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Palagini L, Geoffroy PA, Miniati M, Riemann D, Gemignani A, Marazziti D. Insomnia and circadian rhythms dysregulation in people who have attempted suicide: correlations with markers of inflammation and suicidal lethality. World J Biol Psychiatry 2024; 25:408-416. [PMID: 39163256 DOI: 10.1080/15622975.2024.2391456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 08/22/2024]
Abstract
INTRODUCTION Suicide is a widespread problem, with risk factors still a challenge. The aim was to assess correlations among insomnia, circadian rhythm, and inflammatory markers in individuals who attempted suicide. MATERIALS AND METHODS Consecutive patients hospitalised following an attempted suicide, were assessed. Psychiatric diagnosis (DSM-5-TR Criteria), lethality of the suicide attempt (Suicide Intent Scale-SIS), and inflammatory parameters NLR (neutrophil-lymphocyte ratio) PLR (platelet-lymphocyte ratio), and SII (systemic inflammation index/neutrophil-to-platelet ratio on lymphocytes), were computed. Depressive and manic symptoms (Beck Depression Inventory-BDI-II, Young Mania Rating Scale- YMRS), circadian rhythms disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry-BRIAN), insomnia symptoms (Insomnia Severity Index-ISI) were assessed together with socio-demographic, clinical and pharmacological data. RESULTS The final sample included 52 individuals. Patients who experienced insomnia during the preceding two weeks utilised high lethality methods, reported heightened dysregulation of chronobiological rhythms, heightened severity of depression, and elevated levels of inflammatory markers. High lethality was best predicted by insomnia symptoms (OR = 20.1, CI-95% 4.66-87.25, p = 0.001), by disturbances of circadian rhythms (OR = 6.97, CI-95% 1.82-26.66, p = 0.005), and by NLR indices (OR 4.00, CI-95% 1.14-13.99, p = 0.030). CONCLUSIONS Sleep disturbances may be a risk factor for suicidal lethality, along with markers of inflammation. It is plausible that insomnia and circadian sleep dysregulation may contribute to inflammation, thereby promoting suicidal risk.
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Affiliation(s)
- Laura Palagini
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, Hopital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- Université Paris Cité, Inserm, NeuroDiderot, Paris, France
| | - Mario Miniati
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Angelo Gemignani
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
- Department of Neuroscience, Psychology Unit, University of Pisa, Pisa, Italy
| | - Donatella Marazziti
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
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Mlyncekova Z, Hutka P, Visnovcova Z, Ferencova N, Kovacova V, Macejova A, Tonhajzerova I, Ondrejka I. Effects of Vortioxetine on Sleep Architecture of Adolescents with Major Depressive Disorder. Clocks Sleep 2023; 5:627-638. [PMID: 37987393 PMCID: PMC10660849 DOI: 10.3390/clockssleep5040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/22/2023] Open
Abstract
The relationship between depression and insomnia is bidirectional and both conditions need to be treated adequately, especially in a vulnerable neurodevelopmental stage of adolescence. This study aimed to evaluate the effects of antidepressant treatment using vortioxetine (VOR) on the sleep architecture of depressed adolescents by using video-polysomnography (v-PSG), which has not been researched before. The v-PSG was performed on 30 adolescent in-patients (mean age of 15.0 years ± 1.5 SD, 21 girls) treated with VOR (dosage of 10/15/20 mg/day) administered orally once a day, before and after VOR treatment. The evaluated parameters were conventional sleep parameters, sleep fragmentation parameters, and selected spectral power indices. Symptoms of depression and insomnia before and after the treatment period were evaluated using valid and reliable questionnaires (the Children´s Depression Inventory and the Athens Insomnia Scale). Depressed adolescents showed higher REM latency and decreased REM sleep percentage after treatment than before the treatment period (p = 0.005, p = 0.009, respectively). Our study revealed REM suppression (increased REM latency and reduced REM sleep percentage), indicating altered sleep architecture as a potential result of VOR treatment, which seems to be dose-dependent.
