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Sleep Initiation and Maintenance Disorders: HELP
Articles from California
Based on 357 articles published since 2008

These are the 357 published articles about Sleep Initiation and Maintenance Disorders that originated from California during 2008-2018.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. 2017

Sateia, Michael J / Buysse, Daniel J / Krystal, Andrew D / Neubauer, David N / Heald, Jonathan L. ·Geisel School of Medicine at Dartmouth, Hanover, NH. · University of Pittsburgh School of Medicine, Pittsburgh, PA. · University of California, San Francisco, San Francisco, CA. · Johns Hopkins University School of Medicine, Baltimore, MD. · American Academy of Sleep Medicine, Darien, IL. ·J Clin Sleep Med · Pubmed #27998379.

ABSTRACT: INTRODUCTION: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. METHODS: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences. Literature reviews are provided for those pharmacologic agents for which sufficient evidence was available to establish recommendations. The AASM Board of Directors approved the final recommendations. RECOMMENDATIONS: The following recommendations are intended as a guideline for clinicians in choosing a specific pharmacological agent for treatment of chronic insomnia in adults, when such treatment is indicated. Under GRADE, a STRONG recommendation is one that clinicians should, under most circumstances, follow. A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness. GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data. Downgrading the quality of evidence for these treatments is predictable in GRADE, due to the funding source for most pharmacological clinical trials and the attendant risk of publication bias; the relatively small number of eligible trials for each individual agent; and the observed heterogeneity in the data. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. We suggest that clinicians use suvorexant as a treatment for sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use eszopiclone as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use zaleplon as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use zolpidem as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use triazolam as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use temazepam as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use ramelteon as a treatment for sleep onset insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians use doxepin as a treatment for sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use trazodone as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use tiagabine as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use diphenhydramine as a treatment for sleep onset and sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use melatonin as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use tryptophan as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK). We suggest that clinicians not use valerian as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. (WEAK).

2 Editorial Connecting insomnia, sleep apnoea and depression. 2017

Grandner, Michael A / Malhotra, Atul. ·Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, Arizona, USA. · Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California San Diego, San Diego, California, USA. ·Respirology · Pubmed #28556352.

ABSTRACT: -- No abstract --

3 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 --

4 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 --

5 Review Insomnia in Elderly Patients: Recommendations for Pharmacological Management. 2018

Abad, Vivien C / Guilleminault, Christian. ·Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford Outpatient Medical Center, Stanford University, 450 Broadway St. Pavilion C 2nd Floor MC 5704, Redwood City, CA, 94063, USA. · Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford Outpatient Medical Center, Stanford University, 450 Broadway St. Pavilion C 2nd Floor MC 5704, Redwood City, CA, 94063, USA. cguil@stanford.edu. ·Drugs Aging · Pubmed #30058034.

ABSTRACT: Chronic insomnia affects 57% of the elderly in the United States, with impairment of quality of life, function, and health. Chronic insomnia burdens society with billions of dollars in direct and indirect costs of care. The main modalities in the treatment of insomnia in the elderly are psychological/behavioral therapies, pharmacological treatment, or a combination of both. Various specialty societies view psychological/behavioral therapies as the initial treatment intervention. Pharmacotherapy plays an adjunctive role when insomnia symptoms persist or when patients are unable to pursue cognitive behavioral therapies. Current drugs for insomnia fall into different classes: orexin agonists, histamine receptor antagonists, non-benzodiazepine gamma aminobutyric acid receptor agonists, and benzodiazepines. This review focuses on Food and Drug Administration (FDA)-approved drugs for insomnia, including suvorexant, low-dose doxepin, Z-drugs (eszopiclone, zolpidem, zaleplon), benzodiazepines (triazolam, temazepam), and ramelteon. We review the indications, dosing, efficacy, benefits, and harms of these drugs in the elderly, and discuss data on drugs that are commonly used off-label to treat insomnia, and those that are in clinical development. The choice of a hypnotic agent in the elderly is symptom-based. Ramelteon or short-acting Z-drugs can treat sleep-onset insomnia. Suvorexant or low-dose doxepin can improve sleep maintenance. Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance. Low-dose zolpidem sublingual tablets or zaleplon can alleviate middle-of-the-night awakenings. Benzodiazepines should not be used routinely. Trazodone, a commonly used off-label drug for insomnia, improves sleep quality and sleep continuity but carries significant risks. Tiagabine, sometimes used off-label for insomnia, is not effective and should not be utilized. Non-FDA-approved hypnotic agents that are commonly used include melatonin, diphenhydramine, tryptophan, and valerian, despite limited data on benefits and harms. Melatonin slightly improves sleep onset and sleep duration, but product quality and efficacy may vary. Tryptophan decreases sleep onset in adults, but data in the elderly are not available. Valerian is relatively safe but has equivocal benefits on sleep quality. Phase II studies of dual orexin receptor antagonists (almorexant, lemborexant, and filorexant) have shown some improvement in sleep maintenance and sleep continuity. Piromelatine may improve sleep maintenance. Histamine receptor inverse agonists (APD-125, eplivanserin, and LY2624803) improve slow-wave sleep but, for various reasons, the drug companies withdrew their products.

