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paradoxical insomnia

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...
February 1, 2017: 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 states due to central nervous system lymphoma who was observed to have increased arousal and improved motor function after the administration of zolpidem...
January 16, 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
C H Bastien, T Ceklic, P St-Hilaire, F Desmarais, A D Pérusse, J Lefrançois, M Pedneault-Drolet
Sleep misperception is often observed in insomnia individuals (INS). The extent of misperception varies between different types of INS. The following paper comprised sections which will be aimed at studying the sleep EEG and compares it to subjective reports of sleep in individuals suffering from either psychophysiological insomnia or paradoxical insomnia and good sleeper controls. The EEG can be studied without any intervention (thus using the raw data) via either PSG or fine quantitative EEG analyses (power spectral analysis [PSA]), identifying EEG patterns as in the case of cyclic alternating patterns (CAPs) or by decorticating the EEG while scoring the different transient or phasic events (K-Complexes or sleep spindles)...
October 2014: Pathologie-biologie
Erkki Kronholm, Juha Markkula, Lauri J Virta
UNLABELLED: In Finland, between 2003 and 2010 and parallel to the increase in the prevalence of insomnia-related symptoms among the general population, there has been a cessation of growth and even a decrease in the consumption of traditional hypnotics. The reasons behind this seemingly paradoxical situation are not known. We analyzed trends over the period 2000-2010 in the estimated consumption of traditional hypnotics and some new drugs that are destined for use in insomnia treatment...
June 15, 2012: Journal of Public Health Research
V Bayon, D Léger
The presence of insomnia in patients with sleep apnea seems paradoxical as excessive sleepiness is one of the major symptoms of sleep apnea. However, recent research has shown that about half of patients with sleep disorder breathing experience insomnia. Moreover, patients complaining of insomnia or non-restorative sleep may also present with moderate to severe sleep apnea syndromes. Thus, in recent years, clinicians have become more aware of the possible association between insomnia and sleep apnea. This article reviews data published on different aspects of this co-occurrence...
February 2014: Revue des Maladies Respiratoires
Julia A Shekleton, Erin E Flynn-Evans, Belinda Miller, Lawrence J Epstein, Douglas Kirsch, Lauren A Brogna, Liza M Burke, Erin Bremer, Jade M Murray, Philip Gehrman, Steven W Lockley, Shantha M W Rajaratnam
STUDY OBJECTIVES: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. DESIGN: Cross-sectional, multicenter study. SETTING: Three sleep laboratories in the USA and Australia. PATIENTS: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35...
January 2014: Sleep
Alexandra D Pérusse, Isabelle Turcotte, Geneviève St-Jean, Jason Ellis, Carol Hudon, Célyne H Bastien
STUDY OBJECTIVES: The objective of this study was to identify if hyperarousal is a 24-hour phenomenon in insomnia by comparing sleep during napping between good sleepers (GS) and Insomnia sufferers (INS) (subdivided into paradoxical "PARA-I" and psychophysiological "PSY-I") following a mentally challenging battery of cognitive tests. 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...
December 15, 2013: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Lijun Hou, Xi Han, Ping Sheng, Wusong Tong, Zhiqiang Li, Dayuan Xu, Mingkun Yu, Liuqing Huang, Zhongxin Zhao, Yicheng Lu, Yan Dong
BACKGROUND: Sleep disturbance is very common following traumatic brain injury (TBI), which may initiate or exacerbate a variety of co-morbidities and negatively impact rehabilitative treatments. To date, there are paradoxical reports regarding the associations between inherent characteristics of TBI and sleep disturbance in TBI population. The current study was designed to explore the relationship between the presence of sleep disturbance and characteristics of TBI and identify the factors which are closely related to the presence of sleep disturbance in TBI population...
2013: PloS One
Francesca Pistoia, Marco Sarà, Simona Sacco, Marco Franceschini, Antonio Carolei
Cases of recovery from vegetative and minimally conscious state after the administration of various pharmacological agents have been recently reported. These agents include CNS depressants (zolpidem, baclofen, lamotrigine) and CNS stimulants (tricyclic antidepressants, selective serotonin reuptake inhibitors, dopaminergic agents, methylphenidate). The action of CNS depressants as awakening agents sounds paradoxical, as they are commonly prescribed to slow down brain activity in the management of anxiety, muscle tension, pain, insomnia and seizures...
2014: Current Pharmaceutical Design
Eugene Grudnikoff, Carmel Foley, Claudette Poole, Eva Theodosiadis
OBJECTIVE: Behavioral and psychiatric disorders are common in youth with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD). We outline a rational approach to psychiatric treatment of a patient with a complex medical condition. METHODS: We report the course of symptoms in a teen with ROHHAD, the inpatient treatment, and review current evidence for use of psychopharmacologic agents in youth with sleep and anxiety disturbances...
August 2013: Journal of the Canadian Academy of Child and Adolescent Psychiatry
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