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Primary insomnia

Karim Yahia Jaffer, Tiffany Chang, Brigitte Vanle, Jonathan Dang, Alexander J Steiner, Natalie Loera, Marina Abdelmesseh, Itai Danovitch, Waguih William Ishak
OBJECTIVE: While trazodone is approved for the treatment of depression, the off-label use of this medication for insomnia has surpassed its usage as an antidepressant. In this systematic review, we examined the evidence for the efficacy and safety of trazodone for insomnia. METHODS: A literature search was conducted using MEDLINE/PubMed databases from the past 33 years (1983-2016) and the keywords insomnia, trazodone, sedative, treatment, and hypnotics. The results were restricted to English language and human subjects...
July 2017: Innovations in Clinical Neuroscience
Adel Abdel-Moneim, Alaa Aboud, Mohamed Abdel-Gabbar, Mohamed Zanaty, Mohamed Ramadan
BACKGROUND: The current standard of care for patients with chronic hepatitis C virus (HCV) infection is a combination of direct-acting antiviral agents (DAAs). However, rare clinical trials have been reported on the combination regimen of sofosbuvir (SOF) with ombitasvir, paritaprevir, and ritonavir (OBV/PTV/r) plus ribavirin (RBV) for treated patients with HCV genotype 4 (GT4) infection. AIMS: To clarify the retreatment efficacy and safety of the recent regimen, SOF with OBV/PTV/r + RBV, for chronic HCV GT4-experienced patients who failed treatment with DAA-based regimens...
March 15, 2018: Digestive Diseases and Sciences
Francesco Plotti, Corrado Terranova, Stella Capriglione, Stefania Crispino, Alessandra Li Pomi, Carlo de Cicco Nardone, Roberto Montera, Pierluigi Benedetti Panici, Roberto Angioli, Giuseppe Scaletta
AIMS: The aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III. METHODS: All patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up...
March 14, 2018: International Journal of Gynecological Cancer
Judette M Louis, Matthew A Koch, Uma M Reddy, Robert M Silver, Corette B Parker, Francesca L Facco, Susan Redline, Chia-Ling Nhan-Chang, Judith H Chung, Grace W Pien, Robert C Basner, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Benjamin Carper, George R Saade, Frank P Schubert, Phyllis C Zee
BACKGROUND: Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors. OBJECTIVES: The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy. STUDY DESIGN: Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders...
February 2, 2018: American Journal of Obstetrics and Gynecology
Shannon Stark Taylor, Jaime M Hughes, Cynthia J Coffman, Amy S Jeffreys, Christi S Ulmer, Eugene Z Oddone, Hayden B Bosworth, William S Yancy, Kelli D Allen
BACKGROUND: Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans with OA. Secondary objectives were to assess proportions of individuals with insomnia and OSA symptoms who may have been undiagnosed and to examine Veterans' characteristics associated with insomnia and OSA symptoms. METHODS: Veterans (n = 300) enrolled in a clinical trial completed the Insomnia Severity Index (ISI) and the Berlin Questionnaire (BQ) at baseline; proportions of participants with symptoms consistent with insomnia and OSA were calculated, using standard cut-offs for ISI and BQ...
March 9, 2018: BMC Musculoskeletal Disorders
Suzanne M Bertisch, Benjamin D Pollock, Murray A Mittleman, Daniel J Buysse, Lydia A Bazzano, Daniel J Gottlieb, Susan Redline
Study Objectives: To quantify the association between insomnia/poor sleep with objective short sleep and incident cardiovascular disease (CVD) and mortality in the general population. Methods: We conducted a time-to-event analysis of Sleep Heart Health Study data. Questionnaires and at-home polysomnography were performed between 1994 -1998. Participants were followed for a median 11.4 years (Q1-Q3, 8.8-12.4 years) until death or last contact. The primary exposure was insomnia or poor sleep with short sleep defined as: difficulty falling asleep, difficulty returning to sleep, early morning awakenings, or sleeping pill use, 16-30 nights/month; and total sleep <6 hours on polysomnography (PSG)...