6 Review Gabapentin for the treatment of alcohol use disorder. 2018

Mason, Barbara J / Quello, Susan / Shadan, Farhad. ·a Pearson Center for Alcoholism and Addiction Research , The Scripps Research Institute , La Jolla , CA , USA. · b Division of Hospital Medicine , Scripps Clinic and Scripps Green Hospital , La Jolla , CA , USA. ·Expert Opin Investig Drugs · Pubmed #29241365.

ABSTRACT: INTRODUCTION: Alcohol misuse is the fifth leading risk factor for premature death and disability worldwide. Fewer than 10% of afflicted Americans receive pharmacological treatment for alcohol use disorder. Gabapentin is a calcium channel GABAergic modulator that is widely used for pain. Studies showing reduced drinking and decreased craving and alcohol-related disturbances in sleep and affect in the months following alcohol cessation suggest therapeutic potential for alcohol use disorder. Areas covered: Human laboratory and clinical studies assessing gabapentin for alcohol use disorder are reviewed. Data were obtained by searching for English peer-reviewed articles on PubMed, reference lists of identified articles, and trials registered on clinicaltrials.gov. Additionally, the mechanism of action of gabapentin specific to alcohol use disorder, and studies of gabapentin for alcohol withdrawal and non-alcohol substance use disorders are summarized. Expert opinion: Alcohol use disorder represents a challenge and large, unmet medical need. Evidence from single-site studies lend support to the safety and efficacy of gabapentin as a novel treatment for alcohol use disorder, with unique benefits for alcohol-related insomnia and negative affect, relative to available treatments. Proprietary gabapentin delivery systems may open a path to pivotal trials and registration of gabapentin as a novel treatment for alcohol use disorder.

7 Review Hypnosis in Cancer Care. 2017

Wortzel, Joshua / Spiegel, David. ·a Stanford University School of Medicine , Stanford , California , USA. ·Am J Clin Hypn · Pubmed #28557681.

ABSTRACT: Cancer affects a growing proportion of the population as survival improves. The illness and its treatment brings a substantial burden of symptoms, including pain, anxiety, insomnia, and grief. Here, the uses of hypnosis in the treatment of these cancer-related problems will be reviewed. The utility of measuring hypnotizability in the clinical setting will be discussed. The current neurobiology of hypnotizability and hypnosis will be reviewed. Methods and results of using hypnosis for pain control in acute and chronic settings will be presented. Effects of hypnotic analgesia in specific brain regions associated with pain reduction, notably the dorsal anterior cingulate cortex and the somatosensory cortex, underlies its utility as a potent and side-effect free analgesic. Methods for helping those with cancer to better manage their anxiety, insomnia, and grief will be described. These involve facing disease-related stressors while dissociating the experience from somatic arousal. Given the serious complications of medications widely used to treat pain, anxiety, and insomnia, this article provides methods and an evidence base for wider use of techniques involving hypnosis in cancer care. Altering patients' perception of pain, disease-related stress, and anxiety can help change the reality of their life with cancer.

8 Review Cannabis, Cannabinoids, and Sleep: a Review of the Literature. 2017

Babson, Kimberly A / Sottile, James / Morabito, Danielle. ·National Center for PTSD-Dissemination & Training Division, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA. Kimberly.Babson@va.gov. · Palo Alto University, Palo Alto, CA, USA. · National Center for PTSD-Dissemination & Training Division, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA, 94025, USA. ·Curr Psychiatry Rep · Pubmed #28349316.

