medicine, University of California, Los Angeles, 300 UCLA Medical Plaza, Room 3130, Los Angeles, CA, 90095-7076, USA, mirwin1@ucla.edu. ·Curr Psychiatry Rep · Pubmed #24078066.

ABSTRACT: Over two-thirds of the 11.4 million cancer survivors in the United States can expect long-term survival, with many others living with cancer as a chronic disease controlled by ongoing therapy. Behavioral comorbidities often arise during treatment and persist long term to complicate survival and reduce quality of life. This review focuses on depression and insomnia with an emphasis on understanding the role of cancer-specific factors and their contribution to the prevalence of these behavioral comorbidities in cancer patients following cancer diagnosis and treatment. The clinical significance of depression and insomnia for cancer patients is further stressed by epidemiological observations that link depression and insomnia to cancer morbidity and mortality risk.

14 Review Circadian rhythms and psychiatric illness. 2013

Asarnow, Lauren D / Soehner, Adriane M / Harvey, Allison G. ·University of California, Berkeley, California, USA. · ·Curr Opin Psychiatry · Pubmed #24060916.

ABSTRACT: PURPOSE OF REVIEW: The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. RECENT FINDINGS: In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. SUMMARY: Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions and address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes.

15 Review Supportive care after curative treatment for breast cancer (survivorship care): resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. 2013

Ganz, Patricia A / Yip, Cheng Har / Gralow, Julie R / Distelhorst, Sandra R / Albain, Kathy S / Andersen, Barbara L / Bevilacqua, Jose Luiz B / de Azambuja, Evandro / El Saghir, Nagi S / Kaur, Ranjit / McTiernan, Anne / Partridge, Ann H / Rowland, Julia H / Singh-Carlson, Savitri / Vargo, Mary M / Thompson, Beti / Anderson, Benjamin O. ·University of California, Los Angeles, CA, USA. · ·Breast · Pubmed #24007941.

ABSTRACT: Breast cancer survivors may experience long-term treatment complications, must live with the risk of cancer recurrence, and often experience psychosocial complications that require supportive care services. In low- and middle-income settings, supportive care services are frequently limited, and program development for survivorship care and long-term follow-up has not been well addressed. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert panel identified nine key resources recommended for appropriate survivorship care, and developed resource-stratified recommendations to illustrate how health systems can provide supportive care services for breast cancer survivors after curative treatment, using available resources. Key recommendations include health professional education that focuses on the management of physical and psychosocial long-term treatment complications. Patient education can help survivors transition from a provider-intense cancer treatment program to a post-treatment provider partnership and self-management program, and should include: education on recognizing disease recurrence or metastases; management of treatment-related sequelae, and psychosocial complications; and the importance of maintaining a healthy lifestyle. Increasing community awareness of survivorship issues was also identified as an important part of supportive care programs. Other recommendations include screening and management of psychosocial distress; management of long-term treatment-related complications including lymphedema, fatigue, insomnia, pain, and women's health issues; and monitoring survivors for recurrences or development of second primary malignancies. Where possible, breast cancer survivors should implement healthy lifestyle modifications, including physical activity, and maintain a healthy weight. Health professionals should provide well-documented patient care records that can follow a patient as they transition from active treatment to follow-up care.

16 Review Management and challenges of corticosteroid therapy in men with metastatic castrate-resistant prostate cancer. 2013

Dorff, T B / Crawford, E D. ·Division of Cancer and Blood Diseases, Department of Medicine, USC Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA. dorff_t@med.usc.edu · ·Ann Oncol · Pubmed #22831986.

