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benzodiazepines and sleep

Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Anne Lingford-Hughes, Yash Patel, Owen Bowden-Jones, Mike J Crawford, Paul I Dargan, Fabiana Gordon, Steve Parrott, Tim Weaver, David M Wood
BACKGROUND: GHB (gamma-hydroxybutyrate) and its pro-drugs GBL (gamma-butyrolactone) and 1,4-butanediol (1,4-BD) are central nervous system depressants whose street names include 'G' and 'liquid ecstasy'. They are used recreationally predominately for their stimulant and pro-sexual effects or for sedation to help with sleep and/or to 'come down' after using stimulant recreational drugs. Although overall population prevalence is low (0.1 %), in some groups such as men who have sex with men, GHB/GBL use may reach 20 %...
September 27, 2016: Trials
Zarah Jordahn, Cheme Andersen, Anne Marie Roust Aaberg, Frank Christian Pott
We describe the care for an elderly woman who was admitted to the intensive care unit (ICU) to receive noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease. After administration of the sleeping pill zopiclone, a nonbenzodiazepine receptor agonist (NBRA), the patient became agitated and was confused, a possible paradoxical reaction to benzodiazepines. These symptoms were immediately resolved after treatment with flumazenil, usually used to reverse the adverse effects of benzodiazepines or NBRAs and to reverse paradoxical reactions to benzodiazepines...
2016: Case Reports in Critical Care
Anaïs Bastide, Aloïse de Codt, Pauline Monhonval, Xavier Bongaerts, Juan Martin Tecco
BACKGROUND: Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries. Since BZDs can produce tolerance and dependence even in a short time, their use is recommended for a very limited time. However, these recommendations have been largely disregarded. The chronic use of BZDs causes a number of serious side effects, i.e. cognitive impairment, falls, traffic accidents, dependence and tolerance. METHODS: We present the case of a 37 years old woman taking daily doses of 220 mg of bromazepam...
September 2016: Psychiatria Danubina
O Marom, G Rennert, N Stein, K Landsman, G Pillar
Objectives. To quantify and characterize hypnotics consumption habits among adult patients insured by Clalit Health Services (CHS), the largest health care provider in Israel, in 2000 and 2010. Methods. A retrospective analysis of CHS computerized pharmacy records. Data were collected for all patients over the age of 18 years who were prescribed hypnotics in 2000 and in 2010. Results. Sleep medications were consumed by 8.7% of the adult CHS population in 2000 and by 9.6% in 2010. About one-quarter of consumers were treated for more than 6 months in both years...
2016: Sleep Disorders
Andreea L Seritan, Kyoungmi Kim, Ian Benjamin, Ioana Seritan, Randi J Hagerman
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disease with motor, psychiatric, and cognitive manifestations that occurs in carriers of the fragile X mental retardation 1 (FMR1) gene premutations. This was a retrospective chart review of 196 individuals (127 men and 69 women) with FXTAS. Forty-six (23%) participants were cognitively impaired, of whom 19 (10%) had dementia. Risk factors for dementia were examined (CGG repeat size; alcohol, benzodiazepine, and opioid use; diabetes; hyperlipidemia; hypertension; hypothyroidism; obesity; sleep apnea; surgeries with general anesthesia; depression; family history of dementia)...
September 19, 2016: Journal of Geriatric Psychiatry and Neurology
Fiona Williams, Carl Mahfouz, Andrew Bonney, Russell Pearson, Bastian Seidel, Bridget Dijkmans-Hadley, Rowena Ivers
BACKGROUND: Nocturnal benzodiazepines have a significant negative health impact on the elderly, yet they continue to be used. OBJECTIVE: The aim of this study was to assess elderly patients' use and knowledge of nocturnal benzodiazepines, and their attitudes to cessation. METHODS: Semi-structured telephone interviews were conducted with elderly patients (n = 17) from four general practices in Australia. RESULTS: Our study found that the initiation of benzodiazepine use was often at a time of stress for the patient...
July 2016: Australian Family Physician
Zi-Jun Wang, Jian-Feng Liu
Preclinical Research Insomnia is one of the most common sleep disorders that is characterized by difficulty in sleep initiation, sleep maintenance, and/or poor sleep quality. Treatment for insomnia includes both pharmacological and non-pharmacological interventions. Recently, the development of pharmacological treatment for insomnia has been prompted by the understanding of the molecular neurobiology of sleep-wake regulation. For pharmacological treatment, benzodiazepines that target GABAergic system are the most widely used hypnotics...
September 4, 2016: Drug Development Research
Hyejin Yang, Junsung Woo, Ae Nim Pae, Min Young Um, Nam-Chul Cho, Ki Duk Park, Minseok Yoon, Jiyoung Kim, C Justin Lee, Suengmok Cho
α-Pinene is a major monoterpene of the pine tree essential oils. It has been reported that α-pinene shows anxiolytic and hypnotic effects upon inhaled administration. However, hypnotic effect by oral supplementation and the molecular mechanism of α-pinene have not been determined yet. By combining in vivo sleep behavior, ex vivo electrophysiological recording from brain slices, and in silico molecular modeling, we demonstrate that (-)-α-pinene shows sleep enhancing property through a direct binding to GABAA-benzodiazepine (BZD) receptors by acting as a partial modulator at the BZD binding site...
November 2016: Molecular Pharmacology
Jing Feng, Joseph P Iser, Wei Yang
BACKGROUND: Despite today's heightened concern over opioid overdose, the lack of population-based data examining clinical and contextual factors associated with opioid use represents a knowledge gap with relevance to prevention and treatment interventions. We sought to quantify rates of emergency department (ED) visits and inpatient hospitalizations for harmful opioid effects and their sociodemographic differentials as well as clinical correlates in Southern Nevada, using ED visit and hospital inpatient discharge records from 2011 to 2013...