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Affiliation(s)
- Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Peter Hutka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
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Valencia Carlo YE, Saracco-Alvarez RA, Valencia Carlo VA, Vázquez Vega D, Natera Rey G, Escamilla Orozco RI. Adverse effects of antipsychotics on sleep in patients with schizophrenia. Systematic review and meta-analysis. Front Psychiatry 2023; 14:1189768. [PMID: 37441144 PMCID: PMC10333591 DOI: 10.3389/fpsyt.2023.1189768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Our objective was to conduct a systematic review and meta-analysis of adverse effects on sleep in patients with schizophrenia receiving antipsychotic treatment. Methods A systematic search was performed in PubMed, Cochrane Central, Embase, Toxline, Ebsco, Virtual Health Library, Web of Science, SpringerLink, and in Database of abstracts of Reviews of Effects of Randomized Clinical Trials to identify eligible studies published from January 1990 to October 2021. The methodological quality of the studies was evaluated using the CONSORT list, and the Cochrane bias tool. Network meta-analysis was performed using the Bayesian random-effects model, with multivariate meta-regression to assess the association of interest. Results 87 randomized clinical trials were identified that met the inclusion criteria, and 70 articles were included in the network meta-analysis. Regarding the methodological quality of the studies, 47 had a low or moderate bias risk. The most common adverse effects on sleep reported in the studies were insomnia, somnolence, and sedation. The results of the network meta-analysis showed that ziprasidone was associated with an increased risk of insomnia (OR, 1.56; 95% credible interval CrI, 1.18-2.06). Several of the included antipsychotics were associated with a significantly increased risk of somnolence; haloperidol (OR, 1.90; 95% CrI, 1.12-3.22), lurasidone (OR, 2.25; 95% CrI, 1.28-3.97) and ziprasidone (OR, 1.79; 95% CrI, 1.06-3.02) had the narrowest confidence intervals. In addition, perphenazine (OR, 5.33; 95% CrI, 1.92-14.83), haloperidol (OR, 2.61; 95% CrI, 1.14-5.99), and risperidone (OR, 2.41; 95% CrI, 1.21-4.80) were associated with an increased risk of sedation compared with placebo, and other antipsychotics did not differ. According to the SUCRAs for insomnia, chlorpromazine was ranked as the lowest risk of insomnia (57%), followed by clozapine (20%), while flupentixol (26 %) and perospirone (22.5%) were associated with a lower risk of somnolence. On the other hand, amisulpride (89.9%) was the safest option to reduce the risk of sedation. Discussion Insomnia, sedation, and somnolence were the most frequent adverse effects on sleep among the different antipsychotics administered. The evidence shows that chlorpromazine, clozapine, flupentixol, perospirone, and amisulpride had favorable safety profiles. In contrast, ziprasidone, perphenazine, haloperidol, and risperidone were the least safe for sleep. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017078052, identifier: PROSPERO 2017 CRD42017078052.
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Affiliation(s)
| | | | | | - Daniela Vázquez Vega
- Health Sciences Program, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Guillermina Natera Rey
- Department of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
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Jeon S, Park JE, Do YH, Santos R, Lee SM, Kim BN, Cheong JH, Kim Y. Atomoxetine and Fluoxetine Activate AMPK-ACC-CPT1 Pathway in Human SH-SY5Y and U-87 MG Cells. Psychiatry Investig 2023; 20:212-219. [PMID: 36990664 PMCID: PMC10064201 DOI: 10.30773/pi.2022.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/04/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Atomoxetine and fluoxetine are psychopharmacologic agents associated with loss of appetite and weight. Adenosine monophosphate-activated protein kinase (AMPK) is the cellular energy sensor that regulate metabolism and energy, being activated by fasting and inhibited by feeding in the hypothalamus. METHODS Human brain cell lines (SH-SY5Y and U-87 MG cells) were used to study the outcome of atomoxetine and fluoxetine treatment in the activity of AMPK-acetyl-CoA carboxylase (ACC)- carnitine palmitoyl transferase 1 (CPT1) pathway and upstream regulation by calcium/calmodulin-dependent kinase kinase β (CaMKKβ) using immunoblotting and CPT1 enzymatic activity measures. RESULTS Phosphorylation of AMPK and ACC increased significantly after atomoxetine and fluoxetine treatment in the first 30-60 minutes of treatment in the two cell lines. Activation of AMPK and inhibition of ACC was associated with an increase by 5-fold of mitochondrial CPT1 activity. Although the neuronal isoform CPT1C could be detected by immunoblotting, activity was not changed by the drug treatments. In addition, the increase in phospho-AMPK and phospho-ACC expression induced by atomoxetine was abolished by treatment with STO-609, a CaMKKβ inhibitor, indicating that AMPK-ACC-CPT1 pathway is activated through CaMKKβ phosphorylation. CONCLUSION These findings indicate that at the cellular level atomoxetine and fluoxetine treatments may activate AMPK-ACC-CPT1 pathways through CaMKKβ in human SH-SY5Y and U-87 MG cells.
