Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(4)
Published: Feb. 19, 2023
Insomnia
is
more
prevalent
in
older
adults
(>
60
years)
than
the
general
population.
Cognitive
behavioural
therapy
for
insomnia
gold-standard
treatment;
however,
it
may
prove
too
cognitively
taxing
some.
This
systematic
review
aimed
to
critically
examine
literature
exploring
effectiveness
of
explicitly
interventions
adults,
with
secondary
aims
investigating
their
effect
on
mood
and
daytime
functioning.
Four
electronic
databases
(MEDLINE
-
Ovid,
Embase
CINAHL,
PsycINFO)
were
searched.
All
experimental,
quasi-experimental
pre-experimental
studies
included,
provided
they:
(a)
published
English;
(b)
recruited
insomnia;
(c)
used
sleep
restriction
and/or
stimulus
control;
(d)
reported
outcomes
pre-and-post
intervention.
Database
searches
returned
1689
articles;
15
studies,
summarising
results
498
included
three
focused
control,
four
restriction,
eight
adopted
multicomponent
treatments
comprised
both
interventions.
brought
about
significant
improvements
one
or
subjectively
measured
facets
although,
overall,
therapies
demonstrated
larger
effects
(median
Hedge's
g
=
0.55).
Actigraphic
polysomnographic
smaller
no
effects.
Improvements
measures
depression
seen
interventions,
but
intervention
any
statistically
improvement
anxiety.
corroborates
existing
consensus
that
approaches
confer
most
benefit,
adds
by
demonstrating
this
be
case
brief,
guides
future
study
populations
where
cognitive
not
appropriate.
Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(6)
Published: Nov. 28, 2023
Summary
Progress
in
the
field
of
insomnia
since
2017
necessitated
this
update
European
Insomnia
Guideline.
Recommendations
for
diagnostic
procedure
and
its
comorbidities
are:
clinical
interview
(encompassing
sleep
medical
history);
use
questionnaires
diaries
(and
physical
examination
additional
measures
where
indicated)
(A).
Actigraphy
is
not
recommended
routine
evaluation
(C),
but
may
be
useful
differential‐diagnostic
purposes
Polysomnography
should
used
to
evaluate
other
disorders
if
suspected
(i.e.
periodic
limb
movement
disorder,
sleep‐related
breathing
disorders,
etc.),
treatment‐resistant
(A)
indications
(B).
Cognitive‐behavioural
therapy
as
first‐line
treatment
chronic
adults
any
age
(including
patients
with
comorbidities),
either
applied
in‐person
or
digitally
When
cognitive‐behavioural
sufficiently
effective,
a
pharmacological
intervention
can
offered
Benzodiazepines
(A),
benzodiazepine
receptor
agonists
daridorexant
low‐dose
sedating
antidepressants
(B)
short‐term
(≤
4
weeks).
Longer‐term
these
substances
initiated
some
cases,
considering
advantages
disadvantages
Orexin
antagonists
periods
up
3
months
longer
cases
Prolonged‐release
melatonin
≥
55
years
Antihistaminergic
drugs,
antipsychotics,
fast‐release
melatonin,
ramelteon
phytotherapeutics
are
Light
exercise
interventions
adjunct
therapies
Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(6)
Published: May 14, 2023
Summary
Insomnia
disorder
is
among
the
most
frequent
mental
disorders,
making
research
on
its
aetiology
and
pathophysiology
particularly
important.
A
unifying
element
of
many
aetiological
pathophysiological
models
that
they
support
or
even
centre
role
some
form
hyperarousal.
In
this
theoretical
review,
we
aim
to
summarise
current
evidence
hyperarousal
in
insomnia.
Hyperarousal
discussed
as
a
state
relatively
increased
arousal
physiological,
cortical
cognitive‐emotional
domains.
Regarding
physiological
hyperarousal,
there
no
conclusive
for
involvement
autonomous
variables
such
heart
rate
variability,
whereas
recent
points
neuroendocrine
variables.
addition,
literature
supports
central
arousal,
is,
high‐frequency
electroencephalographic
activity.
An
increasingly
important
focus
other
microstructural
sleep
parameters,
especially
existence
microarousals
during
sleep.
