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Sleep Initiation and Maintenance Disorders: HELP
Articles from Los Angeles
Based on 71 articles published since 2008

These are the 71 published articles about Sleep Initiation and Maintenance Disorders that originated from Los Angeles during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 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.

2 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.

3 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.

4 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.

5 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.

6 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.

7 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.

8 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.

9 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.

10 Review Insomnia (primary) in older people. 2011

Alessi, Cathy / Vitiello, Michael V. ·David Geffen School of Medicine at UCLA, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, USA. ·BMJ Clin Evid · Pubmed #22030082.

ABSTRACT: INTRODUCTION: Up to 40% of older adults have insomnia, with difficulty getting to sleep, early waking, or feeling unrefreshed on waking. The prevalence of insomnia increases with age. Other risk factors include psychological factors, stress, daytime napping, and hyperarousal. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug treatments for insomnia in older people? What are the effects of drug treatments for insomnia in older people? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 34 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antidepressants, benzodiazepines, cognitive behavioural therapy (CBT), diphenhydramine, exercise programmes, timed exposure to bright light, zaleplon, zolpidem, and zopiclone.

11 Review Behavioral symptoms in patients with breast cancer and survivors. 2008

Bower, Julienne E. ·University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA. jbower@ucla.edu ·J Clin Oncol · Pubmed #18258985.

ABSTRACT: Behavioral symptoms are a common adverse effect of breast cancer diagnosis and treatment and include disturbances in energy, sleep, mood, and cognition. These symptoms cause serious disruption in patients' quality of life and may persist for years after treatment. Patients need accurate information about the occurrence of these adverse effects as well as assistance with symptom management. This review considers four of the most common behavioral sequelae of breast cancer, namely fatigue, sleep disturbance, depression, and cognitive impairment. Research on the prevalence, mechanisms, and treatment of each symptom is described, concluding with recommendations for future studies.

12 Clinical Trial Provision of ancillary medications during buprenorphine detoxification does not improve treatment outcomes. 2010

Hillhouse, Maureen / Domier, Catherine P / Chim, David / Ling, Walter. ·University of California, Los Angeles, Integrated Substance Abuse Programs, Los Angeles, CA 90025, USA. hillhous@ucla.edu ·J Addict Dis · Pubmed #20390696.

ABSTRACT: For individuals dependent on opioids, recovery efforts begin with a period of withdrawal that typically includes discomfort from symptoms, possibly precipitating a return to drug use. The study described here investigated whether the provision of ancillary medications for opioid withdrawal symptoms affected treatment outcomes in 139 participants receiving buprenorphine in a 13-day detoxification trial. Outcome measures include the number of opioid-free urine samples collected and retention in treatment. Ancillary medications were provided to 70% of participants: 59% received medication for insomnia, 45% for anxiety, 40% for bone pain, 35% for nausea, and 28% for diarrhea. Findings indicate no difference in the number of opioid-free urine samples between the group receiving ancillary medication and the group who did not, although tests of specific ancillary medications indicate that those who received diarrhea medication had fewer opioid-free urines than those who did not (P = .004). Results also indicate that participants attended fewer days of treatment if they received anxiety, nausea, or diarrhea medication compared to no medication (all P values < .05).

13 Article Are sleep continuity disturbance and fatigue prodromal symptoms of cancer development? 2018

Garland, Sheila N / Irwin, Michael R / Posner, Donn / Perlis, Michael L. ·Departments of Psychology and Oncology, Memorial University, 232 Elizabeth Avenue, St. John's, Newfoundland A1B 3X9, Canada. Electronic address: sheila.garland@mun.ca. · Cousins Center for Psychoneuroimmunology at the UCLA Semel Institute for Neuroscience, and the Departments of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States. · Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, United States. · Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 670, Philadelphia, PA 19104, United States. ·Med Hypotheses · Pubmed #30220346.