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Affiliation(s)
- Songhee Jeon
- Center for Glocal Future Biomedical Scientists at Chonnam National University, Gwangju, Republic of Korea
| | - Jeong-Eun Park
- Department of Otorhinolaryngology Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Young Ho Do
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Renata Santos
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), Laboratory of Dynamics of Neuronal Structure in Health and Disease, Université Paris Cité, Paris, France
| | - Seong Mi Lee
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Cheong
- Institute for New Drug Development, School of Pharmacy, Jeonbuk National University, Jeonju, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
- Institute of Clinical Psychopharmacology, Dongguk University International Hospital, Goyang, Republic of Korea
- Department of Neuropsychiatry, Dongguk University School of Medicine, Goyang, Republic of Korea
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Sertraline as an adjunctive treatment for insomnia comorbid with other mental health disorders. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ito H, Tsuneki H, Sasaoka T, Toyooka N, Matsuo M, Yamazaki M. Suvorexant and mirtazapine improve chronic pain-related changes in parameters of sleep and voluntary physical performance in mice with sciatic nerve ligation. PLoS One 2022; 17:e0264386. [PMID: 35213655 PMCID: PMC8880854 DOI: 10.1371/journal.pone.0264386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Both chronic pain and sleep disorders are associated with a reduction in the quality of life. They can be both a cause and a consequence of each other, and should therefore be simultaneously treated. However, optimal treatments for chronic pain-related sleep disorders are not well established. Here, we aimed to investigate the effects of suvorexant, a novel sleep drug, and mirtazapine, a noradrenergic and specific serotonergic antidepressant, on pain-related changes in sleep parameters in a preclinical chronic pain mice model, by partial sciatic nerve ligation. We evaluated the quantity, duration, and depth of sleep by analyzing the electroencephalogram and voluntary activity by counting the number of wheel rotations to determine various symptoms of sleep disorders, including reduced total sleep time, fragmentation, low quality, and impaired activity in the daytime. Suvorexant and mirtazapine normalized the reduction in sleep time and fragmented sleep, further regaining the sleep depth at sleep onset in the chronic pain state in nerve-ligated mice. Mirtazapine also increased the percentage of rapid eye movement sleep in mice. Suvorexant decreased voluntary activity, which was prolonged after administration; however, mirtazapine did not decrease it. Although the effects of suvorexant and mirtazapine on sleep and activity are different, both suvorexant and mirtazapine could be potential therapeutic agents for chronic pain-related sleep disorders.