ABSTRACT: Extensive clinical development in metastatic castrate-resistant prostate cancer (mCRPC) has led to the introduction of three new agents in little more than a year, with more on the horizon. With the exception of autologous cellular immunotherapy, all of the agents approved by the US Food and Drug Administration for the treatment of mCRPC are approved for use in combination with corticosteroids. Corticosteroids play a crucial role in the management of men with mCRPC, but the availability of multiple lines of therapy that include corticosteroids raises potential toxicity considerations. In addition, the immunosuppressive effects of corticosteroids may alter the efficacy of immunotherapies. The recent increase in treatment options with different mechanisms of action raises the importance of understanding how corticosteroids are used and the implications of such use on treatment selection and sequencing. A number of corticosteroids with varied potencies are used in general medical practice at varying doses. The differences in potency, dose, and disease settings in which corticosteroids are used complicate the ability to fully understand the impact that any one corticosteroid can have, such as prednisone in prostate cancer. This article reviews the published literature on corticosteroid use in advanced cancer, focusing on their role in mCRPC.

17 Review Treatment of sleep disturbances in posttraumatic stress disorder: a review. 2012

Schoenfeld, Frank B / Deviva, Jason C / Manber, Rachel. ·San Francisco Department of Veterans Affairs (VA) Medical Center, San Francisco, CA 94121, USA. Frank.schoenfeld@va.gov · ·J Rehabil Res Dev · Pubmed #23015583.

ABSTRACT: Sleep disturbances are among the most commonly reported posttraumatic stress disorder (PTSD) symptoms. It is essential to conduct a careful assessment of the presenting sleep disturbance to select the optimal available treatment. Cognitive-behavioral therapies (CBTs) are at least as effective as pharmacologic treatment in the short-term and more enduring in their beneficial effects. Cognitive-behavioral treatment for insomnia and imagery rehearsal therapy have been developed to specifically treat insomnia and nightmares and offer promise for more effective relief of these very distressing symptoms. Pharmacotherapy continues to be an important treatment choice for PTSD sleep disturbances as an adjunct to CBT, when CBT is ineffective or not available, or when the patient declines CBT. Great need exists for more investigation into the effectiveness of specific pharmacologic agents for PTSD sleep disturbances and the dissemination of the findings to prescribers. The studies of prazosin and the findings of its effectiveness for PTSD sleep disturbance are examples of studies of pharmacologic agents needed in this area. Despite the progress made in developing more specific treatments for sleep disturbances in PTSD, insomnia and nightmares may not fully resolve.

18 Review Non-pharmacological treatment of insomnia. 2012

Siebern, Allison T / Suh, Sooyeon / Nowakowski, Sara. ·Stanford University School of Medicine, Sleep Medicine Center, Redwood City, California 94063, USA. asiebern@stanford.edu · ·Neurotherapeutics · Pubmed #22935989.

ABSTRACT: Insomnia is one of the most common sleep disorders, which is characterized by nocturnal symptoms of difficulties initiating and/or maintaining sleep, and by daytime symptoms that impair occupational, social, or other areas of functioning. Insomnia disorder can exist alone or in conjunction with comorbid medical and/or psychiatric conditions. The incidence of insomnia is higher in women and can increase during certain junctures of a woman's life (e.g., pregnancy, postpartum, and menopause). This article will focus on an overview of cognitive behavioral therapy for insomnia, evidence of effectiveness for this treatment when insomnia disorder is experienced alone or in parallel with a comorbidity, and a review with promising data on the use of cognitive behavioral therapy for insomnia when present during postpartum and menopause.

19 Review MF101: a multi-component botanical selective estrogen receptor beta modulator for the treatment of menopausal vasomotor symptoms. 2012

Leitman, Dale C / Christians, Uwe. ·University of California, Department of Nutritional Science and Toxicology, 44 Morgan Hall Berkeley, CA 94720, USA. dale@leitmanlab.com · ·Expert Opin Investig Drugs · Pubmed #22616988.

ABSTRACT: INTRODUCTION: The Women's Health Initiative Estrogen Plus Progestin clinical trial demonstrated the risks exceeded the benefits which have led to a decline in menopausal hormone therapy (MHT) by greater than 50%. MHT use was initiated long before there was a significant understanding of the molecular mechanisms of estrogens. It has become clear that the problem with the current estrogens in MHT is they act non-selectively as an agonist in all tissues that contain estrogen receptors. MF101 is an oral, botanically derived extract that was designed to selectively regulate estrogen receptor beta (ERβ) because the increased risk of breast and endometrial cancer is due to the activation of estrogen receptor alpha (ERα) by estrogens. Preclinical and clinical data support a role for selective ERβ agonists, such as MF101, for vasomotor symptoms without increasing cancer risks. AREAS COVERED: The review covers the biological, pharmacological and clinical advantages of MF101, and the unique ability of MF101 to selectively target the ERβ pathway for the treatment of hot flashes (HF). EXPERT OPINION: Preclinical and clinical studies indicate that MF101, a selective estrogen receptor beta agonist, represents a new class of drugs that is safe and effective for treating HF and nighttime awakenings.