ABSTRACT: Sleep continuity disturbance (also known as insomnia) and fatigue are common complaints of individuals diagnosed with cancer. Traditionally, many have believed that sleep continuity disturbance and fatigue are caused, in large measure, by the impact of the cancer diagnosis and treatment. Recent prospective research suggests however, that sleep continuity disturbance and fatigue may actually precede a cancer diagnosis. We suggest that sleep continuity disturbance and fatigue may in fact represent prodromal symptoms of cancer. We review the current perspectives of this sequence of events and present a revised schematic that accounts for the role of biological, behavioural, and cognitive factors that contribute to the development and maintenance of sleep continuity disturbances in cancer patients. Monitoring emergent and unexplained patient-reported fatigue, sleepiness, and insomnia may serve as early warning signs of new onset cancer, providing opportunity for early detection and early intervention.

14 Article Family-Driven Goals to Improve Care for Children With Autism Spectrum Disorder. 2018

Bellesheim, Katherine R / Cole, Lynn / Coury, Daniel L / Yin, Larry / Levy, Susan E / Guinnee, Meghan A / Klatka, Kirsten / Malow, Beth A / Katz, Terry / Taylor, Jane / Sohl, Kristin. ·Thompson Center for Autism and Neurodevelopmental Disorders, and. · Departments of Psychological Sciences and. · University of Rochester Medical Center, University of Rochester, Rochester, New York. · Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio. · Children's Hospital Los Angeles, Los Angeles, California. · Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. · Catalyst Research, Depew, New York. · National Institute for Children's Health Quality, Boston, Massachusetts. · Department of Neurology, School of Medicine, Vanderbilt University, Nashville, Tennessee; and. · Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado. · Thompson Center for Autism and Neurodevelopmental Disorders, and sohlk@health.missouri.edu. · Child Health, University of Missouri, Columbia, Missouri. ·Pediatrics · Pubmed #30108141.

ABSTRACT: OBJECTIVES: Constipation and insomnia are not consistently identified and treated in children with autism spectrum disorder (ASD) despite their high prevalence and deleterious impact in this population. To standardize care, a constipation practice pathway and an insomnia practice pathway were previously developed by Autism Treatment Network clinicians. Our objective was to implement and refine these practice pathways in clinical settings. METHODS: Eleven Autism Treatment Network sites participated in a Learning Collaborative (ie, multidisciplinary quality improvement team) and chose to implement either the constipation or insomnia practice pathway in the clinical setting. Families set intervention goals (eg, increase stool frequency, decrease nighttime awakenings) before treatment. Each site began implementation with 1 patient and then increased implementation by factors of 5. Before each increase, the Learning Collaborative evaluated progress and refined the practice pathways. Process improvement was measured primarily by duration until goal attainment and by percentage of families who meet their goals. RESULTS: Across sites, 82 children with ASD and constipation and 101 children with ASD and insomnia were managed. Difficulties with intervention adherence and communication between providers and families were reported and were subsequently improved with parallel refinements to both practice pathways. The most notable modification was incorporating a goal-setting session in which families generated their own intervention goals (ie, family-driven goals). In this quality improvement initiative, 75% of families met at least 1 constipation or insomnia goal, with the median time to improvement being 6 weeks. CONCLUSIONS: By integrating a family-centered approach into the standardization of care, constipation and insomnia practice pathways may improve engagement, adherence, and management of medical conditions in children with ASD.

15 Article Poor sleep quality and insufficient sleep of a collegiate student-athlete population. 2018

Mah, Cheri D / Kezirian, Eric J / Marcello, Brandon M / Dement, William C. ·Stanford Sleep Disorders Clinic and Research Laboratory, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA; School of Medicine, University of California, San Francisco, San Francisco, CA, USA. Electronic address: cherimah@stanfordalumni.org. · USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. · Department of Athletics, Stanford University, Stanford, CA, USA. · Stanford Sleep Disorders Clinic and Research Laboratory, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA. ·Sleep Health · Pubmed #29776619.

