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Sleep Initiation and Maintenance Disorders: HELP
Articles from Miscellaneous cities in California
Based on 18 articles published since 2009

These are the 18 published articles about Sleep Initiation and Maintenance Disorders that originated from Miscellaneous cities in California during 2009-2019.
+ Citations + Abstracts
1 Review The multidimensional burden of atopic dermatitis: An update. 2018

Bridgman, Alanna C / Block, Julie K / Drucker, Aaron M. ·Department of Medicine, Queen's University, Kingston, Ontario, Canada. · National Eczema Association, San Rafael, California. · Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: aaron.drucker@wchospital.ca. ·Ann Allergy Asthma Immunol · Pubmed #29555350.

ABSTRACT: -- No abstract --

2 Review Medical marijuana: A treatment worth trying? 2016

Metts, Julius / Wright, Steven / Sundaram, Jawahar / Hashemi, Nastran. ·California Substance Abuse and Treatment Center, Department of Corrections and Rehabilitation, Corcoran, CA, USA. Email: julius.metts@cdcr.ca.gov. · Private practice, Littleton, CO, USA. · California Substance Abuse and Treatment Center, Department of Corrections and Rehabilitation, Corcoran, CA, USA. ·J Fam Pract · Pubmed #27158689.

ABSTRACT: With medical marijuana available in more and more states, family physicians need to know what the evidence says about its use. This review includes a step-by-step guide and a list of red flags to watch for.

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

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

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

4 Clinical Trial Health-related quality of life in patients with locally recurrent or metastatic breast cancer treated with etirinotecan pegol versus treatment of physician's choice: Results from the randomised phase III BEACON trial. 2017

Twelves, Chris / Cortés, Javier / O'Shaughnessy, Joyce / Awada, Ahmad / Perez, Edith A / Im, Seock-Ah / Gómez-Pardo, Patricia / Schwartzberg, Lee S / Diéras, Véronique / Yardley, Denise A / Potter, David A / Mailliez, Audrey / Moreno-Aspitia, Alvaro / Ahn, Jin-Seok / Zhao, Carol / Hoch, Ute / Tagliaferri, Mary / Hannah, Alison L / Rugo, Hope S. ·Leeds Institute of Cancer and Pathology and St James's Institute of Oncology, Leeds, UK. Electronic address: c.j.twelves@leeds.ac.uk. · Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. · Baylor-Sammons Cancer Center, Texas Oncology, U.S. Oncology, Dallas, TX, USA. · Medical Oncology Clinic, Jules Bordet Institute, Brussels, Belgium. · Mayo Clinic, Jacksonville, FL, USA. · Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. · Vall d'Hebron Institute of Oncology, Barcelona, Spain. · The West Clinic, Memphis, TN, USA. · Institut Curie, Paris, France. · Sarah Cannon Research Institute, Nashville, TN, USA. · University of Minnesota, Department of Medicine, Masonic Cancer Center, Minneapolis, MN, USA. · Centre Oscar Lambret, Lille, France. · Ramon y Cajal University Hospital, Madrid, Spain. · Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. · Nektar Therapeutics, San Francisco, CA, USA. · Consultant, Sebastopol, CA, USA. · University of California, San Francisco, CA, USA. ·Eur J Cancer · Pubmed #28360015.