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Affiliation(s)
- Hisakatsu Ito
- Department of Anesthesiology, University of Toyama, Toyama, Japan
- * E-mail:
| | - Hiroshi Tsuneki
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Toshiyasu Sasaoka
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Naoki Toyooka
- Faculty of Engineering, University of Toyama, Toyama, Japan
| | - Mitsuhiro Matsuo
- Department of Anesthesiology, University of Toyama, Toyama, Japan
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Hamasaki H. Differences in muscle strength, physical activity, and cardiometabolic risk factors between type 2 diabetic patients with and without benzodiazepines or antipsychotic medications. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hashash JG, Knisely MR, Germain A, McAuliff K, Strassburger M, Vachon A, Binion DG, Regueiro M, Wallace M, Szigethy E. Brief Behavioral Therapy and Bupropion for Sleep and Fatigue in Young Adults With Crohn's Disease: An Exploratory Open Trial Study. Clin Gastroenterol Hepatol 2022; 20:96-104. [PMID: 33010410 DOI: 10.1016/j.cgh.2020.09.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/29/2020] [Accepted: 09/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Sleep disturbances and fatigue are common symptoms amongst patients with Crohn's disease (CD). The aim of this study was to test the feasibility and effects of a pragmatic, stepped-care intervention for the treatment of poor sleep quality and fatigue in adolescents and young adults with CD. METHODS This study is a two-phase open trial exploring interventions for sleep and fatigue. After the initial comprehensive assessment which included quantitative measures and an interview to evaluate sleep and physical and mental health, the 12-week intervention consisted of two sequential steps: 1) a brief behavioral therapy for sleep in inflammatory bowel disease (IBD) (BBTS-I; 4 weeks) and 2) adding the psychotropic medication, bupropion sustained release (BUP-SR; 8 weeks), for the subset of subjects continuing to experience fatigue. RESULTS 232 CD patients (median age=24, median sex=female) were approached over 18 months, of whom 112 screened positive on the Pittsburgh Sleep Quality Index (PSQI) and multi-dimensional fatigue inventory (MFI), with 68 CD patients completing the more comprehensive baseline assessment. Of the 68 patients, 52 participated in Phase I of the BBTS-I intervention. Following 4-weeks of the BBTS-I, there were significant improvements in sleep quality (p < .001) and fatigue (p < .001). As part of Phase II, of the 52 patients who met fatigue threshold criteria, 33 patients participated in the BUP-SR+BBTS-I arm while 19 participated in the BBTS-I only intervention group. After 8 weeks of Phase II, both intervention groups saw significant further improvement in sleep, fatigue, anxiety and depressive symptoms, but without significant differences between the two intervention groups. CONCLUSIONS A stepped-care approach shows that we can improve sleep disturbance with BBTS-I in CD patients, but fatigue only partially improves. For a subset of patients who chose to add BUP-SR to their behavioral therapy, fatigue improves further but not to a statistically significant effect compared to behavioral therapy alone.
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Affiliation(s)
- Jana G Hashash
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Anne Germain
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Katheryn McAuliff
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Meredith Strassburger
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ashley Vachon
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David G Binion
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Miguel Regueiro
- Division of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Meredith Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eva Szigethy
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Guan C, Cheng Z, Xie F, Wang R, Zhang J, Yao F, Fang M. Efficacy of abdomen-rubbing qigong exercise for chronic insomnia: study protocol for a randomized controlled trial. Trials 2021; 22:774. [PMID: 34742345 PMCID: PMC8571850 DOI: 10.1186/s13063-021-05528-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 08/09/2021] [Indexed: 12/29/2022] Open
Abstract
Background Insomnia is a common sleeping disorder which affects the quality of life which can bring harms to physical and mental health of human beings and even economic development. Traditional Chinese medicine (TCM) plays an outstanding role in treating chronic diseases and alleviating their symptoms. Therefore, the purpose of this study is to assess the treatment efficacy in patients with insomnia treated with abdomen-rubbing qigong exercise (ARQE). In addition, the brain function changes of patients will be explored by resting state functional magnetic resonance imaging (rs-fMRI). Method/design This trial is a randomized, single-blind, controlled study planned to transpire between July 1, 2020, and July 31, 2021. A sample size of 114 participants (57 per group) with chronic insomnia will be randomly assigned to receive ARQE or CBTI for 8 weeks. The study duration will be 13 weeks, including a 1-week screening period, 8 weeks of intervention, and another 4 weeks of follow-up. The primary outcome is the Pittsburgh sleep quality index scores. Secondary outcomes include insomnia severity index, gastrointestinal symptom rating scale, the Hamilton Depression Scale, and rs-fMRI scan. The adverse events will be in control. Discussion The results of this study will help to clarify the efficacy of ARQE in the treatment of insomnia and try to use rs-fMRI technology to explore the brain function changes of ARQE in improving sleep quality in patients with insomnia disorder. If the results are as expected, this study will provide high-quality evidence for the treatment of insomnia with ARQE. Trial registration China Clinical Registration Agency ChiCTR1900028009. Registered on 19 December 2019.