ABSTRACT: OBJECTIVE: Poor and inadequate sleep negatively impact cognitive and physical functioning and may also affect sports performance. The study aim is to examine sleep quality, sleep duration, and daytime sleepiness in collegiate student-athletes across a wide range of sports. DESIGN: Questionnaire. SETTING: University setting. PARTICIPANTS: 628 athletes across 29 varsity teams at Stanford University. MEASUREMENTS: Athletes completed a questionnaire inquiring about sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI), sleep duration, and daytime sleepiness via Epworth Sleepiness Scale. Sleep quality on campus and while traveling for competition was rated on a 10-point scale. RESULTS: Collegiate athletes were classified as poor sleepers (PSQI 5.38 ± 2.45), and 42.4% of athletes experience poor sleep quality (reporting PSQI global scores >5). Athletes reported lower sleep quality on campus than when traveling for competition (7.1 vs 7.6, P< .001). Inadequate sleep was demonstrated by 39.1% of athletes that regularly obtain <7 hours of sleep on weekdays. Fifty-one percent of athletes reported high levels of daytime sleepiness with Epworth scores ≥10. Teen student-athletes in the first and second year of college reported the highest mean levels of daytime sleepiness. Greater total sleep time was associated with daytime functioning including lower frequency of difficulty waking up for practice or class (P< .001) and lower frequency of trouble staying awake during daily activities (P< .001). CONCLUSIONS: Collegiate athletes frequently experience poor sleep quality, regularly obtain insufficient sleep, and commonly exhibit daytime sleepiness.

16 Article Insomnia mediates the longitudinal relationship between anxiety and depressive symptoms in a nationally representative sample of adolescents. 2018

Li, Y Irina / Starr, Lisa R / Wray-Lake, Laura. ·Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA. · Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA. ·Depress Anxiety · Pubmed #29697888.

ABSTRACT: BACKGROUND: Anxiety and depression are commonly comorbid with each other, with anxiety often temporally preceding the development of depression. Although increasingly research has begun to investigate the role of sleep problems in depression, no study has examined insomnia as a mediator in the longitudinal relationship between anxiety and subsequent depression. METHODS: The current study utilizes data from Waves I, II, and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative prospective study conducted over a 14-year period (n = 20,745, 50.5% female, M age at Wave I = 16.20). Participants completed portions of the Center for Epidemiologic Studies Depression Scale at Waves I and IV to assess depressive symptoms, a six-item anxiety measure at Wave I, and three items assessing insomnia, sleep quality, and sleep duration at Wave II. RESULTS: Structural equation modeling indicated that insomnia and unrestful sleep significantly mediated the relationship between anxiety and subsequent depression. The relationship between anxiety and depression was not significantly mediated by sleep duration. CONCLUSIONS: Findings suggest that anxiety may increase risk for the development of later depression through insomnia.

17 Article Innovation in the Treatment of Insomnia in Breast Cancer Survivors. 2018

Irwin, Michael R. ·Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA. ·J Natl Cancer Inst · Pubmed #29471409.

ABSTRACT: -- No abstract --

18 Article Psychometrics of the Self-Report Concise Associated Symptoms Tracking Scale (CAST-SR): Results From the STRIDE (CTN-0037) Study. 2018

Trombello, Joseph M / Killian, Michael O / Liao, Allen / Sanchez, Katherine / Greer, Tracy L / Walker, Robrina / Grannemann, Bruce / Rethorst, Chad D / Carmody, Thomas / Trivedi, Madhukar H. ·Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA. · School of Social Work, University of Texas at Arlington, Arlington, Texas, USA. · Current affiliation: Harbor-UCLA Medical Center, Los Angeles, California, USA. · Current affiliation: Center for Applied Health Research, Baylor Scott and White Research Institute, Dallas, Texas, USA. · Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119. madhukar.trivedi@utsouthwestern.edu. ·J Clin Psychiatry · Pubmed #29325238.