ABSTRACT: BACKGROUND: Health-related quality of life (HRQoL) enhances understanding of treatment effects that impact clinical decision-making. Although the primary end-point was not achieved, the BEACON (BrEAst Cancer Outcomes with NKTR-102) trial established etirinotecan pegol, a long-acting topoisomerase-1 (TOP1) inhibitor, as a promising therapeutic for patients with advanced/metastatic breast cancer (MBC) achieving clinically meaningful benefits in median overall survival (OS) for patients with stable brain metastases, with liver metastases or ≥ 2 sites of metastatic disease compared to treatment of physician's choice (TPC). Reported herein are the findings from the preplanned secondary end-point of HRQoL. PATIENTS AND METHODS: HRQoL, assessed by European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) (version 3.0) supplemented by the breast cancer-specific Quality of Life Questionnaire (QLQ-BR23), was evaluated post randomisation in 733 of 852 patients with either anthracycline-, taxane- and capecitabine-pretreated locally recurrent or MBC randomised to etirinotecan pegol (n = 378; 145 mg/m RESULTS: Differences were seen favouring etirinotecan pegol up to 32 weeks for global health status (GHS) and physical functioning scales (P < 0.02); numerical improvement was reported in other functional scales. The findings from HRQoL symptom scales were consistent with adverse event profiles; etirinotecan pegol was associated with worsening gastrointestinal symptoms whereas TPC was associated with worsened dyspnoea and other systemic side-effects. Analysis of GHS and physical functioning at disease progression showed a decline in HRQoL in both treatment arms, with a mean change from baseline of -9.4 and -10.8 points, respectively. CONCLUSION: There was evidence of benefit associated with etirinotecan pegol compared with current standard of care agents in multiple HRQoL measurements, including global health status and physical functioning, despite worse gastrointestinal symptoms (e.g. diarrhoea). Patients in both arms had a decline in HRQoL at disease progression. STUDY NUMBER: NCT01492101.

5 Clinical Trial Population pharmacokinetics and pharmacodynamics of gabapentin after administration of gabapentin enacarbil. 2013

Lal, Ritu / Sukbuntherng, Juthamas / Luo, Wendy / Tovera, James / Lassauzet, Marie Liesse / Cundy, Kenneth C. ·XenoPort, Inc, Santa Clara, CA, USA. ritu.lal@xenoport.com ·J Clin Pharmacol · Pubmed #23400741.

ABSTRACT: Gabapentin enacarbil (GEn) is an actively transported prodrug of gabapentin that provides sustained dose-proportional exposure to gabapentin and predictable bioavailability. Gabapentin enacarbil is approved by the US Food and Drug Administration for the treatment of moderate-to-severe primary restless legs syndrome (RLS) in adults. Using plasma gabapentin concentration data obtained after administration of GEn in 12 phase 1 to 3 GEn studies in healthy adults or patients with RLS (dose range, 300-2400 mg/d), a population pharmacokinetic (PK) model was developed by nonlinear mixed-effect modeling using NONMEM. Data were similar in subjects with and without RLS. Population PK-pharmacodynamic (PD) models were evaluated using gabapentin exposure and change from baseline in investigator- or patient-rated Clinical Global Impression of Improvement (CGI-I) or International Restless Legs Scale (IRLS) total score. Potential PK-PD models for sleep outcomes and safety parameters were also explored. The CGI-I response increased with increasing GEn dose, whereas the IRLS total score was similar at all exposures tested. Early adverse events of dizziness or somnolence/sedation were more frequent for GEn 600 mg than higher doses; however, this is confounded by the fact that all subjects received the 600-mg dose for 3 days prior to titration to higher dosages.

6 Article Sleep Disturbance, Activities of Daily Living, and Depressive Symptoms among Older Adults. 2018

Webb, Christopher A / Cui, Ruifeng / Titus, Caitlin / Fiske, Amy / Nadorff, Michael R. ·a Department of Psychology , Mississippi State University , Starkville , Mississippi , USA. · b Department of Psychology, California Department of State Hospitals- Atascadero , Atascadero , California , USA. · c Department of Psychology , West Virginia University , Morgantown , West Virginia , USA. · d Injury Control Research Center , West Virginia University , Morgantown , West Virginia , USA. · e Department of Psychiatry and Behavioral Sciences , Baylor College of Medicine , Houston , Texas , USA. ·Clin Gerontol · Pubmed #29272210.

