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paradoxical insomnia

Leeba Rezaie, Aaron D Fobian, William Vaughn McCall, Habibolah Khazaie
Paradoxical insomnia is characterized by discrepancy between subjective and objective assessments of sleep and is challenging to diagnosis and treat. Typically, polysomnographic (PSG) findings show significantly longer total sleep time than patients' report of sleep, and the difference between subjective and PSG sleep is greater than that seen in other insomnia subtypes. Subjective-objective sleep discrepancy may also present in different clinical pictures, as marked discrepancies between patients' perception of sleep and objective findings are common in a variety of medical, sleep and psychiatric disorders...
January 6, 2018: Sleep Medicine Reviews
Jingping Liao, Shichao Zhu, Xiaolin Li
Purpose: To compare anxiety and depression among patients with paradoxical insomnia (Para-I), patients with psychophysiological insomnia (Psy-I), and normal sleepers (NS). Patients and methods: A cross-sectional case-control study was conducted in patients with Para-I (n=63), patients with Psy-I (n=63), and NS (n=63) from southwest China. The three groups were matched for age (mean age: 42.0±10.30 years), gender (per group: male =22; female =41), educational level, and nature of occupation...
2018: Neuropsychiatric Disease and Treatment
Erin E Flynn-Evans, Julia A Shekleton, Belinda Miller, Lawrence J Epstein, Douglas Kirsch, Lauren A Brogna, Liza M Burke, Erin Bremer, Jade M Murray, Philip Gehrman, Shantha M W Rajaratnam, Steven W Lockley
Objectives: We aimed to identify the prevalence of circadian phase and phase angle abnormalities in patients with insomnia. Methods: We conducted a cross-sectional, multicenter study at three sleep laboratories in the United States and Australia. Patients with insomnia and healthy control participants completed a sleep log for seven days. Circadian phase was assessed from salivary Dim Light Melatonin Onset (DLMO) time during a 12-hour laboratory visit. Results: Seventy-nine patients meeting the Research Diagnostic Criteria for Primary, Psychophysiological, Paradoxical, and/or Idiopathic Childhood Insomnia (46F, 35...
October 3, 2017: Sleep
Nicole Eichhorn, Rolf-Detlef Treede, Sigrid Schuh-Hofer
Sex matters both in the clinical field of pain and sleep medicine. Sleep disturbances are highly prevalent in chronic pain patients and have been shown to deteriorate the pain condition. The pathomechanisms by which insomnia aggravates pain are currently unknown. Descending pain control may be compromised by disturbed sleep, but respective studies are few, inconsistent and largely imbalanced with respect to sex. We studied the role of sex on the effect of sleep deprivation on endogenous pain modulation and on nociceptive thresholds in a highly homogenous study population of 18 female (23...
October 1, 2017: Neuroscience
Jingping Liao, Shichao Zhu, Qi Zhang, Dingxi Wang, Xiaolin Li
To compare the personal characteristics between the patients with paradoxical insomnia and the patients with primary insomnia or the normal sleepers.
 Methods: A case-control study with the proportion at 1:1:1 was carried out. The patients with paradoxical insomnia were diagnosed in Sleep Medicine Center of West China Hospital of Sichuan University between March 2013 and December 2013. A case of paradoxical insomnia was matched with two controls: a primary insomnia patient and a normal sleeper. A total of 63 matched cases were collected...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Habibolah Khazaie, Amir Sharafkhaneh, Sepideh Khazaie, Mohammad Rasoul Ghadami
BACKGROUND: With increasing use of atypical antipsychotic (AAP) agents, the concern has been raised about the association between AAP agents and medical complications. Obstructive sleep apnea (OSA) is a common breathing disorder that adversely affects health and quality of life. Because the major risk factors for OSA are weight gain and obesity by altering the upper airway anatomy, an association between AAP and development of OSA is predictable. However, we hypothesized that AAP may promote OSA not only by weight gain but also because of its potential effects on upper airway muscle function...
July 13, 2017: Sleep & Breathing, Schlaf & Atmung
Chunhua Lai, Hongzhong Qiu
No abstract text is available yet for this article.
