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Kazemi A, Shojaei-Zarghani S, Eskandarzadeh P, Hashempur MH. Effects of chamomile (Matricaria chamomilla L.) on sleep: A systematic review and meta-analysis of clinical trials. Complement Ther Med 2024; 84:103071. [PMID: 39106912 DOI: 10.1016/j.ctim.2024.103071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVE We aimed to investigate the effects of chamomile (Matricaria chamomilla L.) on sleep in this systematic review and meta-analysis of clinical trials. METHODS PubMed, Scopus, Web of Science, and Cochrane Library were searched until August 2023. All clinical trials that investigated the effects of chamomile on sleep, either in healthy or diseased adults, were eligible to enter the study. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool weighted mean differences (WMD) and 95 % CI for the outcomes assessed by at least three studies with relatively consistent participants. RESULTS The systematic review included ten studies (772 participants). Meta-analysis was conducted for the Pittsburgh Sleep Quality Index (PSQI) score and sleep length. A significant reduction in PSQI score (WMD: -1.88, 95 %CI: -3.46, -0.31, I2: 88.4 %, n = 5) was found. For other outcomes, meta-analysis was not conducted. Sleep onset latency or ease of getting to sleep were improved in three of the four studies. Daytime functioning measures, including fatigue severity index or postpartum fatigue scale, did not change in all three studies. Sleep efficiency did not change in two studies and deteriorated in one. The number of awakenings after sleep or staying asleep was improved in two of the three studies. No adverse events were reported in any of the studies although passive surveillance was used to assess adverse effects except in one study. Only one study surveyed the blinding success and tested the purity and/or potency of the used products. CONCLUSION Chamomile improved sleep, especially the number of awakenings after sleep or staying asleep; however, it did not lead to an improvement in the duration of sleep, percentage of sleep efficiency, and daytime functioning measures. Future studies are suggested to assess objective measures.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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2
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Garbarino S, Bragazzi NL. Revolutionizing Sleep Health: The Emergence and Impact of Personalized Sleep Medicine. J Pers Med 2024; 14:598. [PMID: 38929819 PMCID: PMC11204813 DOI: 10.3390/jpm14060598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/11/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Personalized sleep medicine represents a transformative shift in healthcare, emphasizing individualized approaches to optimizing sleep health, considering the bidirectional relationship between sleep and health. This field moves beyond conventional methods, tailoring care to the unique physiological and psychological needs of individuals to improve sleep quality and manage disorders. Key to this approach is the consideration of diverse factors like genetic predispositions, lifestyle habits, environmental factors, and underlying health conditions. This enables more accurate diagnoses, targeted treatments, and proactive management. Technological advancements play a pivotal role in this field: wearable devices, mobile health applications, and advanced diagnostic tools collect detailed sleep data for continuous monitoring and analysis. The integration of machine learning and artificial intelligence enhances data interpretation, offering personalized treatment plans based on individual sleep profiles. Moreover, research on circadian rhythms and sleep physiology is advancing our understanding of sleep's impact on overall health. The next generation of wearable technology will integrate more seamlessly with IoT and smart home systems, facilitating holistic sleep environment management. Telemedicine and virtual healthcare platforms will increase accessibility to specialized care, especially in remote areas. Advancements will also focus on integrating various data sources for comprehensive assessments and treatments. Genomic and molecular research could lead to breakthroughs in understanding individual sleep disorders, informing highly personalized treatment plans. Sophisticated methods for sleep stage estimation, including machine learning techniques, are improving diagnostic precision. Computational models, particularly for conditions like obstructive sleep apnea, are enabling patient-specific treatment strategies. The future of personalized sleep medicine will likely involve cross-disciplinary collaborations, integrating cognitive behavioral therapy and mental health interventions. Public awareness and education about personalized sleep approaches, alongside updated regulatory frameworks for data security and privacy, are essential. Longitudinal studies will provide insights into evolving sleep patterns, further refining treatment approaches. In conclusion, personalized sleep medicine is revolutionizing sleep disorder treatment, leveraging individual characteristics and advanced technologies for improved diagnosis, treatment, and management. This shift towards individualized care marks a significant advancement in healthcare, enhancing life quality for those with sleep disorders.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, 16126 Genoa, Italy;