March 7, 2018: Sleep
Xiaofen Ma, Guihua Jiang, Shishun Fu, Jin Fang, Yunfan Wu, Mengchen Liu, Guang Xu, Tianyue Wang
Accumulating evidence from neuroimaging studies suggests that primary insomnia (PI) affects interregional neural coordination of multiple interacting functional brain networks. However, a complete understanding of the whole-brain network organization from a system-level perspective in PI is still lacking. To this end, we investigated in topological organization changes in brain functional networks in PI. 36 PI patients and 38 age-, sex-, and education-matched healthy controls were recruited. All participants underwent a series of neuropsychological assessments and resting-state functional magnetic resonance imaging scans...
2018: Frontiers in Psychiatry
Yuchi Wu, Lihong Yang, Lingli Li, Xiuqing Wu, Zhicong Zhong, Zhiren He, Hongyan Ma, Lixin Wang, Zhaoyu Lu, Cun Cai, Daixin Zhao, Xiangxin Meng, Airong Qi, Aicheng Yang, Guobin Su, Xinfeng Guo, Xusheng Liu, Chuan Zou, Qizhan Lin
BACKGROUND: Patients on maintenance hemodialysis (MHD) frequently complain of insomnia. Poor sleep quality impairs their quality of life and adversely affects long-term outcome. Previously we applied auricular acupressure therapy (AAT) for MHD patients with insomnia and yielded favorable results. AAT probably improves sleep quality by stimulating the vagus nerve and inhibiting sympathetic overactivity. However, the efficacy of AAT for insomnia in this population is still lacking. The proposed randomized controlled trial (RCT) will evaluate the efficacy and safety of AAT for improvement of sleep quality in MHD patients with insomnia...
March 7, 2018: Trials
James A Simon, Leonard Derogatis, David Portman, Louise Brown, James Yuan, Robert Kissling
BACKGROUND: To evaluate the safety of flibanserin in premenopausal and naturally postmenopausal women with hypoactive sexual desire disorder (HSDD) in an open-label extension (OLE) study. AIM: To examine the safety and tolerability of flibanserin 100 mg once daily at bedtime in the treatment of premenopausal and naturally postmenopausal women with HSDD in a multicenter 28-week OLE study. METHODS: Patients entering this study received flibanserin or placebo in the double-blinded, placebo-controlled trials of premenopausal and postmenopausal women and in a pharmacokinetic study of postmenopausal women...
March 2018: Journal of Sexual Medicine
Qi-Hui Zhou, Xiao-Li Zhou, Meng-Bei Xu, Ting-Yu Jin, Pei-Qing Rong, Guo-Qing Zheng, Yan Lin
Insomnia disorder is a widespread and refractory disease. Semen Ziziphi Spinosae , Suanzaoren, a well-known Chinese herbal medicine, has been used for treating insomnia for thousands of years. Here, we aimed to assess the available evidence of Chinese herbal formulae that contains Suanzaoren (FSZR) for insomnia according to high-quality randomized controlled trials (RCTs) and reviewed their possible mechanisms based on animal-based studies. Electronic searches were performed in eight databases from inception to November 2016...
2018: Frontiers in Pharmacology
Tania Contreras, Gonzalo Bravo-Soto, Gabriel Rada
INTRODUCTION: It has been suggested that cannabinoids would constitute a therapeutic alternative for patients with insomnia. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
February 13, 2018: Medwave
Mari Campbell, Alex Clarke, Andrew Symes, Sarita Workman, Hans Stauss, A David Webster
PURPOSE: Patients with primary antibody deficiency report poorer quality of life and higher rates of anxiety and depression than the general population. Cognitive-behavioral therapy has been shown to be a valuable treatment for patients with other long-term physical health conditions, improving well-being and enabling them to manage their symptoms more effectively. The aim of this project was to establish the feasibility and effectiveness of providing cognitive-behavioral based therapy to patients with primary antibody deficiency...
February 17, 2018: Journal of Clinical Immunology
Kirstie N Anderson
Hippocrates recognized the importance of asking about sleep as long ago as 400 BC when he wrote " sleep and watchfulness, both of them when immoderate, constitute disease ". Disrupted sleep for any reason has immediate and long term consequences on physical and mental health. Insomnia disorder ("immoderate watchfulness") remains the commonest sleep disorder in primary and secondary care with an estimated 5-10% of the adult population affected. While it is commonly comorbid with other physical and mental health problems, the new diagnostic classification has been helpfully simplified such that it is considered a disorder in itself...