ABSTRACT: OBJECTIVE: The self-report Concise Associated Symptoms Tracking Scale (CAST-SR) was developed to track mania, irritability, anxiety, panic, and insomnia symptoms among depressed outpatients receiving antidepressant medication. Given the overlap between these domains, depression, and stimulant use disorders, we reexamined CAST-SR psychometrics in a novel sample: individuals with stimulant use disorder receiving aerobic exercise or health education interventions. METHODS: Using the subsample of stimulant-dependent (following DSM-IV criteria) individuals prescribed antidepressants (N = 124) from the multisite Stimulant Reduction Intervention Using Dosed Exercise (CTN-0037) trial (total sample N = 302), conducted July 2010 to February 2013, we analyzed CAST-SR data collected at the first assessment after participant's discharge from residential treatment. We also evaluated the convergent/discriminant validity of the CAST-SR with several self-report questionnaires. RESULTS: Confirmatory factor analysis revealed a 12-item measure composed of 4 factors: irritability, anxiety, panic, and insomnia. This factor structure loaded only in participants prescribed antidepressant medication, not in those who were not prescribed antidepressants. These results replicate the original CAST-SR factor structure, except for the mania factor, which failed to load. Internal consistency was high (α = 0.92 for total scale and α = 0.78-0.89 for the 4 factors), and convergent validity was established, especially for the insomnia and irritability factors, alongside the total score with depressive symptoms, insomnia, quality of life, suicide risk, and physical health measures. CONCLUSIONS: These results demonstrate the factor structure, reliability, and validity of the CAST-SR in a novel population of only individuals with stimulant use disorders receiving both exercise/health education interventions and antidepressant medication. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01141608.

19 Article Discrimination and Sleep Difficulties during Adolescence: The Mediating Roles of Loneliness and Perceived Stress. 2018

Majeno, Angelina / Tsai, Kim M / Huynh, Virginia W / McCreath, Heather / Fuligni, Andrew J. ·Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, 911 Broxton Ave, Los Angeles, CA, 90024, USA. amajeno@mednet.ucla.edu. · Department of Child and Adolescent Development, San Jose State University, San Jose, CA, USA. · Child and Adolescent Development Department, California State University Northridge, Northridge, CA, USA. · Division of Geriatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA. · Department of Psychology, UCLA, Los Angeles, CA, USA. · Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA. ·J Youth Adolesc · Pubmed #29164378.

ABSTRACT: Irregular and insufficient sleep place youth at risk for adverse psychological and physical health outcomes. Recent research indicates that discrimination constitutes a type of stressor that interferes with adolescent sleep; however, the mechanisms through which discrimination affects sleep are not well understood. This study examined whether ethnic and non-ethnic (i.e., gender, age, and height/weight) discrimination were associated with adolescents' sleep duration, variability, and quality, and whether loneliness and perceived stress mediated these associations. An ethnically-diverse sample (42% Latino, 29% European American, 23% Asian) of adolescents (N = 316; M

20 Article Risk of pneumonia in patients with insomnia: A nationwide population-based retrospective cohort study. 2018

Lin, Chia-Ling / Liu, Ta-Chun / Chung, Chi-Hsiang / Chien, Wu-Chien. ·Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan. · Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA. · Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan. · Department of Medical Research, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan. Electronic address: chienwu@ndmctsgh.edu.tw. ·J Infect Public Health · Pubmed #28916233.

ABSTRACT: Evidence is lacking regarding whether insomnia increases the risk of infectious disease. Accordingly, the present study examined the risk of pneumonia in patients with insomnia. This study was a population-based retrospective cohort study on a cohort of 8061 patients with insomnia and a control cohort of 16,112 patients (matched by age, sex, and year of diagnosis) from the Taiwan National Health Insurance Research Database for the 2000-2010 period. Overall incidence of pneumonia was 50.6 per 1000 person-years in the insomnia cohort, which was significantly higher than that in the control cohort (30.9 per 1000 person-years). Overall, the insomnia cohort exhibited a higher risk of pneumonia (HR=2.43; CI, 2.24-2.62). By age group, the risk of pneumonia was significantly higher in the insomnia cohort for those aged ≤40 years (HR=3.23, CI: 1.38-7.57), 41-65 years (HR=2.62, CI: 2.07-3.32), and >65years (CI: 2.21-2.61). Compared with the controls, the insomnia cohort exhibited a higher risk of pneumonia, particularly in young adults.

21 Article Sleep and mood in older adults: coinciding changes in insomnia and depression symptoms. 2018

Li, Michael J / Kechter, Afton / Olmstead, Richard E / Irwin, Michael R / Black, David S. ·Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,California,USA. · Cousins Center for Psychoneuroimmunology,Semel Institute for Neuroscience,University of California,Los Angeles,California,USA. ·Int Psychogeriatr · Pubmed #28766467.

