Medications for Sleep Disturbance

2020 ◽  
pp. 185-216
Author(s):  
Andrew J. Roth ◽  
Christian J. Nelson
Keyword(s):  
Quality Of Life ◽  
Sleep Disturbance ◽  
Medication Use ◽  
Sleep Habits ◽  
Medical Problems ◽  
Sleep Complaints ◽  
Potential Benefits ◽  
Timely Referral ◽  
Good Sleep

Insomnia, or sleep disturbance, manifests in many ways in people with cancer. Sleep complaints may be intermittent, often related to specific situations or medical problems. They can develop into an ongoing syndrome and can severely impair a person’s quality of life with compromised energy and risk for falls. Non-prescribers are often called upon to assist with teaching healthy nonpharmacologic sleep hygiene techniques. However, it is important to recognize when a proper medication can assist or supplement good sleep habits and make a timely referral to a prescriber. This chapter discusses the potential benefits and pitfalls of medications used to induce and maintain sleep and how patients can integrate medication use into the standard nonmedication sleep-promoting techniques. All clinicians will be able to monitor for potential side effects of hypnotics (sleep medications), including cognitive and balance abnormalities, as well as compromised daytime energy and alertness, which might discourage patients from taking these medications.

Effect of Adenotonsillectomy on Attention-deficit/hyperactivity Disorder Symptoms, Sleep Disturbance Symptoms, and Quality of Life of Children with Adenotonsillar Hypertrophy and Sleep-disordered Breathing

2017 ◽  
Vol 41 (S1) ◽  
pp. S306-S307
Author(s):  
S. Türkoglu ◽  
B.T. Somuk ◽  
E. Sapmaz ◽  
G. Goktas ◽  
A. Bilgic
Keyword(s):  
Quality Of Life ◽  
Attention Deficit Hyperactivity Disorder ◽  
Sleep Disturbance ◽  
Attention Deficit ◽  
Sleep Habits ◽  
Parent Rating ◽  
Adenotonsillar Hypertrophy ◽  
Hyperactivity Disorder ◽  
The Impact

ObjectivesTo date, limited data has been available regarding the impact of adenotonsillectomy (AT) on the psychosocial well-being of chronic adenotonsillar hypertrophy (CAH) subjects.AimsIn the present study, we examined the impacts of AT on attention-deficit/hyperactivity disorder symptoms (ADHD) and sleep disturbance symptoms and quality of life of children with chronic adenotonsillar hypertrophy.MethodsParents of children with CAH filled in Conners Parent Rating Scale-Revised Short (CPRS-RS), children's sleep habits questionnaire (CSHQ), and the pediatric quality of life inventory, parent versions (PedsQL-P) before and six months after AT.ResultsA total of 64 children were included the study (mean age: 6.8 ± 2.4 years; 50% boys). Mean ADHD Index (11.98 ± 6.94 versus 10.35 ± 6.44) (before AT versus after AT) and oppositional scores (6.73 ± 3.72 versus 5.87 ± 3.52) improved statistically significantly after AT (P < 0.05). All of the CSHQ subdomain scores, except sleep duration, significantly reduced after AT (P < 0.05). Regarding to quality of life, both PedsQL-P physical health (64.20 ± 19.81 versus 69.84 ± 18.63) and psychosocial health subdomain scores (67.83 ± 12.89 versus 75.57 ± 13.16), and PedsQL-P total score (66.57 ± 12.94 versus 73.58 ± 12.46) of the patients were significantly higher six months after AT (P < 0.001).ConclusionsIt is necessary for child and adolescent psychiatrists to query the symptoms of CAH to identify children with chronic adenotonsillar hypertrophy who suffer from ADHD symptoms, oppositionality, and sleep disturbance. To carry out AT seems to be beneficial for coexisting ADHD and sleep disorder symptoms and quality of life in these children.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person

2021 ◽  
Vol 9 (2) ◽  
pp. 31
Author(s):  
Christine E. Mc Carthy
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Older Patients ◽  
Disease Risk ◽  
Medication Management ◽  
Sleep Complaints ◽  
Co Morbidity ◽  
Sleep Assessment ◽  
Form Part

Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson’s disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.

scholarly journals Improved gastrointestinal profile with diroximel fumarate is associated with a positive impact on quality of life compared with dimethyl fumarate: results from the randomized, double-blind, phase III EVOLVE-MS-2 study

2021 ◽  
Vol 14 ◽  
pp. 175628642199399 ◽  
Author(s):  
Annette Wundes ◽  
Sibyl Wray ◽  
Ralf Gold ◽  
Barry A. Singer ◽  
Elzbieta Jasinska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medication Use ◽  
Dimethyl Fumarate ◽  
Daily Activities ◽  
Phase Iii ◽  
Symptomatic Medication ◽  
Gi Symptoms ◽  
Symptom Intensity ◽  
The Impact