ABSTRACT: OBJECTIVE: Research suggests sleep disturbance plays a role in depression and risk for suicidal behavior (i.e., ideation, attempts, death by suicide). How sleep disturbance affects suicide risk is unclear and one's ability to perform activities of daily living (ADLs) may help explain this relation. This study examined associations between sleep problems, ADLs, and either depressive symptoms or suicide risk among older adults. We hypothesized that ADLs would mediate relations between sleep problems and depressive symptoms and suicide risk. METHOD: Participants (N = 134; age ≥65) were recruited through Amazon's Mechanical Turk. Participants completed questionnaires that assessed insomnia symptoms, nightmares, ADLs, depressive symptoms, and suicidal behaviors. RESULTS: Nightmares were associated with depressive symptoms and suicide risk but not independently associated with ADLs. Insomnia symptoms were associated with depressive symptoms, suicide risk, and ADLs. ADLs mediated the relation between insomnia symptoms and depressive symptoms. The insomnia symptom-suicidal behavior relation and the nightmare-suicidal behavior relation were significantly mediated by a pathway containing ADLs and depressive symptoms. DISCUSSION: ADLs help explain how insomnia symptoms and nightmares confer suicide risk among older adults, either independently or in association with depressive symptoms. CLINICAL IMPLICATIONS: Practitioners should attend to ADL performance when treating older adults with insomnia and depression.

7 Article Neuropsychological Functioning in Older Adults with Mild Cognitive Impairment and Insomnia Randomized to CBT-I or Control Group. 2018

Cassidy-Eagle, Erin / Siebern, Allison / Unti, Lisa / Glassman, Jill / O'Hara, Ruth. ·a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA. · c Fayetteville Veterans Affairs Medical Center , Fayetteville , North Carolina , USA. · b ETR , Scotts Valley , California , USA. · d Veterans Affairs Palo Alto Health Care System , Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC) , Palo Alto , California , USA. ·Clin Gerontol · Pubmed #29220627.

ABSTRACT: OBJECTIVES: Improving the sleep of older adults with mild cognitive impairment (MCI) represents a first step in discovering whether interventions directed at modifying this risk factor also have the potential to alter the cognitive decline trajectory. METHODS: A six-session, adapted version of a cognitive behavioral therapy for insomnia (CBT-I) was administered to older adults (N = 28; 14 per group) with MCI across two residential facilities. Participants were randomly assigned to either the sleep intervention or an active control group and completed a neuropsychological battery at three time points (e.g., baseline-T1, post-intervention-T2, 4 month follow-up-T3). RESULTS: Results showed a significant improvement in sleep and a change (p < .05) on a key measure of executive functioning sub task of inhibition (Condition 3 of D-KEF Color-Word Interference Test), a positive trend on the inhibition-switching task (p < .10; Condition 4 of D-KEF Color-Word Interference Test), an no change in a measure of verbal memory (HVLT-R Delayed Recall) compared with the active control group. CONCLUSIONS: CBT-I is a nonpharmacological intervention that has the potential to cognitively benefit individuals with MCI suffering from comorbid insomnia. CLINICAL IMPLICATIONS: Results suggest that a non-pharmacological intervention to improve sleep in older adults with MCI also improve cognitive functioning. Further exploration of the mechanisms underlying these improvements is warranted.

8 Article Comparative Effectiveness of Three Occupational Therapy Sleep Interventions: A Randomized Controlled Study. 2017

Gutman, Sharon A / Gregory, Kristin A / Sadlier-Brown, Megan M / Schlissel, Marcy A / Schubert, Allison M / Westover, Lee Ann / Miller, Richard C. ·1 Columbia University Medical Center, New York, NY, USA. · 2 Integrative Restoration Institute, San Rafael, CA, USA. ·OTJR (Thorofare N J) · Pubmed #27760887.