20 Review (Mis)perception of sleep in insomnia: a puzzle and a resolution. 2012

Harvey, Allison G / Tang, Nicole K Y. ·Department of Psychology, University of California, Berkeley, 3210 Tolman Hall, Berkeley, CA 94720-1650, USA. aharvey@berkeley.edu · ·Psychol Bull · Pubmed #21967449.

ABSTRACT: Insomnia is prevalent, causing severe distress and impairment. This review focuses on illuminating the puzzling finding that many insomnia patients misperceive their sleep. They overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST), relative to objective measures. This tendency is ubiquitous (although not universal). Resolving this puzzle has clinical, theoretical, and public health importance. There are implications for assessment, definition, and treatment. Moreover, solving the puzzle creates an opportunity for real-world applications of theories from clinical, perceptual, and social psychology as well as neuroscience. Herein we evaluate 13 possible resolutions to the puzzle. Specifically, we consider the possible contribution, to misperception, of (1) features inherent to the context of sleep (e.g., darkness); (2) the definition of sleep onset, which may lack sensitivity for insomnia patients; (3) insomnia being an exaggerated sleep complaint; (4) psychological distress causing magnification; (5) a deficit in time estimation ability; (6) sleep being misperceived as wake; (7) worry and selective attention toward sleep-related threats; (8) a memory bias influenced by current symptoms and emotions, a confirmation bias/belief bias, or a recall bias linked to the intensity/recency of symptoms; (9) heightened physiological arousal; (10) elevated cortical arousal; (11) the presence of brief awakenings; (12) a fault in neuronal circuitry; and (13) there being 2 insomnia subtypes (one with and one without misperception). The best supported resolutions were misperception of sleep as wake, worry, and brief awakenings. A deficit in time estimation ability was not supported. We conclude by proposing several integrative solutions.

21 Review Treating nightmares and insomnia in posttraumatic stress disorder: a review of current evidence. 2012

Nappi, Carla M / Drummond, Sean P A / Hall, Joshua M H. ·University of California, San Diego and Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC116B, San Diego, CA 92161, United States. cnappi@ucsd.edu · ·Neuropharmacology · Pubmed #21396945.

ABSTRACT: Emerging evidence supports the notion of disrupted sleep as a core component of Posttraumatic Stress Disorder (PTSD). Effective treatments for nighttime PTSD symptoms are critical because sleep disruption may be mechanistically linked to development and maintenance of PTSD and is associated with significant distress, functional impairment, and poor health. This review aimed to describe the state of science with respect to the impact of the latest behavioral and pharmacological interventions on posttraumatic nightmares and insomnia. Published studies that examined evidence for therapeutic effects upon sleep were included. Some behavioral and pharmacological interventions show promise, especially for nightmares, but there is a need for controlled trials that include valid sleep measures and are designed to identify treatment mechanisms. Our ability to treat PTSD-related sleep disturbances may be improved by moving away from considering sleep symptoms in isolation and instead conducting integrative studies that examine sequential or combined behavioral and/or pharmacological treatments targeting both the daytime and nighttime aspects of PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

22 Review Measures of sleep in rheumatologic diseases: Epworth Sleepiness Scale (ESS), Functional Outcome of Sleep Questionnaire (FOSQ), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). 2011

Omachi, Theodore A. ·Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Francisco, CA 94115, USA. omachi@ucsf.edu ·Arthritis Care Res (Hoboken) · Pubmed #22588751.