2016: BMC Health Services Research
Sameer Hassamal, Karen Miotto, Tisha Wang, Andrew J Saxon
BACKGROUND AND OBJECTIVES: Opioids increase the risk for sleep disordered breathing (SDB), but there are few studies examining the prevalence and risk factors for SDB, specifically central sleep apnea (CSA), and obstructive sleep apnea (OSA) in chronic pain patients on opioids as well as methadone maintained patients (MMPs). METHODS: A literature review was conducted in which SDB was confirmed by polysomnography (PSG) in chronic pain patients on opioids as well as patients with a diagnosis of an opioid use disorder or opioid dependence on methadone maintenance treatment (MMT)...
September 2016: American Journal on Addictions
Brian B Koo, Terri Blackwell, Hochang B Lee, Katie L Stone, Elan D Louis, Susan Redline
OBJECTIVE: To investigate an association between restless legs syndrome (RLS) and depression and to what extent sleep disturbance, periodic limb movements during sleep (PLMS), and antidepressant medication mediate this relationship. METHODS: A cross-sectional analysis was conducted of the Osteoporotic Fractures in Older Men Study data in 982 men assessed for RLS (International RLS Study Group scale [IRLSS]) and depression (Geriatric Depression Scale [GDS]), who underwent actigraphy (for sleep latency/efficiency) and polysomnography (for PLMS)...
November 2016: American Journal of Geriatric Psychiatry
Karl Doghramji, William C Jangro
Psychotropic medications such as antidepressants, antipsychotics, stimulants, and benzodiazepines are widely prescribed. Most of these medications are thought to exert their effects through modulation of various monoamines as well as interactions with receptors such as histamine and muscarinic cholinergic receptors. Through these interactions, psychotropics can also have a significant impact on sleep physiology, resulting in both beneficial and adverse effects on sleep.
September 2016: Psychiatric Clinics of North America
Cristina A Reichner
Insomnia and sleep deficiency in pregnancy are very common with most women reporting sleep disturbances during pregnancy. Insomnia and sleep deficiency are also more prevalent as pregnancy progresses, possibly related to pregnancy-related physical symptoms or discomfort. There is increasing evidence indicating that these sleep problems may be associated with adverse maternal and fetal outcomes such as depressive symptoms, increased pain during labor, more Caesarean sections, preterm birth, and low birth weight...
December 2015: Obstetric Medicine
Yusuke Furukawa, Kentaro Tanemura, Katsuhide Igarashi, Maky Ideta-Otsuka, Ken-Ichi Aisaki, Satoshi Kitajima, Masanobu Kitagawa, Jun Kanno
Gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the mammalian central nervous system, is also known to be important for brain development. Therefore, disturbances of GABA receptor (GABA-R) mediated signaling (GABA-R signal) during brain development may influence normal brain maturation and cause late-onset brain malfunctions. In this study, we examined whether the stimulation of the GABA-R signal during brain development induces late-onset adverse effects on the brain in adult male mice...
2016: Frontiers in Neuroscience
Eva Klaskova, Jiri Drabek, Milada Hobzova, Vratislav Smolka, Miroslav Seda, Jiri Hyjanek, Rastislav Slavkovsky, Jana Stranska, Martin Prochazka
BACKGROUND: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder resulting from mutations in the PHOX2B gene located on chromosome 4p12.3, characterized by hypoventilation secondary to missing responses to both hypercapnia and hypoxia. CASE REPORT: Proband. A girl, hospitalised 5 times for respiratory failure from 6 weeks old, presented at 4 years of age severe cyanosis related to pneumonia. Tracheostomy was done, and she was discharged home using a portable positive pressure ventilator during sleep...
August 2, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Lois M Platt, Amy Irene Whitburn, Alexander G Platt-Koch, Ronald L Koch
Overuse of benzodiazepine drugs to treat anxiety, mood, and sleep disorders is a growing problem in clinical practice. GABAergic medications (benzodiazepine drugs in particular) have side effects, drug interactions, and the potential to create tolerance and dependence in users. GABA-enhancing dietary supplements have similar and unique risks. Natural, non-chemical, anxiolytic treatments exist and can be safely recommended to patients. Three such treatments have been the focus of study in the past 20 years: mindfulness, meditation, and yoga...
August 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
Salmaan Kanji, Alexandru Mera, Brian Hutton, Lisa Burry, Erin Rosenberg, Erika MacDonald, Vanessa Luks
OBJECTIVES: Patients often suffer from disturbed sleep in hospital. Poor-quality sleep in hospitalised patients has been associated with significant morbidity and pharmacological sleep aids are often prescribed. The objective of this systematic review is to evaluate the comparative efficacy and safety of pharmacological interventions used for sleep in hospitalised patients. SETTING/PARTICIPANTS: We searched MEDLINE, Embase, the Cochrane database and grey literature for prospective studies that evaluated sleep in hospitalised adults after a pharmacological intervention...
2016: BMJ Open
Jessica L Norman, Sarah L Anderson
Insomnia, a highly prevalent disorder, can be detrimental to patients' overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists...
2016: Nature and Science of Sleep
Laura Combe, Ishaq Abu-Arafeh
This is a retrospective study of all patients presenting to our paediatric unit with status dystonicus (SD) over a period of five years. Anonymous information was collected and a descriptive analysis is made. There were four episodes of SD in three children between 11 and 15 years of age. All children are known to have severe dyskinetic cerebral palsy and presented with an acute or sub-acute deterioration in their symptoms. Symptoms were triggered by infections in three of the four episodes. Early features included frequent and repetitive generalized muscle spasms, poor swallowing, poor sleep, distress and pain...
November 2016: European Journal of Paediatric Neurology: EJPN
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