ABSTRACT: Although sleep intervention is within the domain of occupational therapy, few studies exist supporting practice. Effectiveness of three sleep interventions was compared: Dreampad Pillow®, iRest® meditation, and sleep hygiene. Twenty-nine participants were randomly assigned to the Dreampad Pillow® ( n = 10), iRest® meditation ( n = 9), and sleep hygiene ( n = 10) groups. In Phase 1, all participants used a 7-day sleep hygiene regimen to reduce poor sleep habits. In Phase 2 (14 days), 10 participants used the Dreampad Pillow® and sleep hygiene, nine used the iRest meditation and sleep hygiene, and 10 continued sleep hygiene only. At intervention-end, the iRest meditation group experienced statistically greater time asleep than both the Dreampad Pillow® ( p < .006, d = 1.87) and sleep hygiene groups ( p < .03, d = 1.80). The Dreampad Pillow® group experienced statistically fewer nighttime awakenings than the iRest® meditation ( p < .04, d = -1.53) and sleep hygiene ( p < .004, d = -1.43) groups. No differences were found between groups in perceived sleep quality, length of time needed to fall asleep, and fatigue level next day. This study provides support for sleep interventions within occupational therapy's domain.

9 Article Sleep and performance in simulated Navy watch schedules. 2017

Skornyakov, Elena / Shattuck, Nita L / Winser, Michael A / Matsangas, Panagiotis / Sparrow, Amy R / Layton, Matthew E / Gabehart, Rylie J / Van Dongen, Hans P A. ·Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: elenaskorn@gmail.com. · Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA 93943, USA. Electronic address: nlshattu@nps.edu. · Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: mike.winser@wsu.edu. · Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA 93943, USA. Electronic address: pmatsang@nps.edu. · Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: amy.sparrow@wsu.edu. · Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: layton@wsu.edu. · Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: rylie.gabehart@wsu.edu. · Sleep and Performance Research Center and Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA 99210-1495, USA. Electronic address: hvd@wsu.edu. ·Accid Anal Prev · Pubmed #26691014.

ABSTRACT: To operate Navy ships 24h per day, watchstanding is needed around the clock, with watch periods reflecting a variety of rotating or fixed shift schedules. The 5/15 watch schedule cycles through watch periods with 5h on, 15h off watch, such that watches occur 4h earlier on the clock each day - that is, the watches rotate backward. The timing of sleep varies over 4-day cycles, and sleep is split on some days to accommodate nighttime watchstanding. The 3/9 watch schedule cycles through watch periods with 3h on, 9h off watch, allowing for consistent sleep timing over days. In some sections of the 3/9 watch schedule, sleep may need to be split to accommodate nighttime watchstanding. In both the 5/15 and 3/9 watch schedules, four watch sections alternate to cover the 24h of the day. Here we compared sleep duration, psychomotor vigilance and subjective sleepiness in simulated sections of the 5/15 and 3/9 watch schedules. Fifteen healthy male subjects spent 6 consecutive days (5 nights) in the laboratory. Sleep opportunities were restricted to an average of 6.5h daily. Actigraphically estimated sleep duration was 5.6h per watch day on average, with no significant difference between watch sections. Sleep duration was not reduced when sleep opportunities were split. Psychomotor vigilance degraded over watch days, and tended to be more variable in the 5/15 than in the 3/9 watch sections. These laboratory-based findings suggest that Navy watch schedules are associated with cumulative sleep loss and a build-up of fatigue across days. The fixed watch periods of the 3/9 watch schedule appear to yield more stable performance than the backward rotating watch periods of the 5/15 watch schedule. Optimal performance may require longer and more consistent daily opportunities for sleep than are typically obtained in Navy operations.

10 Article EFT (Emotional Freedom Techniques) and Resiliency in Veterans at Risk for PTSD: A Randomized Controlled Trial. 2016

Church, Dawson / Sparks, Terry / Clond, Morgan. ·National Institute for Integrative Healthcare, 3340 Fulton Rd, #442, Fulton, CA 95439. Electronic address: dawsonchurch@gmail.com. · Oklahoma City VA Health Care System, Oklahoma City, OK. · School of Medicine, Ben Gurion University, Beer-Sheva, Israel. ·Explore (NY) · Pubmed #27543343.