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Affiliation(s)
- Chong Guan
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ziji Cheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fangfang Xie
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital, Shanghai, 200050, China
| | - Jing Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fei Yao
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Min Fang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. .,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, 200437, China.
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Weber FC, Wetter TC. The Many Faces of Sleep Disorders in Post-Traumatic Stress Disorder: An Update on Clinical Features and Treatment. Neuropsychobiology 2021; 81:85-97. [PMID: 34474413 PMCID: PMC9153357 DOI: 10.1159/000517329] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/17/2021] [Indexed: 11/19/2022]
Abstract
Sleep disorders and nightmares are core symptoms of post-traumatic stress disorder (PTSD). The relationship seems to be bidirectional, and persistent disturbed sleep may influence the course of the disorder. With regard to sleep quality, insomnia and nocturnal anxiety symptoms, as well as nightmares and stressful dreams, are the most prominent sleep symptoms. Polysomnographic measurements reveal alterations of the sleep architecture and fragmentation of rapid eye movement sleep. In addition, sleep disorders, such as sleep-related breathing disorders and parasomnias are frequent comorbid conditions. The complex etiology and symptomatology of trauma-related sleep disorders with frequent psychiatric comorbidity require the application of multimodal treatment concepts, including psychological and pharmacological interventions. However, there is little empirical evidence on the effectiveness of long-term drug treatment for insomnia and nightmares. For nondrug interventions, challenges arise from the current lack of PTSD-treatment concepts integrating sleep- and trauma-focused therapies. Effective therapy for sleep disturbances may consequently also improve well-being during the day and probably even the course of PTSD. Whether early sleep interventions exert a preventive effect on the development of PTSD remains to be clarified in future studies.
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Affiliation(s)
- Franziska C. Weber
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Thomas C. Wetter
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Abanes JJ, Ridner SH, Dietrich MS, Hiers C, Rhoten B. Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members: A Randomized Controlled Trial. Clin Nurs Res 2021; 31:239-250. [PMID: 34229475 DOI: 10.1177/10547738211030602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This RCT and mixed-methods study examined the difference between two groups receiving the following interventions: (1) brief manual standardized stress acupuncture (MSSA) combined with an abbreviated Cognitive Behavioral Therapy (ACBT) versus (2) ACBT alone. Three study aims: Aim (1): Insomnia Severity Index (ISI) and Pittsburg Sleep Quality Index (PSQI) scores were analyzed using descriptive summaries, linear regression, and reliable change index (RCI). Aim (2): Journal entries were analyzed using content analysis. Aim (3): Acupuncture Expectancy Scale (AES) scores were analyzed using paired t-test and RCI. Aim (1): Both groups demonstrated similar improvements in the ISI scores (p = .480). Aim (2): The ACBT/MSSA group reported greater benefits in sleep and in other life areas including mental, physical, and social functioning. Aim (3): The AES showed that 21.6% had a clinically meaningful increase in expectations in the effect of acupuncture for stress (p = .965). The study was registered in ClinicalTrials.gov (NCT04031365) at https://clinicaltrials.gov/ct2/show/NCT04031365 on July 24, 2019.