ABSTRACT: -- No abstract --

23 Review Trazodone: properties and utility in multiple disorders. 2011

Mittur, Aravind. ·IMPAX Pharmaceuticals, Department of Clinical Pharmacology, 31047 Genstar Road, Hayward, CA 94544, USA. amittur@impaxlabs.com ·Expert Rev Clin Pharmacol · Pubmed #22115401.

ABSTRACT: Trazodone is an established antidepressant that is prescribed frequently as an off-label hypnotic with wide acceptance among psychiatrists. Owing to its atypical mixed serotonergic and adrenolytic pharmacology, trazodone has been investigated in a number of disorders besides depression and insomnia, including anxiety disorders, chronic pain, frontal cognitive dysfunctions, erectile dysfunction and others. Clinical studies using subjective and objective measures generally tend to support its efficacy as a hypnotic in depressed subjects. Various other attributes of trazodone, including interaction with adrenergic receptors, formation of an active metabolite with potent serotonergic activity, low abuse potential and putative utility in various disorders, warrant further exploration. The adverse effects of trazodone generally mirror its serotonergic activity and include sedation, headache, sweating, weight changes and gastrointestinal effects such as nausea and vomiting. Clinicians and patients should be cognizant of the risk for potential, but rare, cardiovascular adverse effects of trazodone. The safety and toxicology of trazodone should be examined under current standards of drug development before exposure to new patient populations. This article provides an overview of trazodone with a focus on its clinical pharmacology and opportunities, gaps and scientific strategies in developing it for new indications such as insomnia, anxiety disorders, chronic pain and frontal cognitive dysfunction. Modified release formulations, alternate forms of drug delivery and combination products are discussed as strategies to optimize the efficacy of trazodone and improve its safety profile.

24 Review A review of sodium oxybate and baclofen in the treatment of sleep disorders. 2011

Brown, Mark A / Guilleminault, Christian. ·Stanford Sleep Medicine Center, Redwood City, CA 94063-5704, USA. mbrown8@stanford.edu · ·Curr Pharm Des · Pubmed #21476957.

ABSTRACT: Studies examining GABA(B) receptor agonists have reported effects on sleep including decreased sleep onset latency (SOL), increased sleep consolidation and increases in slow wave sleep (SWS). γ-hydroxybutyrate (GHB) is proposed to act as a GABA(B) receptor agonist; however, the mechanism of action of GHB is controversial. In addition, the GABA(B) receptor agonist, baclofen, has also been proposed to exert similar effects on sleep. The aim of this paper is to provide a review of the human clinical studies of sodium oxybate and baclofen regarding sleep and the treatment of sleep disorders including narcolepsy and insomnia, as well as other disorders involving disrupted sleep such as fibromyalgia.

25 Review Hypocretin antagonists in insomnia treatment and beyond. 2011

Ruoff, Chad / Cao, Michelle / Guilleminault, Christian. ·Stanford Sleep Medicine Program, Stanford University School of Medicine, Redwood City, California, USA. cmruoff@gmail.com · ·Curr Pharm Des · Pubmed #21476951.

ABSTRACT: Hypocretin neuropeptides have been shown to regulate transitions between wakefulness and sleep through stabilization of sleep promoting GABAergic and wake promoting cholinergic/monoaminergic neural pathways. Hypocretin also influences other physiologic processes such as metabolism, appetite, learning and memory, reward and addiction, and ventilatory drive. The discovery of hypocretin and its effect upon the sleep-wake cycle has led to the development of a new class of pharmacologic agents that antagonize the physiologic effects of hypocretin (i.e. hypocretin antagonists). Further investigation of these agents may lead to novel therapies for insomnia without the side-effect profile of currently available hypnotics (e.g. impaired cognition, confusional arousals, and motor balance difficulties). However, antagonizing a system that regulates the sleep-wake cycle while also influencing non-sleep physiologic processes may create an entirely different but equally concerning side-effect profile such as transient loss of muscle tone (i.e. cataplexy) and a dampened respiratory drive. In this review, we will discuss the discovery of hypocretin and its receptors, hypocretin and the sleep-wake cycle, hypocretin antagonists in the treatment of insomnia, and other implicated functions of the hypocretin system.

Next