ABSTRACT: Prior research indicates elevated but subclinical posttraumatic stress disorder (PTSD) symptoms as a risk factor for a later diagnosis of PTSD. This study examined the progression of symptoms in 21 subclinical veterans. Participants were randomized into a treatment as usual (TAU) wait-list group and an experimental group, which received TAU plus six sessions of clinical emotional freedom techniques (EFT). Symptoms were assessed using the PCL-M (Posttraumatic Checklist-Military) on which a score of 35 or higher indicates increased risk for PTSD. The mean pretreatment score of participants was 39 ± 8.7, with no significant difference between groups. No change was found in the TAU group during the wait period. Afterward, the TAU group received an identical clinical EFT protocol. Posttreatment groups were combined for analysis. Scores declined to a mean of 25 (-64%, P < .0001). Participants maintained their gains, with mean three-month and six-month follow-up PCL-M scores of 27 (P < .0001). Similar reductions were noted in the depth and breadth of psychological conditions such as anxiety. A Cohen's d = 1.99 indicates a large treatment effect. Reductions in traumatic brain injury symptoms (P = .045) and insomnia (P = .004) were also noted. Symptom improvements were similar to those assessed in studies of PTSD-positive veterans. EFT may thus be protective against an increase in symptoms and a later PTSD diagnosis. As a simple and quickly learned self-help method, EFT may be a clinically useful element of a resiliency program for veterans and active-duty warriors.

11 Article Role of community pharmacists in the detection of potentially inappropriate benzodiazepines prescriptions for insomnia. 2015

Urru, Silvana Anna Maria / Pasina, Luca / Minghetti, Paola / Giua, Corrado. ·Biomedicine Sector, CRS4 Science and Technology Park Polaris, Piscina Manna, 09010, Pula, CA, Italy. silvanaurru@crs4.it. · IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. · Department of Pharmaceutical Sciences, Università degli Studi di Milano, Milan, Italy. · Dipartimento Scienze della Vita, Università degli Studi di Trieste, Trieste, Italy. ·Int J Clin Pharm · Pubmed #26198541.

ABSTRACT: BACKGROUND: The appropriate management of chronic insomnia is crucial and prescribing of hypnotic drugs is common. Regular and prolonged use of hypnotics should be avoided because of the risk of tolerance to effects, dependence and an increased risk of adverse events. In 2012, updated Beers criteria for potentially inappropriate medication in older adults suggested to avoid all benzodiazepines in older adults to treat insomnia. In addition, successful discontinuation may result in improvements on cognitive and psychomotor function, particularly in older people. OBJECTIVE: To investigate the appropriateness of benzodiazepines prescription for insomnia and explore the role that community pharmacists can have in identifying signals of potential inappropriate drug prescriptions. SETTING: Community pharmacies in Italy. METHOD: This is an observational study conducted in 8 community pharmacies. Each pharmacist was asked to interview a sample of patients with the prescriptions of at least one benzodiazepine and to complete a minimum data set collecting information about socio-demographic characteristics, drug indication, duration of drug prescription, number of hypnotic-drugs, previous attempt to drug-discontinuation, preference of patients about benzodiazepine withdrawal and modality of drug tapering. Main outcome measure Indications, treatment duration, dosage and drug discontinuation attempts and modalities. RESULTS: A total of 181 participants were interviewed. About half of respondents (n = 81) reported to be treated for insomnia and 62 % were elderly (mean age 68, range 27-93). Fifty-two patients (64 %) were on long term treatment (>3 years) while for thirteen patients (16 %) duration of treatment was comprised between 1 and 3 years. Thirty-three patients were in favour of benzodiazepine-discontinuation but in all cases discontinuation was unsuccessful. CONCLUSION: Use of community pharmacy survey data allowed us to obtain information about incorrect management of insomnia and inappropriate benzodiazepines prescriptions. Stricter adherence to evidence-based guidelines is essential for a rational use of hypnotic and sedatives.