ABSTRACT: PURPOSE OF REVIEW: The current review aims to summarize the state of research on cannabis and sleep up to 2014 and to review in detail the literature on cannabis and specific sleep disorders from 2014 to the time of publication. RECENT FINDINGS: Preliminary research into cannabis and insomnia suggests that cannabidiol (CBD) may have therapeutic potential for the treatment of insomnia. Delta-9 tetrahydrocannabinol (THC) may decrease sleep latency but could impair sleep quality long-term. Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabinol may have short-term benefit for sleep apnea due to their modulatory effects on serotonin-mediated apneas. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness, while nabilone may reduce nightmares associated with PTSD and may improve sleep among patients with chronic pain. Research on cannabis and sleep is in its infancy and has yielded mixed results. Additional controlled and longitudinal research is critical to advance our understanding of research and clinical implications.

9 Review Genetic prion disease: Experience of a rapidly progressive dementia center in the United States and a review of the literature. 2017

Takada, Leonel T / Kim, Mee-Ohk / Cleveland, Ross W / Wong, Katherine / Forner, Sven A / Gala, Ignacio Illán / Fong, Jamie C / Geschwind, Michael D. ·Department of Neurology, Cognitive and Behavioral Neurology Unit, University of São Paulo, São Paulo, Brazil. · Department of Neurology, Memory and Aging Center, University of California, San Francisco, California. · Department of Pediatrics, The University of Vermont Children's Hospital, University of Vermont, Burlington, Vermont. · Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. ·Am J Med Genet B Neuropsychiatr Genet · Pubmed #27943639.

ABSTRACT: Although prion diseases are generally thought to present as rapidly progressive dementias with survival of only a few months, the phenotypic spectrum for genetic prion diseases (gPrDs) is much broader. The majority have a rapid decline with short survival, but many patients with gPrDs present as slowly progressive ataxic or parkinsonian disorders with progression over a few to several years. A few very rare mutations even present as neuropsychiatric disorders, sometimes with systemic symptoms such as gastrointestinal disorders and neuropathy, progressing over years to decades. gPrDs are caused by mutations in the prion protein gene (PRNP), and have been historically classified based on their clinicopathological features as genetic Jakob-Creutzfeldt disease (gJCD), Gerstmann-Sträussler-Scheinker (GSS), or Fatal Familial Insomnia (FFI). Mutations in PRNP can be missense, nonsense, and octapeptide repeat insertions or a deletion, and present with diverse clinical features, sensitivities of ancillary testing, and neuropathological findings. We present the UCSF gPrD cohort, including 129 symptomatic patients referred to and/or seen at UCSF between 2001 and 2016, and compare the clinical features of the gPrDs from 22 mutations identified in our cohort with data from the literature, as well as perform a literature review on most other mutations not represented in our cohort. E200K is the most common mutation worldwide, is associated with gJCD, and was the most common in the UCSF cohort. Among the GSS-associated mutations, P102L is the most commonly reported and was also the most common at UCSF. We also had several octapeptide repeat insertions (OPRI), a rare nonsense mutation (Q160X), and three novel mutations (K194E, E200G, and A224V) in our UCSF cohort. © 2016 Wiley Periodicals, Inc.

10 Review Memory consolidation in sleep disorders. 2017

Cellini, Nicola. ·Department of General Psychology, University of Padova, Padova, Italy; Department of Psychology, University of California, Riverside, CA, USA. Electronic address: cellini.nicola@gmail.com. ·Sleep Med Rev · Pubmed #27765468.

ABSTRACT: In recent years sleep-related memory consolidation has become a central topic in the sleep research field. Several studies have shown that in healthy individuals sleep promotes memory consolidation. Notwithstanding this, the consequences of sleep disorders on offline memory consolidation remain poorly investigated. Research studies indicate that patients with insomnia, obstructive sleep apnea, and narcolepsy often exhibit sleep-related impairment in the consolidation of declarative and procedural information. On the other hand, patients with parasomnias, such as sleep-walking, night terrors and rapid eye movement (REM) behavior disorder, do not present any memory impairment. These studies suggest that only sleep disorders characterized by increased post-learning arousal and disrupted sleep architecture seem to be associated with offline memory consolidation issues. Such impairments, arising already in childhood, may potentially affect the development and maintenance of an individual's cognitive abilities, reducing their quality of life and increasing the risk of accidents. However, promising findings suggest that successfully treating sleep symptoms can result in the restoration of memory functions and marked reduction of direct and indirect societal costs of sleep disorders.

11 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.