ABSTRACT: The aim of this analysis was to test if changes in insomnia symptoms and global sleep quality are associated with coinciding changes in depressed mood among older adults. We report on results yielded from secondary analysis of longitudinal data from a clinical trial of older adults (N = 49) aged 55 to 80 years who reported at least moderate levels of sleep problems. All measures were collected at baseline and after the trial ten weeks later. We computed change scores for two separate measures of disturbed sleep, the Athens Insomnia Scale (AIS) and the Pittsburgh Sleep Quality Index (PSQI), and tested their association with change in depressed mood (Beck Depression Inventory-II; BDI-II) in two separate linear regression models adjusted for biological covariates related to sleep (sex, age, body mass index, and NF-κB as a biological marker previously correlated with insomnia and depression). Change in AIS scores was associated with change in BDI-II scores (β = 0.38, p < 0.01). Change in PSQI scores was not significantly associated with change in BDI-II scores (β = 0.17, p = 0.26). Our findings suggest that improvements over ten weeks in insomnia symptoms rather than global sleep quality coincide with improvement in depressed mood among older adults.

22 Article Nocturia is Associated with Poor Sleep Quality Among Older Women in the Study of Osteoporotic Fractures. 2017

Fung, Constance H / Vaughan, Camille P / Markland, Alayne D / Huang, Alison J / Mitchell, Michael N / Bliwise, Donald L / Ancoli-Israel, Sonia / Redline, Susan / Alessi, Cathy A / Stone, Katie. ·Department of Veterans Affairs Greater, Los Angeles Geriatric Research, Education, and Clinical Center, Los Angeles, California. · Department of Medicine, University of California Los Angeles, Los Angeles, California. · Department of Veterans Affairs Birmingham, Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama. · Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia. · Department of Medicine, Division of Geriatrics, Gerontology and Palliative Medicine, University of Alabama at Birmingham, Birmingham, Alabama. · Department of Medicine, University of California San Francisco, San Francisco, California. · Sleep Program, Emory University School of Medicine, Atlanta, Georgia. · Departments of Psychiatry and Medicine, University of California, San Diego, La Jolla, California. · Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts. · California Pacific Medical Center, San Francisco, California. ·J Am Geriatr Soc · Pubmed #28914959.

ABSTRACT: OBJECTIVES: (1) To examine relationships between frequency of nocturia and self-reported sleep quality and objective sleep measures in older women, and (2) to estimate the amount of variation in sleep measures that is specifically attributable to frequency of nocturia. DESIGN AND SETTING: Secondary, cross sectional analysis of the multicenter prospective cohort Study of Osteoporotic Fractures (SOF). PARTICIPANTS: Community-dwelling women aged ≥80 years. MEASUREMENTS: Frequency of nocturia in the previous 12 months, Pittsburgh Sleep Quality Index sleep quality subscale, and actigraphy-measured wake after sleep onset (WASO) and total sleep time (TST). RESULTS: Of 1,520 participants, 25% (n = 392) reported their nocturia frequency was 3-4 times/night and an additional 60% (n = 917) reported their nocturia frequency was 1-2 times/night. More frequent nocturia was associated with poor sleep quality (3-4/night: 26.8% reported fairly bad or very bad sleep quality; 1-2/night: 14.7%; 0/night: 7.7%; P < .001) and longer WASO (3-4/night: 89.8 minutes; 1-2/night: 70.6; 0/night: 55.5; P < .001). In nested regression models, a nocturia frequency of 3-4/night quadrupled the odds of poor sleep quality (odds ratio: 4.26 [95% CI 1.65, 11.01]; P = .003) and was associated with a 37-minute worsening in WASO (95% CI 26.0, 49.0; P < .001). Frequency of nocturia explained an additional 6% variation in WASO, above and beyond demographic, medical/psychiatric conditions, and medication factors (∆R CONCLUSIONS: Nocturia is common among octogenarian and nonagenarian women and is independently associated with poor sleep quality and longer wake time at night. Interventions that improve nocturia may be useful in improving sleep quality and wake time at night.