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Human Nutrition Unit (HNU), Department of Food and Drugs, University of Parma, 43125 Parma, Italy
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3
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Moreau A, Monnier L, Medde A, Bourgin P, Ruppert E. Images: Sleep-related painful erection with concomitant hypnic headache. J Clin Sleep Med 2024; 20:837-839. [PMID: 38305789 PMCID: PMC11063697 DOI: 10.5664/jcsm.11044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
Sleep-related painful erection (SRPE) is a parasomnia defined by the repetition of painful erections during rapid eye movement (REM) sleep. Hypnic headache (HH) is a primary headache occurring exclusively at night, often during REM sleep. We report the observation of a 33-year-old man with simultaneous SRPE and HH. Physical examination was normal. Comprehensive urological and endocrine explorations excluded other organic differential diagnoses. Polysomnography revealed several awakenings in REM, due to SRPE and concurrent HH. Medication by baclofen at bedtime seemed to have resulted in a decrease in SRPE episodes, confirmed by polysomnography, but at the cost of excessive daytime sleepiness, and was discontinued by the patient. Caffeine intake at bedtime was proposed, but the patient was reluctant because he was concerned about worsening insomnia. At 9-month follow-up, the patient had accepted his medical condition and was coping with both SRPE and HH. He felt reassured and wished no "overmedicalization." To our knowledge, the coexistence of both conditions has not yet been reported, yet their frequencies might be underestimated. We hypothesize a common underlying pathophysiology with a possible dysfunction of the vascular control and/or the autonomic nervous system and that could involve the hypothalamus. Somnologists should be aware of SRPE, potentially overlapping with HHs. SRPE should be considered in case of sleep-maintenance insomnia. Patient reassurance seems to be central in the care process of SRPE. CITATION Moreau A, Monnier L, Medde A, Bourgin P, Ruppert E. Images: sleep-related painful erection with concomitant hypnic headache. J Clin Sleep Med. 2024;20(5):837-839.
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Affiliation(s)
- Augustin Moreau
- CIRCSom (International Research Center for ChronoSomnology) and Sleep Disorder Center, Strasbourg University Hospital, Strasbourg, France
| | - Lucile Monnier
- CIRCSom (International Research Center for ChronoSomnology) and Sleep Disorder Center, Strasbourg University Hospital, Strasbourg, France
| | - Alessandro Medde
- CIRCSom (International Research Center for ChronoSomnology) and Sleep Disorder Center, Strasbourg University Hospital, Strasbourg, France
| | - Patrice Bourgin
- CIRCSom (International Research Center for ChronoSomnology) and Sleep Disorder Center, Strasbourg University Hospital, Strasbourg, France
- Centre National de la Recherche Scientifique, Unité Propre de Recherche 3212, Institute of Cellular and Integrative Neuroscience, University of Strasbourg, Strasbourg, France
| | - Elisabeth Ruppert
- CIRCSom (International Research Center for ChronoSomnology) and Sleep Disorder Center, Strasbourg University Hospital, Strasbourg, France
- Centre National de la Recherche Scientifique, Unité Propre de Recherche 3212, Institute of Cellular and Integrative Neuroscience, University of Strasbourg, Strasbourg, France
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4
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Halász P, Simor P, Szűcs A. Fearful arousals in sleep terrors and sleep-related hypermotor epileptic seizures may involve the salience network and the acute stress response of Cannon and Selye. Epilepsy Behav Rep 2024; 25:100650. [PMID: 38328672 PMCID: PMC10847862 DOI: 10.1016/j.ebr.2024.100650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
We consider the disorders of arousal and sleep-related hypermotor epilepsy as genetic twin-conditions, one without, one with epilepsy. They share an augmented arousal-activity during NREM sleep with sleep-wake dissociations, culminating in sleep terrors and sleep-related hypermotor seizures with similar symptoms. The known mutations underlying the two spectra are different, but there are multifold population-genetic-, family- and even individual (the two conditions occurring in the same person) overlaps supporting common genetic roots. In the episodes of disorders of arousal, the anterior cingulate, anterior insular and pre-frontal cortices (shown to be involved in fear- and emotion processing) are activated within a sleeping brain. These regions overlap with the seizure-onset zones of successfully operated sleep-related hypermotor seizures, and notably, belong to the salience network being consistent with its hubs. The arousal-relatedness and the similar fearful confusion occurring in sleep terrors and hypermotor seizures, make them alike acute stress-responses emerging from sleep; triggered by false alarms. The activation of the anterior cingulate, prefrontal and insular regions in the episodes of both conditions, can easily mobilize the hypothalamo-pituitary-adrenal axis (preparing fight-flight responses in wakefulness); through its direct pathways to and from the salience network. This hypothesis has never been studied.