January 2018: Journal of Thoracic Disease
Rajesh R Tampi, Geetha Manikkara, Silpa Balachandran, Piyush Taparia, Stephanie Hrisko, Shilpa Srinivasan, Deena J Tampi
The aim of this review was to identify published randomized control trials (RCTs) that evaluated the efficacy and tolerability of suvorexant for the treatment of insomnia among older adults (≥65 years). A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO and Cochrane collaboration databases for RCTs in any language evaluating suvorexant for the treatment of insomnia in older adults. Additionally, references of full-text articles that were included in this review were searched for further studies...
2018: Drugs in Context
J Maarrawi, J Abdel Hay, S Kobaiter-Maarrawi, P Tabet, R Peyron, L Garcia-Larrea
BACKGROUND: Amitriptyline has well-established efficacy in several chronic pain conditions. While optimal treatment for chronic neck pain (CNP) remains controversial, amitriptyline was not tested for CNP. We evaluated the effect of bedtime amitriptyline in the management of CNP. METHODS: 220 patients suffering from idiopathic CNP were randomized to receive either placebo pill (n = 108) or 5 mg of amitriptyline (n = 112) at bedtime for two months. Primary outcome measure was visual analog scale (VAS) for pain...
February 13, 2018: European Journal of Pain: EJP
Li Feng, Dingbang Chen, Hongyan Zhou, Cunzhou Shen, Haiyan Wang, Xunsha Sun, Xiulin Liang, Ling Chen
Primary central nervous system lymphoma (PCNSL) is a very rare tumor of increasing incidence. It is often misdiagnosed due to the unspecific presentation or unavailable biopsy, and results in poor prognosis. PCNSL involved the spinal cord is extremely sparse. Here we report a gentleman presented with one-year history of progressive tremor in the left limbs and slight dysarthria as well as three-month history of paraparesis, tinnitus and insomnia. MR images disclosed the swollen cerebellum and cauda equine, with contrast enhancement in both meninges and nerve roots...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Deldar Morad Abdulah, Rasoul Sabri Piro
BACKGROUND: College students experience various types of sleep disorders that impact daily functioning. Previous studies have focused on the effect of one sleep disorder. OBJECTIVE: Examine factors that might relate to several sleep disorders and the impacts of sleep disorders on the daily functioning in medical students. DESIGN: Cross-sectional study. SETTING: Medical college. SUBJECTS AND METHODS: A random sample of medical students from a public university was invited to participate in a cross-sectional study using the structured SLEEP-50 self-reported questionnaire...
January 2018: Annals of Saudi Medicine
Chao-Ming Hung, Ying-Chun Li, Han-Jung Chen, Kang Lu, Cheng-Loong Liang, Po-Chou Liliang, Yu-Duan Tsai, Kuo-Wei Wang
BACKGROUND: To investigate the association between primary insomnia and dementia using a Taiwanese population-based database. METHODS: This case-control study involved a subset of Taiwan's National Health Insurance Research Database of reimbursement claims. We included 51,734 patients who were diagnosed with primary insomnia from 2002 to 2004 as the test group and 258,715 nonprimary insomnia participants aged 20 years or older as the reference group. We excluded patients under 20 and those with depression, post-traumatic stress disorder, and/or sleep disorders caused by organic lesion(s), drugs, or alcohol...
February 7, 2018: BMC Psychiatry
Andy Forbes, Mary Hobart, John Ouyang, Lily Shi, Stephanie Pfister, Mika Hakala
Background: Brexpiprazole is a serotonin-dopamine activity modulator with efficacy in acute schizophrenia and relapse prevention. The aim of this Phase 3, multicenter study was to assess the long-term safety, tolerability, and efficacy of treatment with brexpiprazole flexible-dose 1-4 mg/day. Methods: Patients rolled over into this 52-week open-label study (amended to 26 weeks towards the end) from three randomized, double-blind, placebo-controlled Phase 3 studies...
February 3, 2018: International Journal of Neuropsychopharmacology
Robin E Cushing, Kathryn L Braun, Susan W Alden C-Iayt, Alan R Katz
Introduction: Among veterans of post-9/11 conflicts, estimates of post-traumatic stress disorder (PTSD) range from 9% shortly after returning from deployment to 31% a year after deployment. Clinical and pharmaceutically based treatments are underutilized. This could be due to concerns related to lost duty days, as well as PTSD patients' fears of stigma of having a mental health condition. Yoga has been shown to reduce PTSD symptoms in the civilian population, but few studies have tested the impact of yoga on veterans of post-9/11 conflicts...
February 5, 2018: Military Medicine
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