The role of insufficient sleep and circadian misalignment in obesity

Nature Reviews Endocrinology, Год журнала: 2022, Номер 19(2), С. 82 - 97

Опубликована: Окт. 24, 2022

Язык: Английский

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Effect of Intraoperative Esketamine Infusion on Postoperative Sleep Disturbance After Gynecological Laparoscopy

JAMA Network Open, Год журнала: 2022, Номер 5(12), С. e2244514 - e2244514

Опубликована: Дек. 1, 2022

Importance Postoperative sleep disturbance (PSD) is common in patients after surgery. Objective To examine the effect of intraoperative esketamine infusion on incidence PSD who underwent gynecological laparoscopic Design, Setting, and Participants This single-center, double-blind, placebo-controlled randomized clinical trial was conducted from August 2021 to April 2022 First Affiliated Hospital Zhengzhou University China. included aged 18 65 years with an American Society Anesthesiologist Physical Status classification I III (with indicating a healthy patient, II patient mild systemic disease, severe disease) Patients were randomly assigned either group or control group. Data analyzed using per protocol principle. Interventions received continuous esketamine, 0.3 mg/kg/h, intraoperatively. equivalent volume saline. Main Outcomes Measures The primary outcome postoperative days (PODs) 1 3. defined as numeric rating scale score 6 higher Athens Insomnia Scale points higher. secondary outcomes anxiety depression scores Anxiety Depression Scale, pain visual analog scale, hydromorphone consumption, risk factors associated PSD. Results A total 183 female (n = 91; median [IQR] age, 45 [35-49] years) 92; 43 [32-49] years). significantly lower than POD (22.8% vs 44.0%; odds ratio [OR], 0.38 [95% CI, 0.20-0.72]; P .002) 3 (7.6% 19.8%; OR, 0.33 0.13-0.84]; .02). There no differences between 2 groups. consumption first 24 hours (3.0 [range, 2.8-3.3] mg 3.2 2.9-3.4] mg; .04) movement (3 [3-4] 4 [3-5] points; < .001) On multivariable logistic regression, preoperative (OR, 1.31; 95% 1.01-1.70) 1.67; 1.04-1.80) scores, duration anesthesia 1.04; 1.00-1.08), 1.92; 1.24-2.96) identified Conclusions Relevance this showed prophylactic Further studies are needed confirm these results. Trial Registration Chinese Clinical Registry Identifier: ChiCTR2100048587

Язык: Английский

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Suvorexant ameliorated sleep disturbance, opioid withdrawal, and craving during a buprenorphine taper

Science Translational Medicine, Год журнала: 2022, Номер 14(650)

Опубликована: Июнь 22, 2022

Increased orexin/hypocretin signaling is implicated in opioid withdrawal, sleep disturbances, and drug-seeking behaviors. This study examined whether a dual-orexin receptor antagonist would improve withdrawal outcomes when compared with placebo during buprenorphine/naloxone taper. Thirty-eight participants use disorder were recruited to clinical research unit maintained on 8/2 16/4 mg of treatment for 3 days before being randomized 20 suvorexant ( n = 14), 40 12), or 12); 26 individuals completed the study. After randomization, underwent 4-day taper post-taper observation period. Total time (TST) was collected nightly wireless electroencephalography device wrist-worn actigraphy; symptoms assessed via Subjective Opiate Withdrawal Scale (SOWS); abuse potential 0- 100-point visual analog scale “High” every morning. A priori included two-group (collapsing doses versus placebo) three-group comparisons area-under-the-curve (AUC) scores TST, SOWS, High. In comparisons, receiving displayed increased TST decreased SOWS AUC taper, but there no difference among groups. There evidence two- analyses. The results suggest that might be promising undergoing

Язык: Английский

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Sleep disturbance as a therapeutic target to improve opioid use disorder treatment.

Experimental and Clinical Psychopharmacology, Год журнала: 2021, Номер 30(6), С. 1024 - 1035

Опубликована: Июнь 10, 2021

Sleep health is an important factor across several physical and mental disorders, a growing scientific consensus has identified sleep as critical component of opioid use disorder (OUD), both in the active disease state during OUD recovery. The goal this narrative review to collate literature on sleep, use, means identifying therapeutic targets improve treatment outcomes. disturbance common often severe persons with OUD, especially withdrawal, but also maintenance therapies. There ample evidence that disturbances including reduced total time, disrupted continuity, poor quality accompany negative are bidirectionally associated other factors related outcomes, chronic stress, stress reactivity, low positive affect, high pain, drug craving. This constellation outcome variables represents more comprehensive appraisal life recovery than typically assessed clinical trials. To date, there very few trials or experimental studies aimed at improving patients, either craving potential mechanistic target reduce withdrawal behaviors. As such, direct impact improvement patients largely unknown, yet research suggests interventions promising avenue treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Язык: Английский

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Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review

Drug Design Development and Therapy, Год журнала: 2022, Номер Volume 16, С. 251 - 264

Опубликована: Янв. 1, 2022

Background: The adverse effects of short-term opioid analgesics are well known and acknowledged; however, the spectrum sequelae long-term use seems less clear. Some may remain undetected but still have potential to cause harm reduce patients' quality life. Objective: To review literature on therapy. Methods: We performed a quasi-systematic search, analyzing articles published in MEDLINE database between January 2000 March 2021 that identified opioids used for chronic pain treatment. Results: Growing evidence indicates there multiple serious Long-term significant endocrine, immune, cardiovascular, respiratory, gastrointestinal, neural systems. Studies show treatment increases risk fractures, infections, cardiovascular complications, sleep-disordered breathing, bowel dysfunction, overdose, mortality. Opioids potentially affect cancer development. Most consequences been studies patients with non-malignant pain. Conclusion: indicate drug-related events number patients. Clinicians should be aware these complications associated prescribing opioids, discuss them patients, prevent if possible, diagnose early manage adequately. More human needed assess risk, including trials individual because they different effect profiles. Keywords: pain, effects, treatment, safe therapy