12 Article Memory for therapy in bipolar disorder and comorbid insomnia. 2015

Lee, Jason Y / Harvey, Allison G. ·Department of Psychology, University of California. ·J Consult Clin Psychol · Pubmed #25222800.

ABSTRACT: OBJECTIVE: To examine the extent to which patients recall the contents of therapy from 1 session to the next and to determine whether recall is associated with treatment outcome. METHOD: Thirty interepisode individuals with bipolar disorder and comorbid insomnia (ages 21-62 years, 56.7% women, 56.7% Caucasian) participated in a randomized controlled trial of psychotherapies. Patients received either cognitive behavior therapy for insomnia (CBTI-BP; n = 17) or psychoeducation (PE; n = 13). At the beginning of each weekly session, patients freely recalled as many therapy points (i.e., distinct ideas, principles, and experiences) as they could from their previous session. After each session, therapists recorded a list of all therapy points delivered. Treatment outcome was measured via the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Patient-Reported Outcome Measurement Info System-Sleep, and Quality of Life-Sleep (QOL-Sleep), administered pre- and posttreatment, and treatment evaluation questions administered posttreatment. RESULTS: Patients recalled 19.6% to 36.9% of therapy points listed by therapists. Raw numbers of therapy points recalled were positively correlated with reductions in ISI scores and gains in QOL-Sleep and with most treatment evaluation questions. Percentages of therapy points recalled were positively correlated with gains in QOL-Sleep but with no other sleep outcome measures or any of the treatment evaluation questions. Patients in CBTI-BP recalled more therapy points than did those in PE but did not differ in the percentages of points recalled. CONCLUSIONS: Memory for therapy is poor. The amount of content recalled is positively associated with treatment outcome. Enhancing memory for therapy might play a key role in improving treatment outcome.

13 Article A randomized, double-blind, placebo-controlled, multicenter, 28-day, polysomnographic study of gabapentin in transient insomnia induced by sleep phase advance. 2014

Furey, Sandy A / Hull, Steven G / Leibowitz, Mark T / Jayawardena, Shyamalie / Roth, Thomas. ·Pfizer Consumer Healthcare, Pfizer Inc, Madison, NJ. · Vince and Associates Clinical Research, Overland Park, KS. · California Clinical Trials, Glendale, CA. · Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI. ·J Clin Sleep Med · Pubmed #25317091.

ABSTRACT: STUDY OBJECTIVE: To evaluate multiple doses of gabapentin 250 mg on polysomnography (PSG) and participant-reported sleep assessments in a 5-h phase advance insomnia model. METHODS: Adults reporting occasional disturbed sleep received gabapentin 250 mg (n = 128) or placebo (n = 128). On Days 1 and 28, participants received medication 30 min before bedtime and were in bed from 17:00 to 01:00, ∼5 h before their habitual bedtime. Sleep was assessed by PSG, a post sleep questionnaire, and the Karolinska Sleep Diary. Next-day residual effects and tolerability were evaluated. On Days 2-27, participants took medication at home 30 min before their habitual bedtime. RESULTS: Treatment-group demographics were comparable. Gabapentin resulted in significantly less PSG wake after sleep onset (WASO) compared with placebo on Day 1 (primary endpoint, mean: 107.0 versus 149.1 min, p ≤ 0.001) and Day 28 (113.6 versus 152.3 min, p = 0.002), and significantly greater total sleep time (TST; Day 1: 347.6 versus 283.9 min; Day 28: 335.3 versus 289.1 min) (p ≤ 0.001). Participant-reported WASO and TST also showed significant treatment effects on both days. Gabapentin was associated with less %stage1 on Day 1, and greater %REM on Day 28, versus placebo. During home use, gabapentin resulted in significantly less participant-reported WASO and higher ratings of sleep quality. Gabapentin was well tolerated (most common adverse events: headache, somnolence) with no evidence of next-day impairment. CONCLUSION: Gabapentin 250 mg resulted in greater PSG and participant-reported sleep duration following a 5-h phase advance on Day 1 and Day 28 of use without evidence of next-day impairment, and greater sleep duration during at-home use.