23 Article Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. 2017

Irwin, Michael R / Olmstead, Richard / Carrillo, Carmen / Sadeghi, Nina / Nicassio, Perry / Ganz, Patricia A / Bower, Julienne E. ·All authors: University of California Los Angeles, Los Angeles, CA. ·J Clin Oncol · Pubmed #28489508.

ABSTRACT: Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups. Conclusion CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

24 Article A Four-Session Sleep Intervention Program Improves Sleep for Older Adult Day Health Care Participants: Results of a Randomized Controlled Trial. 2017

Martin, Jennifer L / Song, Yeonsu / Hughes, Jaime / Jouldjian, Stella / Dzierzewski, Joseph M / Fung, Constance H / Rodriguez Tapia, Juan Carlos / Mitchell, Michael N / Alessi, Cathy A. ·Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA. · David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA. · University of North Carolina, Chapel Hill, NC. · Health Services Research & Development, Durham VA Medical Center, Durham, NC. · Department of Psychology, Virginia Commonwealth University, Richmond, VA. · Department of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile. ·Sleep · Pubmed #28482053.

ABSTRACT: Study Objective: To test the effectiveness of a 4-week behavioral Sleep Intervention Program (SIP: sleep compression, modified stimulus control, and sleep hygiene) compared to a 4-week information-only control (IC) among older adults attending a VA Adult Day Health Care (ADHC) program in a double-blind, randomized, clinical trial. Methods: Forty-two individuals (mean age: 77 years, 93% male) enrolled in a VA ADHC program were randomized to receive SIP or IC. All completed in-person sleep and health assessments at baseline, post-treatment and 4-months follow-up that included 3 days/nights of wrist actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Mixed repeated measures analysis was used to compare sleep outcomes at post-treatment and 4-months follow-up, with baseline values as covariates. Results: SIP participants (n = 21) showed significant improvement on actigraphy sleep efficiency (p = .007), number of nighttime awakenings (p = .016), and minutes awake at night (p = .001) at post-treatment, compared to IC participants (n = 21). Benefits were slightly attenuated but remained significant at 4-month follow-up (all p's < .05). There were no differences in total sleep time between groups. There was significant improvement on PSQI factor 3 (daily disturbances) at 4-month follow-up (p = .016), but no differences were observed between SIP and IC on other PSQI components or ISI scores at post-treatment or 4-month follow-up. Conclusions: A short behavioral sleep intervention may have important benefits in improving objectively measured sleep in older adults participating in ADHC. Future studies are needed to study implementation of this intervention into routine clinical care within ADHC.

25 Article A model linking video gaming, sleep quality, sweet drinks consumption and obesity among children and youth. 2017

Turel, O / Romashkin, A / Morrison, K M. ·Department of Information Systems and Decision Sciences, California State University, Fullerton, Fullerton, CA, USA. · Brain and Creativity Institute, Department of Psychology, University of Southern California, Los Angeles, CA, USA. · Department of Pediatrics, McMaster Children Hospital and Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. · School of Medicine, University of Queensland, Brisbane, Queensland, Australia. ·Clin Obes · Pubmed #28320073.

ABSTRACT: There is a growing need to curb paediatric obesity. The aim of this study is to untangle associations between video-game-use attributes and obesity as a first step towards identifying and examining possible interventions. Cross-sectional time-lagged cohort study was employed using parent-child surveys (t1) and objective physical activity and physiological measures (t2) from 125 children/adolescents (mean age = 13.06, 9-17-year-olds) who play video games, recruited from two clinics at a Canadian academic children's hospital. Structural equation modelling and analysis of covariance were employed for inference. The results of the study are as follows: (i) self-reported video-game play duration in the 4-h window before bedtime is related to greater abdominal adiposity (waist-to-height ratio) and this association may be mediated through reduced sleep quality (measured with the Pittsburgh Sleep Quality Index); and (ii) self-reported average video-game session duration is associated with greater abdominal adiposity and this association may be mediated through higher self-reported sweet drinks consumption while playing video games and reduced sleep quality. Video-game play duration in the 4-h window before bedtime, typical video-game session duration, sweet drinks consumption while playing video games and poor sleep quality have aversive associations with abdominal adiposity. Paediatricians and researchers should further explore how these factors can be altered through behavioural or pharmacological interventions as a means to reduce paediatric obesity.