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Affiliation(s)
- Péter Halász
- Szentágothai János Doctoral School, Semmelweis University, Budapest, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE Faculty of Education and Psychology, Budapest, Hungary
| | - Anna Szűcs
- Institute of Behavioural Sciences Semmelweis University, Budapest, Hungary
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5
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Ghaderi S, Mohammadi S, Mohammadi M. Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments. Brain Behav 2023; 13:e3262. [PMID: 37743582 PMCID: PMC10636416 DOI: 10.1002/brb3.3262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Obstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients. METHODS We searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits. RESULTS We included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings. CONCLUSIONS We found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.
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Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction StudiesSchool of Advanced Technologies in MedicineTehran University of Medical SciencesTehranIran
| | - Sana Mohammadi
- Department of Medical SciencesSchool of MedicineIran University of Medical SciencesTehranIran
| | - Mahdi Mohammadi
- Department of Medical Physics and Biomedical Engineering, School of MedicineTehran University of Medical SciencesTehranIran
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Ramalho S, Martins-Mendes D, Macedo JM, Barros C, Luis C, Sá S, Gestoso Á, Pereira AC, Baylina P, Fernandes R. Unveiling the Path to Resilience: Prioritizing Mental Health, Sleep, and Nutrition in the Post-COVID Era. Healthcare (Basel) 2023; 11:2463. [PMID: 37685496 PMCID: PMC10487180 DOI: 10.3390/healthcare11172463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic has disrupted daily life, impacting relationships, work, and education. This has led to increased stress, anxiety, and depression, along with altered sleep patterns and eating behaviors. Quarantine and isolation have worsened mental health, especially in children and the elderly, due to the loss of activities and physical contact. Sleep disorders and negative dreams perpetuate poor sleep quality, increasing the risk of health issues. Sedentary lifestyles and emotional effects contribute to unhealthy eating patterns and obesity, exacerbated by disrupted routines and limited outdoor activities. Addressing these challenges requires prioritizing mental health, promoting healthy sleep habits, and addressing obesity factors. The pandemic has profoundly affected human well-being, but resilience, mental health, sleep, and nutrition can enhance overall well-being and adaptability in the post-COVID era. This comprehensive opinion aims to raise awareness of the wide-ranging impacts of this pandemic on various aspects of human well-being and to emphasize the importance of implementing strategies that prioritize mental health, improve sleep habits, address eating behaviors, and foster resilience to navigate and thrive in the face of future challenges.
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Affiliation(s)
- Susana Ramalho
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Daniela Martins-Mendes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - José Mário Macedo
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Carla Barros
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- Faculdade de Ciências Humanas e Sociais, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Carla Luis
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sara Sá
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Álvaro Gestoso
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Ana Cláudia Pereira
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Pilar Baylina
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Escola S. Saúde, Instituto Politécnico do Porto, 4200-465 Porto, Portugal
| | - Rúben Fernandes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
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Mutti C, Pollara I, Abramo A, Soglia M, Rapina C, Mastrillo C, Alessandrini F, Rosenzweig I, Rausa F, Pizzarotti S, Salvatelli ML, Balella G, Parrino L. The Contribution of Sleep Texture in the Characterization of Sleep Apnea. Diagnostics (Basel) 2023; 13:2217. [PMID: 37443611 PMCID: PMC10340273 DOI: 10.3390/diagnostics13132217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Obstructive sleep apnea (OSA) is multi-faceted world-wide-distributed disorder exerting deep effects on the sleeping brain. In the latest years, strong efforts have been dedicated to finding novel measures assessing the real impact and severity of the pathology, traditionally trivialized by the simplistic apnea/hypopnea index. Due to the unavoidable connection between OSA and sleep, we reviewed the key aspects linking the breathing disorder with sleep pathophysiology, focusing on the role of cyclic alternating pattern (CAP). Sleep structure, reflecting the degree of apnea-induced sleep instability, may provide topical information to stratify OSA severity and foresee some of its dangerous consequences such as excessive daytime sleepiness and cognitive deterioration. Machine learning approaches may reinforce our understanding of this complex multi-level pathology, supporting patients' phenotypization and easing in a more tailored approach for sleep apnea.
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Affiliation(s)
- Carlotta Mutti
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Irene Pollara
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Anna Abramo
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Margherita Soglia
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Clara Rapina
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Carmela Mastrillo
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Francesca Alessandrini
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK;
| | - Francesco Rausa
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Silvia Pizzarotti
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
| | - Marcello luigi Salvatelli
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
- Neurology Unit, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Giulia Balella
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK;
| | - Liborio Parrino
- Sleep Disorders Center, Department of Medicine and Surgery, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy; (C.M.); (I.P.); (A.A.); (M.S.); (C.R.); (C.M.); (F.A.); (F.R.); (S.P.); (M.l.S.); (G.B.)