June 15, 2017: American Family Physician
Kuk-In Jang, Miseon Shim, Sang Min Lee, Hyu Jung Huh, Seung Huh, Ji-Young Joo, Seung-Hwan Lee, Jeong-Ho Chae
AIM: The Sewol ferry capsizing accident on South Korea's southern coast resulted in the death of 304 people, and serious bereavement problems for their families. Electroencephalography (EEG) beta frequency is associated with psychiatric symptoms, such as insomnia. The aim of this study was to investigate the relation between frontal beta power, psychological symptoms, and insomnia in the bereaved families. METHODS: Eighty-four family members of the Sewol ferry victims (32 men and 52 women) were recruited and their EEG was compared with that of 25 (13 men and 12 women) healthy controls...
June 20, 2017: Psychiatry and Clinical Neurosciences
Jacques Dayan, Géraldine Rauchs, Bérengère Guillery-Girard
Post-traumatic stress disorder (PTSD) is a complex syndrome that may occur after exposure to one or more traumatic events. It associates physiological, emotional, and cognitive changes Brain and hormonal modifications contribute to some impairments in learning, memory, and emotion regulation. Some of these biological dysfunctions may be analyzed in terms of rhythms dysregulation that would be expressed through endocrine rhythmicity, sleep organization, and temporal synchrony in brain activity. In the first part of this article, we report studies on endocrine rhythmicity revealing that some rhythms abnormalities are frequently observed, although not constantly, for both cortisol and sympathetic nervous system (SNS) activity...
November 2016: Journal of Physiology, Paris
Ingo Fietze
This article highlights the potential uses that smartphone applications may have for helping those with sleep problems. Applications in smartphones offer the promised possibility of detection of sleep. From the author's own experience, one can also conclude that sleep applications are approximately as good as polysomnography in detection of sleep time, similar to the conventional wearable actimeters. In the future, sleep applications will help to further enhance awareness of sleep health and to distinguish those who actually poorly and only briefly sleep from those who suffer more likely from paradox insomnia...
December 2016: Sleep Medicine Clinics
Adam Abba-Aji, Prajjita Bardoloi
We present a case of a man aged 20 years who was diagnosed with a major depressive disorder and was started on escitalopram and zopiclone. The patient had a significant response to escitalopram except that he developed severe insomnia which dramatically resolved following discontinuation of zopiclone. The patient was recommenced on low dose of zopiclone and unfortunately redeveloped moderate insomnia. The patient was thoroughly investigated and zopiclone was determined to have paradoxically caused the insomnia...
January 19, 2017: BMJ Case Reports
Martin Nicholas Bomalaski, Sean Robinson Smith
Patients with disorders of consciousness (DOC) have profound functional limitations with few treatment options for improving arousal and quality of life. Zolpidem is a nonbenzodiazepine hypnotic used to treat insomnia that has also been observed to paradoxically improve arousal in those with DOC, such as the vegetative or minimally conscious states. Little information exists on its use in patients with DOC who have intracranial space-occupying lesions. We present a case of a 24-year-old man in a minimally conscious state due to central nervous system lymphoma who was observed to have increased arousal and improved motor function after the administration of zolpidem...
August 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Thomas E Joiner, Ian H Stanley
When perceiving a dangerous predation threat, mammalian and other species activate antipredator defensive reactions. These include the seemingly paradoxical-but compatible-activation of overarousal (e.g., agitation, insomnia) and "shutdown" (e.g., mutism, withdrawal) states. Acute suicidal crises, too, are characterized by the co-occurrence of overarousal and shutdown behaviors. In the minutes, hours, and days prior to one's death by suicide, it is not uncommon for one to be simultaneously agitated and socially withdrawn, states that resemble antipredator defensive reactions...
2016: Psychiatry
Marie-Pier Normand, Patrick St-Hilaire, Célyne H Bastien
Cortical hyperarousal is higher in insomnia sufferers (INS) than in good sleepers (GS) and could be related to an alteration in sleep protection mechanisms, like reduced density or altered characteristics in sleep spindles. The deficient sleep protection mechanisms might in turn enhance underestimation of sleep. This study's objective was to document sleep spindles characteristics in INS compared with GS and to investigate their potential role in sleep consolidation and misperception. Seventeen individuals with paradoxical insomnia (PARA-I), 24 individuals with psychophysiological insomnia (PSY-I), and 29 GS completed four consecutive polysomnographic nights in laboratory...