Beyond
that,
broad
range
exists
supporting
insomnia‐related
thought
worries,
their
concomitant
emotional
symptoms.
Besides
being
marker
insomnia,
considered
crucial
predisposition
insomnia
development
comorbid
disorders.
Thus,
beyond
presenting
from
cross‐sectional
studies
markers
hypotheses
about
mechanisms
are
presented.
Nevertheless,
longitudinal
needed
further
elucidate
mechanism
throughout
course
disorder,
future
should
also
similarities
differences
across
different
diagnostic
entities.
Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(6)
Published: May 22, 2023
Summary
Longitudinal
studies
observed
that
individuals
suffering
from
insomnia
disorder
have
a
higher
vulnerability
to
develop
symptoms
of
psychopathology
compared
with
good
sleepers.
Particularly,
has
been
associated
an
increased
risk
for
depression.
Previous
indicate
relatively
stable
effects;
however,
replication
is
needed
as
the
last
meta‐analysis
on
topic
published
4
years
ago.
We
conducted
previous
systematic
review
and
evaluating
longitudinal
association
between
psychopathology,
including
original
works
2018
2022.
Literature
search
was
April
August
2022
using
key
words
identifying
evaluate
sleepers
at
baseline,
onset
all
possible
mental
disorders
long‐term
follow‐up.
Only
one
work
added
sample
in
2019
looking
Meta‐analytic
results
confirmed
observation,
even
effect
link
This
again
recognizes
transdiagnostic
process
consequent
important
clinical
implications.
Nevertheless,
more
are
disorders.
The Lancet,
Journal Year:
2023,
Volume and Issue:
402(10406), P. 975 - 987
Published: Aug. 10, 2023
Insomnia
is
prevalent
and
distressing
but
access
to
the
first-line
treatment,
cognitive
behavioural
therapy
(CBT),
extremely
limited.
We
aimed
assess
clinical
cost-effectiveness
of
sleep
restriction
therapy,
a
key
component
CBT,
which
has
potential
be
widely
implemented.We
did
pragmatic,
superiority,
open-label,
randomised
controlled
trial
versus
hygiene.
Adults
with
insomnia
disorder
were
recruited
from
35
general
practices
across
England
randomly
assigned
(1:1)
using
web-based
randomisation
programme
either
four
sessions
nurse-delivered
plus
hygiene
booklet
or
only.
There
was
no
on
usual
care
for
group.
Outcomes
assessed
at
3
months,
6
12
months.
The
primary
endpoint
self-reported
severity
months
measured
index
(ISI).
analysis
included
participants
according
their
allocated
group
who
contributed
least
one
outcome
measurement.
Cost-effectiveness
evaluated
UK
National
Health
Service
personal
social
services
perspective
expressed
in
terms
incremental
cost
per
quality-adjusted
life
year
(QALY)
gained.
prospectively
registered
(ISRCTN42499563).Between
Aug
29,
2018,
March
23,
2020
we
642
(n=321)
(n=321).
Mean
age
55·4
years
(range
19-88),
489
(76·2%)
being
female
153
(23·8%)
male.
580
(90·3%)
provided
data
At
mean
ISI
score
10·9
(SD
5·5)
13·9
(5·2)
(adjusted
difference
-3·05,
95%
CI
-3·83
-2·28;
p<0·0001;
Cohen's
d
-0·74),
indicating
that
reported
lower
than
QALY
gained
£2076,
giving
95·3%
probability
treatment
cost-effective
threshold
£20
000.
Eight
each
had
serious
adverse
events,
none
judged
related
intervention.Brief
reduces
symptoms,
likely
cost-effective,
implemented
as
disorder.The
Institute
Care
Research
Technology
Assessment
Programme.
Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(6)
Published: March 14, 2023
Summary
Insomnia
is
a
stress‐related
sleep
disorder
conceptualised
within
diathesis‐stress
framework,
which
it
thought
to
result
from
predisposing
factors
interacting
with
precipitating
stressful
events
that
trigger
the
development
of
insomnia.
Among
genetics
and
epigenetics
may
play
role.