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8
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Ellis J, Ferini-Strambi L, García-Borreguero D, Heidbreder A, O’Regan D, Parrino L, Selsick H, Penzel T. Chronic Insomnia Disorder across Europe: Expert Opinion on Challenges and Opportunities to Improve Care. Healthcare (Basel) 2023; 11:healthcare11050716. [PMID: 36900721 PMCID: PMC10001099 DOI: 10.3390/healthcare11050716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
One in ten adults in Europe have chronic insomnia, which is characterised by frequent and persistent difficulties initiating and/or maintaining sleep and daily functioning impairments. Regional differences in practices and access to healthcare services lead to variable clinical care across Europe. Typically, a patient with chronic insomnia (a) will usually present to a primary care physician; (b) will not be offered cognitive behavioural therapy for insomnia-the recommended first-line treatment; (c) will instead receive sleep hygiene recommendations and eventually pharmacotherapy to manage their long-term condition; and (d) will use medications such as GABA receptor agonists for longer than the approved duration. Available evidence suggests that patients in Europe have multiple unmet needs, and actions for clearer diagnosis of chronic insomnia and effective management of this condition are long overdue. In this article, we provide an update on the clinical management of chronic insomnia in Europe. Old and new treatments are summarised with information on indications, contraindications, precautions, warnings, and side effects. Challenges of treating chronic insomnia in European healthcare systems, considering patients' perspectives and preferences are presented and discussed. Finally, suggestions are provided-with healthcare providers and healthcare policy makers in mind-for strategies to achieve the optimal clinical management.
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Affiliation(s)
- Jason Ellis
- Department of Psychology, Northumbria University, Newcastle NE1 8ST, UK
| | - Luigi Ferini-Strambi
- Department of General Psychology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | | | - Anna Heidbreder
- Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - David O’Regan
- Faculty of Life Sciences and Medicine, King’s College, London WC2R 2LS, UK
- Disorder Centre, Guy’s Hospital, London SE1 9RT, UK
| | - Liborio Parrino
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Hugh Selsick
- Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals, London NW1 2PG, UK
| | - Thomas Penzel
- Interdisciplinary Centre of Sleep Medicine, Medicine Centre, Charité Universitätsmedizin, 10117 Berlin, Germany
- Correspondence:
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He D, Guo Z, Mcclure MA, Mu Q, Jiang B. Cognitive-behavioral therapy for insomnia with objective short sleep duration phenotype: A systematic review with meta-analysis. Sleep Med Rev 2023; 67:101736. [PMID: 36543054 DOI: 10.1016/j.smrv.2022.101736] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Cognitive-behavioral therapy for insomnia (CBT-I) has been recommended as the first-line therapy for this condition. However, insomnia disorder with objective short sleep duration (ISS) phenotype is a distinct subtype from insomnia with normal sleep duration (INS) phenotype, and it may have a differential therapeutic response. We searched PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov using the PICOS principle for studies that examined the efficacy of cognitive-behavioral therapy for those with the ISS phenotype versus the INS phenotype, and identified nine studies with 612 patients with insomnia disorder. This included 270 patients with the ISS phenotype and 342 patients with the INS phenotype. The main outcome was that CBT-I had a better efficacy for the INS phenotype compared with the ISS phenotype, with about 30% higher response and about 20% higher remission. Similar results were indicated in the secondary outcomes. The therapeutic response of the ISS phenotype was significantly different from that of the INS phenotype. In the future, research is needed to clarify how to optimally treat insomnia disorder with the ISS phenotype in prospective randomized clinical trials, and to understand whether decreasing physiologic arousal will be necessary to improve results.
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Affiliation(s)
- Dongmei He
- Department of Neurology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Zhiwei Guo
- Institute of Brain Function, Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Morgan A Mcclure
- Institute of Brain Function, Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Qiwen Mu
- Institute of Brain Function, Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Binghu Jiang
- Institute of Brain Function, Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
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Parrino L. Now that automatic processing makes CAP scoring fast and reliable is the sleep field ready for a paradigm shift? Sleep 2023; 46:6832051. [PMID: 36394264 DOI: 10.1093/sleep/zsac255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Liborio Parrino
- Neurology Unit, Sleep Disorders Center, Parma University Hospital, Parma, Italy
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