14 Article Comorbid insomnia and obstructive sleep apnea in military personnel: correlation with polysomnographic variables. 2014

Mysliwiec, Vincent / Matsangas, Panagiotis / Baxter, Tristin / McGraw, Leigh / Bothwell, Nici E / Roth, Bernard J. ·Department of Pulmonary, Sleep Medicine, Critical Care, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA 98431. · Operations Research Department, Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA 93943. ·Mil Med · Pubmed #24594464.

ABSTRACT: OBJECTIVES: Military personnel undergoing polysomnography are typically diagnosed only with obstructive sleep apnea (OSA). Comorbid insomnia with OSA is a well-established, underappreciated diagnosis. We sought to determine if military personnel with mild OSA met clinical criteria for insomnia and if there was a pattern of polysomnogram (PSG) variables that identified insomnia in these patients. METHODS: Retrospective chart review of military personnel with mild OSA; cluster analysis to describe PSG variables. RESULTS: 206 personnel assessed, predominately male (96.6%), mean age 36.5 ± 8.14 years, body mass index 30.2 ± 3.66 kg/m(2) and apnea hypopnea index of 8.44 ± 2.92 per hour; 167 (81.1%) met criteria for insomnia. Cluster analysis identified a group of patients (N = 52) with PSG variables of increased wakefulness after sleep onset 77.3 minutes (27.7) (p < 0.001) and decreased sleep efficiency 82.6% (5.82) (p < 0.001) consistent with insomnia. Patients in this group were more likely to meet criteria for insomnia with an odds ratio 5.27 (1.20, 23.1), (p = 0.009). CONCLUSIONS: The majority of military personnel with mild OSA meet criteria for insomnia. Roughly one-third of these patients can be identified by a pattern of PSG variables. Recognizing and treating both comorbid insomnia and OSA could improve clinical outcomes.

15 Article Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. 2014

Dupont, Alexandra / Bower, Julienne E / Stanton, Annette L / Ganz, Patricia A. ·Department of Psychology, University of California. · UCLA School of Medicine. ·Health Psychol · Pubmed #23379385.

ABSTRACT: OBJECTIVE: Behavioral symptoms are common in breast cancer survivors, including disturbances in energy, sleep, and mood, though few risk factors for these negative outcomes have been identified. Our study examined intrusive thoughts as a predictor of lingering symptoms in breast cancer survivors in the year following treatment. METHOD: Data come from the Moving Beyond Cancer psychoeducational intervention trial, aimed at easing the transition from patient to survivor. Women (n = 558) completed psychosocial questionnaires within 4 weeks posttreatment and again 2, 6, and 12 months later. We examined intrusive thoughts about cancer at the baseline assessment as a predictor of fatigue, sleep problems, pain, breast cancer-specific symptoms, depressive symptoms, negative affect, and quality of life using growth curve modeling, controlling for study condition and other covariates. RESULTS: Intrusive thoughts were associated with higher levels of all symptoms at baseline and at the 12-month assessment. Intrusive thoughts also influenced the trajectory of pain, depressive symptoms, negative affect, and physical functioning over time; women with higher intrusions at baseline started worse and improved over time, whereas those with lower intrusions remained at a constant, lower level over time. Intrusions were not associated with the trajectory of fatigue, sleep, breast cancer-specific symptoms, or mental functioning; women with higher intrusions at baseline started worse and remained worse over time. CONCLUSION: Intrusive thoughts are associated with enduring elevations in behavioral symptoms and impaired quality of life in the year after breast cancer treatment and may be a risk factor for poor outcomes.