A
systematic
review
current
evidence
for
genetic
epigenetic
basis
insomnia
was
conducted
according
Preferred
Reporting
Items
Systematic
Reviews
Meta‐Analyses
(PRISMA)
system.
total
24
studies
were
collected
twins
family
heritability,
55
genome‐wide
association
studies,
26
about
candidate
genes
insomnia,
eight
epigenetics.
Data
showed
complex
polygenic
disorder,
likely
be
caused
by
synergy
environmental
factors,
reactivity
being
important
trait.
Even
if
few
have
been
date
on
framework
understand
long‐lasting
consequences
interaction
between
effects
stress
brain
in
Interestingly,
risk
has
causally
linked
different
mental
medical
disorders.
Probably,
treating
would
possible
intervene
effect
prevent
some
conditions.
Journal of Sleep Research,
Journal Year:
2023,
Volume and Issue:
32(4)
Published: Feb. 14, 2023
Summary
Insomnia
disorder
is
considered
as
a
stress‐related
associated
with
hyperarousal,
stress
and
emotion
dysregulation
the
instability
of
‘flip‐flop’
switch
system.
The
orexinergic
system
well
known
for
its
key
role
in
sleep
arousal
processes
but
also
allostatic
regulating
emotions
may
thus
be
major
interest
insomnia
treatment.
Accordingly,
we
discuss
potential
orexins
on
processes,
brain
systems
modulating
implications
pathophysiology.
We
reviewed
available
data
effect
dual
orexin
receptor
antagonists
(DORAs)
stress/emotions
present
our
findings
narrative
review.
Few
animals
humans
have
reported
that
disrupted
related
to
overactivation
system,
while
some
more
consistent
response
acute
disorders.
Taken
together
these
let
us
hypothesise
an
hyperarousal
hyperactivation
arousal‐promoting
insomnia.
On
other
hand,
it
possible
by
rebalancing
DORAs
regulate
both
systems,
turn,
contributing
‘switch
off’
Nevertheless,
studies
are
needed
clarify
evaluate
effects
sleep,
systems.
Nature and Science of Sleep,
Journal Year:
2023,
Volume and Issue:
Volume 15, P. 17 - 38
Published: Jan. 1, 2023
After
a
detailed
description
of
orexins
and
their
roles
in
sleep
other
medical
disorders,
we
discuss
here
the
current
clinical
evidence
on
effects
dual
(DORAs)
or
selective
(SORAs)
orexin
receptor
antagonists
insomnia
with
aim
to
provide
recommendations
for
further
assessment
context
personalized
precision
medicine.
In
last
decade,
many
trials
have
been
conducted
antagonists,
which
represent
an
innovative
valid
therapeutic
option
based
multiple
mechanisms
action
different
biological
circuits,
both
centrally
peripherally,
role
wide
range
conditions
are
often
associated
insomnia.
A
very
interesting
aspect
this
new
category
drugs
is
that
they
limited
abuse
liability
discontinuation
does
not
seem
significant
rebound
effects.
Further
studies
efficacy
DORAs
required,
especially
children
adolescents
particular
conditions,
such
as
menopause.
Which
DORA
most
suitable
each
patient,
comorbidities
and/or
concomitant
treatments,
should
be
focus
careful
research.
On
contrary,
SORAs,
some
appropriate
also
patients
psychiatric
diseases,
still
at
early
stage
and,
therefore,
do
allow
draw
definite
conclusions.
Neuroscience Applied,
Journal Year:
2024,
Volume and Issue:
3, P. 103936 - 103936
Published: Jan. 1, 2024
Anxiety
and
anxiety-related
disorders
are
the
most
common
mental
disturbances,
with
dysregulation
in
emotions
cognition
as
central
features.
Since
function
of
sleep
regulating
is
quintessential
stress
response
inflammation,
disturbances
may
be
ideal
modifiable
factors
anxiety
related
disorders.
Accordingly,
aim
review
was
to
systematically
association
between
insomnia
symptoms
A
systematic
search
has
been
conducted,
93
papers
have
selected
for
General
Disorder,
Panic
Disorders,
Social
Separation
anxiety,
Obsessive
Compulsive
Disorder
Post
Traumatic
Stress
according
PRISMA.
This
represents
a
comprehensive
overview
clinical
therapeutic
approaches
framework
discussion
potential
mechanisms
underlying
their
complex
link.