12 Review Sleep deprivation: a mind-body approach. 2016

Aguirre, Claudia C. ·Department of Biological Sciences, University of Southern California, Los Angeles, California, USA. ·Curr Opin Pulm Med · Pubmed #27583670.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this review is to summarize recent advances in our understanding of the impact sleep disturbances have on our health, with particular focus on the brain. The present review considers the influence of sleep disturbance on the neurovascular unit; the role of sleep disturbance in neurodegenerative diseases; and relevant strategies of neuro-immuno-endocrine interactions that likely contribute to the restorative power of sleep. Given the latest discoveries about the brain's waste clearance system and its relationship to neurodegenerative diseases like Alzheimer's disease, this review gives a brief overview on the molecular mechanisms behind sleep loss-related impairments. RECENT FINDINGS: Recent evidence indicates that sleep plays a vital role in neuro-immuno-endocrine homeostasis. Sleep loss has been linked to elevated risks for cognitive and mood disorders, underscored by impaired synaptic transmission. The glymphatic system has been shown to be modulated by sleep and implicated in neurodegenerative disorders. SUMMARY: Interactions between sleep quality, the immune system, and neurodegenerative disease are complex and a challenge to distil. These interactions are frequently bidirectional, because of sleep's characterization as an early symptom and as a potential factor contributing to the development and progression of mood and cognitive disorders. VIDEO ABSTRACT.

13 Review Sleep in Chronic Obstructive Pulmonary Disease: Evidence Gaps and Challenges. 2016

Jen, Rachel / Li, Yanru / Owens, Robert L / Malhotra, Atul. ·Clinical Investigator Program, Department of Medicine, University of British Columbia, Vancouver, BC, Canada V5Z 1M9; Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, La Jolla, CA 92037, USA. · Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Medicine Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. · Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, La Jolla, CA 92037, USA. ·Can Respir J · Pubmed #27445564.

ABSTRACT: Chronic obstructive pulmonary disease (COPD) prevalence is rising to epidemic proportions due to historical smoking trends, the aging of the population, and air pollution. Although blaming the victims has been common in COPD, the majority of COPD worldwide is now thought to be nonsmoking related, that is, caused by air pollution and cookstove exposure. It is increasingly appreciated that subjective and objective sleep disturbances are common in COPD, although strong epidemiological data are lacking. People with obstructive sleep apnea (OSA) plus COPD (the so-called overlap syndrome) have a high risk of cardiovascular death, although again mechanisms are unknown and untested. This review aims to draw attention to the problem of sleep in COPD, to encourage clinicians to ask their patients about symptoms, and to stimulate further research in this area given the large burden of the disease.

14 Review How do I best manage insomnia and other sleep disorders in older adults with cancer? 2016

Loh, Kah Poh / Burhenn, Peggy / Hurria, Arti / Zachariah, Finly / Mohile, Supriya Gupta. ·James Wilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14620, United States. Electronic address: melissalkp@gmail.com. · City of Hope Cancer Center, 1500 E. Duarte Road, Duarte, CA 91010, United States. · James Wilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14620, United States. ·J Geriatr Oncol · Pubmed #27266675.

ABSTRACT: Insomnia is common in older adults with cancer, with a reported prevalence of 19-60% in prior studies. Cancer treatments are associated with increased risk of insomnia or aggravation of pre-existing insomnia symptoms, and patients who are receiving active cancer treatments are more likely to report insomnia. Insomnia can lead to significant physical and psychological consequences with increased mortality. We discuss physiological sleep changes in older adults, and illustrated the various sleep disorders. We present a literature review on the prevalence and the effects of insomnia on the quality of life in older adults with cancer. We discuss the risk factors and presented a theoretical framework of insomnia in older adults with cancer. We present a case study to illustrate the assessment and management of insomnia in older adults with cancer, comparing and contrasting a number of tools for sleep assessment. There are currently no guidelines on the treatment of sleep disorders in older adults with cancer. We present an algorithm developed at the City of Hope Comprehensive Cancer Center by a multidisciplinary team for managing insomnia, using evidence-based pharmacologic and non-pharmacologic interventions.

15 Review Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns. 2016

Bei, Bei / Wiley, Joshua F / Trinder, John / Manber, Rachel. ·Monash Institute of Cognitive and Clinical Neurosciences, Monash School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Australia. Electronic address: bei.bei@monash.edu. · Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia. · Melbourne School of Psychological Sciences, University of Melbourne, Australia. · Stanford University School of Medicine, Department of Psychiatry and Behavioral Science, USA. ·Sleep Med Rev · Pubmed #26588182.