Язык: Английский

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The disruptive relationship among circadian rhythms, pain, and opioids

Frontiers in Neuroscience, Год журнала: 2023, Номер 17

Опубликована: Фев. 15, 2023

Pain behavior and the systems that mediate opioid analgesia reward processing display circadian rhythms. Moreover, pain system systems, including mesolimbic circuitry, reciprocally interact with system. Recent work has demonstrated disruptive relationship among these three systems. Disruption of rhythms can exacerbate modulate processing, opioids influence This review highlights evidence demonstrating circadian, pain, Evidence how disruption one lead to reciprocal disruptions other is then reviewed. Finally, we discuss interconnected nature emphasize importance their interactions in therapeutic contexts.

Язык: Английский

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Optimizing the Recovery of Pediatric Tonsillectomy: Application of Opioid-Free Anesthesia and Analgesia

Journal of PeriAnesthesia Nursing, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Opioids are considered the gold standard for controlling postoperative acute pain. However, side effects such as nausea, vomiting, respiratory depression, and pain sensitization have gained significant attention. The risks higher in children with enlarged tonsils sleep apnea, making effective management while minimizing analgesia-related a pressing concern. This was randomized (1:1), single-blind, parallel-group superiority trial. A prospective single-blind study conducted 44 aged 3 to 7 years who planned undergo tonsillectomy under general anesthesia. They were into two groups: experimental group control using computer-assisted randomization. received standardized opioid drugs anesthesia induction maintenance. In group, used maintenance replaced nonopioid alternatives esketamine dexmedetomidine. primary outcome of interest score within 48 hours after surgery, secondary outcomes included time first food ingestion, quality, insufficient analgesia, number requiring hydromorphone rescue differences psychological symptoms excitement hallucinations, bleeding, caregiver satisfaction. experienced significantly lower scores post surgery compared statistical significance at P less than .01 6, 12, 24 hours, .05 surgery. terms incidence adverse events, reported better nausea needed fewer instances analgesia those group. Additionally, had satisfaction (P < .05). Nonopioid regimens can improve children, shorten reduce increase

Язык: Английский

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Molecular rhythm alterations in prefrontal cortex and nucleus accumbens associated with opioid use disorder

Translational Psychiatry, Год журнала: 2022, Номер 12(1)

Опубликована: Март 26, 2022

Abstract Severe and persistent disruptions to sleep circadian rhythms are common in people with opioid use disorder (OUD). Preclinical evidence suggests altered molecular the brain modulate reward relapse. However, whether disrupted brains of OUD remained an open question, critical understanding role addiction. Using subjects’ times death as a marker time day, we investigated transcriptional subjects compared unaffected comparison subjects. We discovered rhythmic transcripts both dorsolateral prefrontal cortex (DLPFC) nucleus accumbens (NAc), key areas involved OUD, that were largely distinct between Fewer identified DLPFC subjects, whereas NAc, nearly double number was OUD. In NAc peaked either evening or near sunrise, associated opioid, dopamine, GABAergic neurotransmission. Associations neurotransmission further supported by co-expression network analysis which OUD-specific modules enriched for GABA, glutamatergic synaptic functions. Additionally, genomic loci sleep-related GWAS traits, including duration insomnia. Collectively, our findings connect rhythm changes opioidergic, dopaminergic, signaling human traits

Язык: Английский

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Mu-opioid receptor-expressing neurons in the paraventricular thalamus modulate chronic morphine-induced wake alterations

Translational Psychiatry, Год журнала: 2023, Номер 13(1)

Опубликована: Март 3, 2023

Abstract Disrupted sleep is a symptom of many psychiatric disorders, including substance use disorders. Most drugs abuse, opioids, disrupt sleep. However, the extent and consequence opioid-induced disturbance, especially during chronic drug exposure, understudied. We have previously shown that disturbance alters voluntary morphine intake. Here, we examine effects acute exposure on Using an oral self-administration paradigm, show disrupts sleep, most significantly dark cycle in morphine, with concomitant sustained increase neural activity Paraventricular Nucleus Thalamus (PVT). Morphine binds primarily to Mu Opioid Receptors (MORs), which are highly expressed PVT. Translating Ribosome Affinity Purification (TRAP)-Sequencing PVT neurons express MORs showed significant enrichment circadian entrainment pathway. To determine whether MOR + cells mediate morphine-induced sleep/wake properties, inhibited these while mice were self-administering morphine. This inhibition decreased wakefulness but not general wakefulness, indicating contribute opioid-specific wake alterations. Overall, our results suggest important role for mediating disturbance.

Язык: Английский

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Sleep disturbance and cognition in the elderly: a narrative review

Anesthesiology and Perioperative Science, Год журнала: 2024, Номер 2(3)

Опубликована: Авг. 5, 2024

Abstract Sleep is an essential physiological process that promotes physical recovery and helps consolidate learning memory. Common manifestations of sleep disturbances include insomnia, hypersomnia, circadian rhythm disorders, parasomnias, all which impair cognitive function, particularly in the elderly. Cognitive impairment a significant factor threatens quality life elderly, there currently no effective treatment for conditions such as dementia. The relationship between cognition complex. Studies have shown disorders adversely affect function increase incidence decline. This article focuses on their effects elderly by reviewing research conducted over past 20 years describing potential mechanisms. Additionally, we explore during perioperative period, aiming to identify strategies optimizing quality. We believe this review provides deeper understanding association offers new perspective management.

Язык: Английский

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