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Affiliation(s)
| | | | - Mary S Dietrich
- Vanderbilt University School of Nursing, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Cynthia Hiers
- James H. Quillen VA Medical Center, Sevierville, TN, USA
| | - Bethany Rhoten
- Vanderbilt University School of Nursing, Nashville, TN, USA
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Dhuna NA, Malkani RG. Antidepressants and Their Impact on Sleep. CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00189-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Laniepce A, Cabé N, André C, Bertran F, Boudehent C, Lahbairi N, Maillard A, Mary A, Segobin S, Vabret F, Rauchs G, Pitel AL. The effect of alcohol withdrawal syndrome severity on sleep, brain and cognition. Brain Commun 2020; 2:fcaa123. [PMID: 33543128 PMCID: PMC7846181 DOI: 10.1093/braincomms/fcaa123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 12/28/2022] Open
Abstract
In alcohol use disorder, drinking cessation is frequently associated with an alcohol withdrawal syndrome. Early in abstinence (within the first 2 months after drinking cessation), when patients do not exhibit physical signs of alcohol withdrawal syndrome anymore (such as nausea, tremor or anxiety), studies report various brain, sleep and cognitive alterations, highly heterogeneous from one patient to another. While the acute neurotoxicity of alcohol withdrawal syndrome is well-known, its contribution to structural brain alterations, sleep disturbances and neuropsychological deficits observed early in abstinence has never been investigated and is addressed in this study. We included 54 alcohol use disorder patients early in abstinence (from 4 to 21 days of sobriety) and 50 healthy controls. When acute physical signs of alcohol withdrawal syndrome were no longer present, patients performed a detailed neuropsychological assessment, a T1-weighted MRI and a polysomnography for a subgroup of patients. According to the severity of the clinical symptoms collected during the acute withdrawal period, patients were subsequently classified as mild alcohol withdrawal syndrome (mild-AWS) patients (Cushman score ≤ 4, no benzodiazepine prescription, N = 17) or moderate alcohol withdrawal syndrome (moderate-AWS) patients (Cushman score > 4, benzodiazepine prescription, N = 37). Patients with severe withdrawal complications (delirium tremens or seizures) were not included. Mild-AWS patients presented similar grey matter volume and sleep quality as healthy controls, but lower processing speed and episodic memory performance. Compared to healthy controls, moderate-AWS patients presented non-rapid eye movement sleep alterations, widespread grey matter shrinkage and lower performance for all the cognitive domains assessed (processing speed, short-term memory, executive functions and episodic memory). Moderate-AWS patients presented a lower percentage of slow-wave sleep, grey matter atrophy in fronto-insular and thalamus/hypothalamus regions, and lower short-term memory and executive performance than mild-AWS patients. Mediation analyses revealed both direct and indirect (via fronto-insular and thalamus/hypothalamus atrophy) relationships between poor sleep quality and cognitive performance. Alcohol withdrawal syndrome severity, which reflects neurotoxic hyperglutamatergic activity, should be considered as a critical factor for the development of non-rapid eye movement sleep alterations, fronto-insular atrophy and executive impairments in recently detoxified alcohol use disorder patients. The glutamatergic activity is involved in sleep-wake circuits and may thus contribute to molecular mechanisms underlying alcohol-related brain damage, resulting in cognitive deficits. Alcohol withdrawal syndrome severity and sleep quality deserve special attention for a better understanding and treatment of brain and cognitive alterations observed early in abstinence, and ultimately for more efficient relapse prevention strategies.
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Affiliation(s)
- Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Claire André
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Françoise Bertran
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Céline Boudehent
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Angéline Maillard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Alison Mary
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - François Vabret
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
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14
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Ostroumova OD, Isaev RI, Pereverzev AP. [Drug-induced insomnia in old and very old patients]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:142-152. [PMID: 31626183 DOI: 10.17116/jnevro2019119081142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
According to modern concepts, sleep disorders are considered as a common geriatric syndrome, which also emphasizes their polyfactorial genesis. One of the important factors inducing sleep disorders is the intake of various drugs, which becomes especially significant with the problems of polymorbidity and polypharmacy occurring in older age groups. The article provides a classification of drug-induced sleep disorders, which presents a wide range of conditions associated with a disturbance of the sleep-wake cycle. The authors present the frequency of insomnia associated with taking drugs from different pharmacological groups according to the literature, and consider mechanisms of insomnia development due to the effect on various receptors and neurotransmitter systems, as well as data on their effect on sleep structure. The article presents risk factors for drug-induced insomnia and discusses preventive measures and management of patients.