16 Article Psychological trauma symptom improvement in veterans using emotional freedom techniques: a randomized controlled trial. 2013

Church, Dawson / Hawk, Crystal / Brooks, Audrey J / Toukolehto, Olli / Wren, Maria / Dinter, Ingrid / Stein, Phyllis. ·Foundation for Epigenetic Medicine, Santa Rosa, CA, USA. ·J Nerv Ment Dis · Pubmed #23364126.

ABSTRACT: This study examined the effect of Emotional Freedom Techniques (EFT), a brief exposure therapy combining cognitive and somatic elements, on posttraumatic stress disorder (PTSD) and psychological distress symptoms in veterans receiving mental health services. Veterans meeting the clinical criteria for PTSD were randomized to EFT (n = 30) or standard of care wait list (SOC/WL; n = 29). The EFT intervention consisted of 6-hour-long EFT coaching sessions concurrent with standard care. The SOC/WL and EFT groups were compared before and after the intervention (at 1 month for the SOC/WL group and after six sessions for the EFT group). The EFT subjects had significantly reduced psychological distress (p < 0.0012) and PTSD symptom levels (p < 0.0001) after the test. In addition, 90% of the EFT group no longer met PTSD clinical criteria, compared with 4% in the SOC/WL group. After the wait period, the SOC/WL subjects received EFT. In a within-subjects longitudinal analysis, 60% no longer met the PTSD clinical criteria after three sessions. This increased to 86% after six sessions for the 49 subjects who ultimately received EFT and remained at 86% at 3 months and at 80% at 6 months. The results are consistent with that of other published reports showing EFT's efficacy in treating PTSD and comorbid symptoms and its long-term effects.

17 Article Insomnia risks and costs: health, safety, and quality of life. 2010

Rosekind, Mark R / Gregory, Kevin B. ·Alertness Solutions, Cupertino, CA 95014, USA. bealert@alertsol.com ·Am J Manag Care · Pubmed #20712395.

ABSTRACT: The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace productivity, as well as workplace and public safety. These daytime effects of insomnia are translated into indirect costs that are reportedly higher than the direct costs of this disorder. These observations have significant implications for managed care organizations and healthcare providers. Improvements in diagnosing and treating insomnia can significantly reduce the healthcare cost of insomnia and its comorbid disorders, while providing additional economic benefits from improved daytime functioning and from increased productivity.

18 Article Disrupted sleep in breast and prostate cancer patients undergoing radiation therapy: the role of coping processes. 2010

Thomas, Kamala S / Bower, Julienne / Hoyt, Michael A / Sepah, Saviz. ·Department of Psychology, Pitzer College, Claremont, CA 91711, USA. kamala_thomas@pitzer.edu ·Psychooncology · Pubmed #19885853.

ABSTRACT: BACKGROUND: Sleep problems are a common complaint in cancer patients that have been understudied. METHODS: This study examined changes in sleep in 33 breast cancer (BC) patients and 23 prostate cancer (PC) patients during radiation therapy and over a 6-month followup. Coping processes were examined as predictors of sleep. Self-reported sleep was assessed at eight time-points before, during, and after treatment using the Medical Outcomes Study-Sleep Scale. The COPE Scale was used to assess coping processes before treatment onset. RESULTS: Mixed effects linear modeling analyses revealed that both BC and PC patients reported the most sleep problems prior to and during the early weeks of treatment. Coping strategies predicted sleep trajectories in both groups. In particular, approach coping predicted better sleep in PC patients, whereas avoidance coping predicted worst sleep in both PC and BC patients (p's<0.05). CONCLUSION: These findings highlight the importance of evaluating sleep in patients as they undergo treatment for cancer. Additionally, they suggest that interventions aimed at increasing the use of approach-oriented coping strategies may improve sleep and quality of life in these patients.