2016: Neural Plasticity
David T Plante, Laurel A Finn, Erika W Hagen, Emmanuel Mignot, Paul E Peppard
STUDY OBJECTIVES: To examine associations of depression with habitual sleep duration, daytime sleepiness, and objective sleep propensity in a nonclinical population. METHODS: Data from adults participating in the Wisconsin Sleep Cohort Study were utilized in analyses. There were 1,287 adults (3,324 observations) who were used in the analysis of subjective hypersomnolence measures; 1,155 adults (2,981 observations) were used in the analysis of objective sleep propensity assessed by the multiple sleep latency test (MSLT)...
April 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
David L Maness, Muneeza Khan
Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are difficulty falling asleep, difficulty staying asleep, or early awakening despite the opportunity for sleep; symptoms must be associated with impaired daytime functioning and occur at least three times per week for at least one month...
December 15, 2015: American Family Physician
Jade Q Wu, Erica R Appleman, Robert D Salazar, Jason C Ong
IMPORTANCE: Cognitive behavioral therapy for insomnia (CBT-I) is the most prominent nonpharmacologic treatment for insomnia disorders. Although meta-analyses have examined primary insomnia, less is known about the comparative efficacy of CBT-I on comorbid insomnia. OBJECTIVE: To examine the efficacy of CBT-I for insomnia comorbid with psychiatric and/or medical conditions for (1) remission from insomnia; (2) self-reported sleep efficiency, sleep onset latency, wake after sleep onset, total sleep time, and subjective sleep quality; and (3) comorbid symptoms...
September 2015: JAMA Internal Medicine
Alexandra D Pérusse, Maude Pedneault-Drolet, Christine Rancourt, Isabelle Turcotte, Geneviève St-Jean, Célyne H Bastien
STUDY OBJECTIVES: The objective was to study REM sleep macrostructure and microstructure as potential indicators of hyperarousal in insomnia by comparing good sleepers (GS) and insomnia sufferers (INS) (subdivided into psychophysiological "PSY-I" and paradoxical "PARA-I"). DESIGN: Cross-sectional comparisons of GS, PSY-I and PARA-I. SETTING: Participants slept for 4 consecutive nights in the laboratory where PSG was recorded. Nights 2 and 3 were combined to compare REM sleep between groups...
March 2015: International Journal of Psychophysiology
Mohammad Rasoul Ghadami, Behnam Khaledi-Paveh, Marzieh Nasouri, Habibolah Khazaie
BACKGROUND: Sleep disturbance is a common self-reported complaint by PTSD patients. However, there are controversies in documenting objective indices of disrupted sleep in these patients. The aim of the present study was to assess sleep disturbances in veterans with chronic PTSD, using both subjective and objective assessments. METHODS: Thirty two PTSD patients with complaints of insomnia were evaluated using the Clinician Administrated PTSD Scale version 1 (CAPS) and completed the Pittsburg Sleep Quality Index (PSQI) for subjective evaluation of their sleep...
July 2015: Journal of Injury & Violence Research
Anthony L Gotter, Susan L Garson, Joanne Stevens, Regina L Munden, Steven V Fox, Pamela L Tannenbaum, Lihang Yao, Scott D Kuduk, Terrence McDonald, Jason M Uslaner, Spencer J Tye, Paul J Coleman, Christopher J Winrow, John J Renger
BACKGROUND: The current standard of care for insomnia includes gamma-aminobutyric acid receptor A (GABAA) activators, which promote sleep as well as general central nervous system depression. Dual orexin receptor antagonists (DORAs) represent an alternative mechanism for insomnia treatment that induces somnolence by blocking the wake-promoting effects of orexin neuropeptides. The current study compares the role and interdependence of these two mechanisms on their ability to influence sleep architecture and quantitative electroencephalography (qEEG) spectral profiles across preclinical species...
2014: BMC Neuroscience
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