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Affiliation(s)
- O D Ostroumova
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation Russian Clinical and Research Center of Gerontology, Moscow, Russia
| | - R I Isaev
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation Russian Clinical and Research Center of Gerontology, Moscow, Russia
| | - A P Pereverzev
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation Russian Clinical and Research Center of Gerontology, Moscow, Russia
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15
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Greydanus DE, Cates KW, Sadigh N. Adverse effects of stimulant medications in children and adolescents: focus on sleep and growth disturbances. Int J Adolesc Med Health 2019; 34:ijamh-2019-0173. [PMID: 33725756 DOI: 10.1515/ijamh-2019-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Donald E Greydanus
- Founding Chair and Professor, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| | - Kevin W Cates
- Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| | - Nina Sadigh
- Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
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16
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Theal R, McLeay S, Gleeson S, Lowrie F, O'Sullivan R. Comparison of Sleep Patterns in Vietnam Veterans With and Without Posttraumatic Stress Disorder Using Wrist Actigraphy. J Clin Sleep Med 2019; 15:725-732. [PMID: 31053212 DOI: 10.5664/jcsm.7762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/16/2019] [Indexed: 01/26/2023]
Abstract
STUDY OBJECTIVES Disturbed sleep is a hallmark feature of posttraumatic stress disorder (PTSD). However, few studies have examined sleep objectively in individuals with PTSD compared to trauma-exposed controls. This study used wrist actigraphy to measure and compare sleep patterns in trauma-exposed Australian Vietnam veterans (VV) with and without PTSD. METHODS Trauma-exposed Australian VV with and without PTSD were recruited from the PTSD Initiative. VV wore wrist accelerometers over 14 days and completed daily sleep diaries. Sleep parameters were compared between groups including sleep latency (SL), time in bed (TIB), total sleep time (TST), wake after sleep onset (WASO), and movement index (MI). Night-to-night and overall within-individual variability were assessed by root mean squared successive differences and comparison of individual standard deviations. Correlations between sleep diary (self-reported) and wrist actigraphy (objective) variables were also assessed. RESULTS A total of 40 male VV (20 with PTSD) participated in the study. We found no difference in sleep patterns determined by wrist actigraphy between groups with the exception of reduced SL in VV with PTSD (3.9 ± 0.9 versus 4.9 ± 1.4 minutes, P < .05). Overall within-individual variability was significantly greater in VV with PTSD for TIB, TST, WASO, and MI. Self-reported and objective TST and WASO were more strongly correlated in VV without PTSD than those with PTSD. CONCLUSIONS Although there were no significant differences in sleep parameters, VV with PTSD had increased within-individual overall sleep variability and reduced correlation between self-reported and objective sleep parameters compared to trauma-exposed controls. Further evaluation of extended sleep patterns by actigraphy in VV with PTSD is warranted.
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Affiliation(s)
- Rebecca Theal
- Gallipoli Medical Research Institute, Brisbane, Queensland, Australia.,The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah McLeay
- Gallipoli Medical Research Institute, Brisbane, Queensland, Australia.,The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Gleeson
- Sleep Care, Greenslopes Private Hospital, Brisbane, Queensland, Australia.,Greenslopes Private Hospital, Brisbane, Queensland, Australia
| | - Fraser Lowrie
- Sleep Care, Greenslopes Private Hospital, Brisbane, Queensland, Australia
| | - Robyn O'Sullivan
- Sleep Care, Greenslopes Private Hospital, Brisbane, Queensland, Australia.,Greenslopes Private Hospital, Brisbane, Queensland, Australia
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17
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Greydanus DE, Cates KW, Sadigh N. Adverse effects of stimulant medications in children and adolescents: focus on sleep and growth disturbances. Int J Adolesc Med Health 2019; 31:/j/ijamh.2019.31.issue-2/ijamh-2019-0089/ijamh-2019-0089.xml. [PMID: 31079090 DOI: 10.1515/ijamh-2019-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| | - Kevin W Cates
- Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| | - Nina Sadigh
- Western Michigan University, Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
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18
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Lee-Tobin PA, Ogeil RP, Savic M, Lubman DI. Rate My Sleep: Examining the Information, Function, and Basis in Empirical Evidence Within Sleep Applications for Mobile Devices. J Clin Sleep Med 2017; 13:1349-1354. [PMID: 28992831 DOI: 10.5664/jcsm.6814] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/07/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep applications (apps) have proliferated in online spaces, but few studies have examined the validity of the information contained within the apps. This study aimed to examine the information and functions found within sleep apps, determine if the information is based on empirical evidence, and whether or not user ratings were affected by these factors. METHODS Sleep apps found in the Google Play store (n = 76) were coded using content analysis to examine the types of information, functions, and evidence base of each app. RESULTS Only 32.9% of sleep apps contained empirical evidence supporting their claims, 15.8% contained clinical input, and 13.2% contained links to sleep literature. Apps also contained information on how sleep is affected by alcohol or drugs (23.7%), food (13.2%), daily activities (13.2), and stress (13.2%). A mean difference in average user rating was found between apps that contained at least one source of information compared those that did not. App user ratings were not associated with an app having multiple functions, or from an app drawing on multiple sources of evidence (except for sleep literature only). Last, there was a higher average user rating among apps that contained a sleep tip function. CONCLUSIONS Sleep apps are increasingly popular, demonstrated by the large number of downloads in the Google Play store. Users favored apps that contained sleep tips; however, these tips and other information in the apps were generally not based on empirical evidence. Future research in the area of sleep apps should consider constructing sleep apps derived from empirical evidence and examining their effectiveness.
