Epidemiological Investigation of Insomnia (original) (raw)
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Insomnia: psychological and neurobiological aspects and non-pharmacological treatments
Arquivos de Neuro-Psiquiatria, 2014
Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning) and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature). From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.
The neurobiology, investigation, and treatment of chronic insomnia
The Lancet. Neurology, 2015
Chronic insomnia is defined by difficulties in falling asleep, maintaining sleep, and early morning awakening, and is coupled with daytime consequences such as fatigue, attention deficits, and mood instability. These symptoms persist over a period of at least 3 months (Diagnostic and Statistical Manual 5 criteria). Chronic insomnia can be a symptom of many medical, neurological, and mental disorders. As a disorder, it incurs substantial health-care and occupational costs, and poses substantial risks for the development of cardiovascular and mental disorders, including cognitive deficits. Family and twin studies confirm that chronic insomnia can have a genetic component (heritability coefficients between 42% and 57%), whereas the investigation of autonomous and central nervous system parameters has identified hyperarousal as a final common pathway of the pathophysiology, implicating an imbalance of sleep-wake regulation consisting of either overactivity of the arousal systems, hypoac...
Comprehensive Overview on Sleep
Indian Journal of Sleep Medicine
The circadian rhythm mediated by the suprachiasmatic nucleus of the hypothalamus is primarily responsible for maintaining the sleep and wakefulness states. Numerous physiologic mechanisms and bodily repairs occur during the state of sleep along with functional alterations in both the autonomic and somatic nervous systems. Most individuals cycle through three stages of nonrapid eye movement sleep, accounting for about 75% of total sleep duration, followed by rapid eye movement sleep, which makes up the remaining 25%. Besides the above, endocrine factors like the release of melatonin from the pineal gland also have a significant impact on the initiation and maintenance of sleep phases. The emotional factors and the limbic system in association with a multitude of variables like stress, drugs, substance use like alcohol, appetite, and behavioral patterns are known to modulate a typical sleep cycle. Given below is a detailed review of normal sleep physiology and numerous sleep-related disorders, their risk factors along with their management, and a brief description of all factors that influence as well as alter the neuronal signaling processes of the brain.
Insomnia: Types , pathophysiology ,treatment An overview
Sleep is vital component of health .insomnia is day by day become a major health concern and effect all age group. It has negative effect on quality of life individual increase physical,social economic burden. involves complex process of cognitive psychological arousal, altered circadian rhythm and homeostatic mechanism Insomnia persistently leads to many mental and psychological disorders such as anxiety, depression, mood disorder. Deprived sleep increases the chances of dependence on alcohol, substance abuse, or drug dependence DSM IV TR standard criteria used for diagnose of primary insomnia. Various self reported instruments are used such as PSQI (Pittsburgh sleep Quality Index) ,ISI (Insomnia severity index) treatment involve both pharmacological, nonpharmacological approaches Nonpharmacological approaches : it involved cognitive behavioral approaches,Stimulus controle Therapy, Sleep restriction, Sleep hygiene techniques. The different investigations identified with commonness were done in European and Western nations. prevalence rate found was 19.
Insomnia: Therapy and Role of neurotransmitters
Journal of University of Shanghai for Science and Technology, 2021
Insomnia is one of the most common sleep disorders which affects 30-40 percent of the adult population. The present article provides a combined review on prevalence, categories of insomnia, pathophysiology, role of neurotransmitter on sleep and different types of therapies for insomnia. From this review it was estimated that hormones like melatonin, cortisol, and others produced by the hypothalamic-pituitary-adrenal axis regulate the sleep-wake cycle. Disturbance of this cycle leads to insomnia. Furthermore, Neurotransmitter like GABA-Lglutamic acid, Acetylcholine, Norepinephrine, Dopamine, Serotonin, Steroids, Orexin, and Adenosine plays a major role in sleep regulation. Any alteration or disturbance in the neurotransmitter level affects sleep. It was concluded that Mechanism of action of almost all natural and synthetic derived drugs in regulation of neurotransmitters.
Sleep is a complex neurological state, with its primary function of providing rest and restoring the body's energy levels. The importance of sleep could be seen from the fact that people spend about one-third of their lifespan in sleep. Normal human sleep is divided into non-rapid eye movement (NREM) and rapid eye movement (REM) sleep, and the alteration between NREM and REM occurs about 4-5 times during a night of normal sleep. Human NREM sleep could be classified into four stages, namely, stage I, II, III and IV, representing successively deeper stages of sleep. Sleep is an active rhythmic neural process produced by several brain areas, of which the preoptic and other basal forebrain areas play a major role in the generation of NREM sleep. Interaction of the pedenculo-pontine and lateral dorsal tegmental areas with the dorsal raphae nucleus and locus coeruleus, is important for REM sleep generation. Suprachiasmatic nucleus of the hypothalamus and the pineal gland ensure that sleep and wakefulness follow a circadian periodicity of nearly 24 hours. Alterations in the quality, quantity and pattern of sleep result in sleep disorders. Persistent and repeated interruption of sleep affects the health of an individual. Undiagnosed and untreated wake/sleep complaints cause not only misery to the sufferer, but it also has socioeconomic consequences. Sleep disorders cover a wide spectrum of diseases. Though there are more than 100 identified sleep/wake disorders, most sleep complaints can be categorised into five, namely, hypersomnia, insomnia, circadian rhythm disorders, parasomnias, and sleep disorders associated with mental, neurological, and other medical disorders. Researches during the last 50 years, and the advances made in clinical sleep medicine, have lead to more effective treatments for the myriad human sleep disorders. It is not possible to assign a specific reason for many of the sleep disorders, but some aspects of sleep and wakefulness are genetically influenced. But, most commonly, sleepiness during waking hours, results from volitional or forced sleep deprivation during previous nights, due to social, economic and environmental reasons. So, public awareness about sleep disorders should be an essential part of any programme aimed at global management of sleep disorders.
Insomnia: Neurophysiological and NeuropsychologicalApproaches
Neuropsychology Review, 2011
Insomnia is a symptom, a syndrome and a comorbid disorder. Its diagnosis relies on subjective reports from the afflicted individual and is defined as difficulties in initiating sleep, maintaining sleep, waking up too early or non-restorative sleep. However, insomnia and especially, primary insomnia, has received much attention in insomnia research with the use of objective measures. Insomnia, its peculiarities, most frequent subtypes and two most prominent models will first be briefly introduced. Then, insomnia will be reviewed according to results obtained with the use of neurophysiological measures as basic/ traditional as polysomnography to more sophisticated ones such as power spectral analysis, neuroimaging, cyclic alternating patterns and event-related potentials. In addition, a review of the discrepancies between subjective and objective reports of cognitive alterations through neuropsychological testing is offered. The need to combine measures is then highlighted in conclusion.
Insomnia: Pathophysiology and implications for treatment
Sleep Medicine Reviews, 2007
Interest in developing a greater understanding of the pathophysiogical mechanisms underlying primary insomnia has increased. Recent evidence indicates that there may be some neuroendocrine and clinical similarities between primary insomnia and major depressive disorder, that abnormal corticotropin releasing factor (CRF) activity occurs in major depression, and that CRF hyperactivity appears to mediate the hyperarousal seen in primary insomnia. These findings all point to the possibility of hypothalamic-pituitary-adrenal (HPA) axis and CRF overactivity in both disorders. More recent findings have strengthened the evidence that primary insomnia may be linked with mood disorders and is associated with HPA axis overactivity and excess secretion of CRF, adrenocorticotropin releasing hormone, and cortisol. These insights have implications for managing chronic primary insomnia, such as use of antiglucocorticoid agents.