ABSTRACT: Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.

16 Review Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies. 2016

Bjurstrom, Martin F / Irwin, Michael R. ·Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, USA. Electronic address: mfbjurstrom@ucla.edu. · Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, USA. ·Sleep Med Rev · Pubmed #26140866.

ABSTRACT: Sleep and pain are critical homeostatic systems that interact in a bidirectional manner. Complaints of sleep disturbance are ubiquitous among patients with chronic pain disorders, and conversely, patients with persistent insomnia symptoms commonly report suffering from chronic pain. Sleep deprivation paradigms demonstrate that partial or complete sleep loss induce hyperalgesia, possibly due to shared mechanistic pathways including neuroanatomic and molecular substrates. Further, chronic pain conditions and sleep disturbances are intertwined through comorbidities, which together cause detrimental psychological and physical consequences. This critical review examines 29 polysomnography studies to evaluate whether nonmalignant chronic pain patients, as compared to controls, show differences in objective measures of sleep continuity and sleep architecture. Whereas these controlled studies did not reveal a consistent pattern of objective sleep disturbances, alterations of sleep continuity were commonly reported. Alterations of sleep architecture such as increases in light sleep or decreases in slow-wave sleep were less commonly reported and findings were mixed and also inconsistent. Methodological flaws were identified, which complicated interpretation and limited conclusions; hence, recommendations for future research are suggested. Knowledge of abnormalities in the sleep process has implications for understanding the pathophysiology of chronic pain conditions, which might also direct the development of novel intervention strategies.

17 Review Insomnia disorder. 2015

Morin, Charles M / Drake, Christopher L / Harvey, Allison G / Krystal, Andrew D / Manber, Rachel / Riemann, Dieter / Spiegelhalder, Kai. ·Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec City, Québec G1V 0A6, Canada. · Henry Ford Hospital Sleep Disorders and Research Center, Detroit, Michigan, USA. · Department of Psychology, University of California, Berkeley, Berkeley, California, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA. · Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany. ·Nat Rev Dis Primers · Pubmed #27189779.

ABSTRACT: Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. It can present as the chief complaint or, more often, co-occurs with other medical or psychiatric disorders, such as pain and depression. Persistent insomnia has been linked with adverse long-term health outcomes, including diminished quality of life and physical and psychological morbidity. Despite its high prevalence and burden, the aetiology and pathophysiology of insomnia is poorly understood. In the past decade, important changes in classification and diagnostic paradigms have instigated a move from a purely symptom-based conceptualization to the recognition of insomnia as a disorder in its own right. These changes have been paralleled by key advances in therapy, with generic pharmacological and psychological interventions being increasingly replaced by approaches that have sleep-specific and insomnia-specific therapeutic targets. Psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient and accessible therapies.

18 Review Sleep in caregivers: what we know and what we need to learn. 2015

McCurry, Susan M / Song, Yeonsu / Martin, Jennifer L. ·aUniversity of Washington, Seattle, Washington bGeriatric Research, Education, and Clinical Center, Department of Veterans Affairs Greater Los Angeles Healthcare System cDavid Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USA. ·Curr Opin Psychiatry · Pubmed #26397027.

ABSTRACT: PURPOSE OF REVIEW: The number of informal caregivers providing assistance to adults is increasing commensurate with our aging society. Sleep disturbances are prevalent in caregivers and associated with negative physical, medical, and functional outcomes. Here, we describe the predisposing, precipitating, and perpetuating factors contributing to the development of sleep problems in caregivers, and discuss three understudied caregiving populations that have clinical importance and unique circumstances influencing sleep quality and health. RECENT FINDINGS: There is clear evidence supporting the interaction between sleep loss, caregiving stress, and vulnerability to chronic disease. Telehealth and telemedicine sleep interventions for caregivers combined with assistive technologies targeting care-receivers have potential to be more individualized, affordable, and widely accessible than traditional in-person insomnia treatment approaches. Limited data exist describing the etiology and treatment of sleep problems in caregivers of veterans, medical patients newly discharged from the hospital, and developmentally disabled adults. SUMMARY: There is a growing literature describing the general determinants of sleep disturbances in caregivers, the health consequences of these disturbances, and intervention strategies for treating them. Identifying effective sleep treatments suited to more specialized caregiving situations and increasing intervention access will help caregivers continue to provide quality care while protecting their own health and well-being.

19 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.

20 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.

21 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.

22 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.

23 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.

24 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.

25 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.