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Affiliation(s)
- Peta A Lee-Tobin
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
| | - Rowan P Ogeil
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
| | - Michael Savic
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Turning Point, Eastern Health, Fitzroy, Victoria, Australia
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19
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Palesh O, Scheiber C, Kesler S, Mustian K, Koopman C, Schapira L. Management of side effects during and post-treatment in breast cancer survivors. Breast J 2017; 24:167-175. [DOI: 10.1111/tbj.12862] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Oxana Palesh
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | - Caroline Scheiber
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | | | - Karen Mustian
- Department of Surgery; University of Rochester; Rochester NY USA
| | - Cheryl Koopman
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
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20
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Singh A, Zhao K. Treatment of Insomnia With Traditional Chinese Herbal Medicine. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 135:97-115. [PMID: 28807167 DOI: 10.1016/bs.irn.2017.02.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Insomnia is a condition with sleep problems and many people suffered from it. Chronic insomnia can last for long time and it will severely affect people's health and the quality of life. In conventional medicine, the most commonly used the medicine is benzodiazepine. It is effective but also has significant side effects. Patients try to use some kinds of alternative medicines. Chinese medicinal herbs and formulas have been used in the treatment of insomnia for more than 2000 years in China. In recent decades, Chinese herbal medicine has been widely used in the Western countries. Many clinical studies including randomized controlled clinical trials and research on pharmacological action mechanisms of the herbs for treatment of insomnia have been conducted. It is very important and very helpful to review the published research papers to gather the available information for a critical analysis. This chapter evaluated the data from both of clinical studies and pharmacological researches on the therapeutic formulas and on some key herbs used in the treatment of insomnia. Clinical studies showed a very wide spectrum of herbs that were used in clinical treatment of insomnia. This was due to different syndrome patterns happened with insomnia. This brought complexity and difficulties to identify which are the essential key herbs or formulas. It was found Suanzaoren decoction (Ziziphus spinose decoction ) is the most frequently used formula for the treatment of insomnia. Based on the clinical data, several herbs were identified as most frequently used sedative and hypnotic herbs in Chinese herbal medicine including Suanzaoren (Ziziphus spinose ), Fuling (Poria cocos ), and Gancao (Glycyrrhiza uralensis ). The underlying pharmacological action mechanisms discovered in the studies on some key herbs used in the treatment of insomnia were evaluated. The major pharmacological action mechanisms shared by most of the sedative herbs are to act through the neurotransmitter gamma-aminobutyric acid (GABA) or via stimulation of GABAAA receptor. Some herbs exert sedative activities via inhibition of 5-hydroxytryptamine 1A receptor. Another mechanism shown by some herbs is to upregulate the expression of orexin-A, leptin, orexin receptor-1, and leptin receptor in the brain, reducing insomnia-induced negative consequences, and thus indirectly help improvement of insomnia.
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Affiliation(s)
- Amrinder Singh
- Traditional Chinese Herbal Medicine Programme, Middlesex University, The Borough, Hendon, London, United Kingdom
| | - Kaicun Zhao
- Traditional Chinese Herbal Medicine Programme, Middlesex University, The Borough, Hendon, London, United Kingdom.
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