Background: Diroximel fumarate (DRF) is a novel oral fumarate approved for relapsing forms of multiple sclerosis (MS). DRF demonstrated significantly improved gastrointestinal (GI) tolerability versus dimethyl fumarate (DMF) with fewer days of Individual Gastrointestinal Symptom and Impact Scale (IGISIS) scores ⩾2, GI adverse events (AEs), and treatment discontinuations due to GI AEs. Our aim was to evaluate the impact of GI tolerability events on quality of life (QoL) for patients with relapsing–remitting MS who received DRF or DMF in EVOLVE-MS-2. Methods: A post hoc analysis was conducted in patients who were enrolled in the randomized, blinded, 5-week, EVOLVE-MS-2 [ClinicalTrials.gov identifier: NCT03093324] study of DRF versus DMF. Patients completed daily IGISIS and Global GISIS (GGISIS) eDiary questionnaires to assess GI symptom intensity and interference with daily activities and work. Results: In total, 504 patients (DRF, n = 253; DMF, n = 251) received study drug and 502 (DRF, n = 253; DMF, n = 249) completed at least one post-baseline questionnaire. With DRF, GI symptoms were less likely to interfere ‘quite a bit’ or ‘extremely’ with regular daily activities [IGISIS: DRF, 9.5% (24/253) versus DMF, 28.9% (72/249)] or work productivity [GGISIS: DRF, 6.1% (10/165) versus DMF, 11.3% (18/159)]. DRF-treated patients had fewer days with ⩾1 h of missed work (DRF, 43 days, n = 20 versus DMF, 88 days, n = 26). DMF-treated patients reported highest GI symptom severity and missed work at week 2–3 shortly after completing the titration period, which coincided with the majority of GI-related treatment discontinuations [58.3% (7/12)]. GI tolerability AEs [DRF, 34.8% (88/253); DMF, 48.2% (121/251)], concomitant symptomatic medication use [DRF, 19.3% (17/88) versus DMF, 30.6% (37/121)], and GI-related discontinuations (DRF, 0.8% versus DMF, 4.8%) were lower with DRF versus DMF. Conclusions: The improved GI tolerability with DRF translated into clinically meaningful benefits to QoL, as patients experienced less impact on daily life and work and required less concomitant symptomatic medication use. Trial registration: [ClinicalTrials.gov identifier: NCT03093324]

scholarly journals A randomised controlled clinical trial comparing the effectiveness of bandaging compared to the JuxtaCures™ device in the management of people with venous ulceration: Feasibility study

2021 ◽  
pp. 026835552098822
Author(s):  
Philip Stather ◽  
Carroll Petty ◽  
Helen Langthorne ◽  
Emma Rayner ◽  
Jufen Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Feasibility Study ◽  
Multicentre Trial ◽  
Compression Therapy ◽  
Controlled Clinical Trial ◽  
Venous Ulceration ◽  
Significant Difference ◽  
Potential Benefits ◽  
Randomised Controlled

Introduction The mainstay of treatment for venous ulceration remains compression therapy. Velcro Wrap devices are being increasingly used in these patients despite limited evidence. This feasibility study aimed to compare standard bandaging to the JuxtaCures™ Velcro wrap device. Methods A single centre, unblinded RCT compared participants with venous ulceration randomised to either the JuxtaCures™ device or short stretch bandaging. Participants were followed up for 26 weeks. Results 160 participants were screened with 40 randomised. 3 participants in bandaging and 1 in JuxtaCures™ didn’t complete the study. 60% in JuxtaCures™ healed v 55% in bandaging despite larger ulcers in the JuxtaCures™ arm (9.33 cm2 v 6.97 cm2). There was no significant difference in time to healing (12.17 v 13.64 weeks). JuxtaCures™ showed improved ulcer reduction for those that didn’t heal (14.91–5.00 cm2 v 14.20–8.62 cm2; P = 0.06). JuxtaCures™ had more consistent sub-bandage pressure dropping from 39–36 mmHg versus 41–25 mmHg in bandaging between application and removal (P < 0.001). Quality of life (EQ5D) was improved in JuxtaCures at 3 months (mean difference 0.14, p = 0.04), but not at 1 and 6 months, or in disease specific quality of life. Cost was lower in JuxtaCures™ £842.47 v £1064.68. Duration of appointment was significantly shorter in JuxtaCures™ (41 minutes v 53 minutes; P = 0.003). Conclusion This study has shown the feasibility and necessity of running a multicentre trial to evaluate the use of Velcro wrap devices for venous ulceration. It highlights the potential benefits of more consistent pressure, increased self-care, and potential with regards to ulcer healing, cost, nursing resource and quality of life.

Abstract P546: Sleep Quality in Medical Students A Cross-sectional Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Lilian S Costa ◽  
Marina C Marins ◽  
Jocasta C Ansel ◽  
Carolina P Tavares ◽  
Fernanda T Queiroz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Students ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Female Group ◽  
Sleep Habits ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Hours

Introduction: Medical students, susceptible to sleep disorders, have irregular sleep-awake cycle, with repercussions on the quality of life and reduced academic performance, often with greater incidence of psychiatric disorders, estimated at 15% to 25% during your academic training. Objective: To evaluate the sleep habits in students of medical school in a private college of Rio de Janeiro, Brazil. Method: This subset study is a part of an observational study with cross-sectional delineation, with data collected through the application of an anonymous questionnaire, where they were asked about the number (and modification) of hours they sleep daily, in addition to reports of “stress and anxiety”. These data collected formed the basis of an instrument for assessing the quality of life on the medical students of this College. Results: We analyzed data from 481 students: 82 (17%) at the first year, 118 (24.5%) at the second year, 99 (20.6%) at the third, 64 (13.3%) and 118 (24.5%) within the fifth and sixth years. The average age was 21.7 years (16-42) and 306 (63.6%) of female gender. As for the hours of sleep, 445 students (92.5%) report 5 to 8 hours of sleep, and 216 (44.9%) a minimum of 6 hours. In the sleep of the weekends, 394 (81.9%) reported change in the number of hours and, 313 (65.1%) referred to a reduction after the entrance into college. It was reported "some level of stress and anxiety,“ not related to the least number of hours sleepping (0.07). Comparing the data obtained among the 199 students of the first and second years (62.8% female-group A) to 117 at fifth and sixth years (70.9% female-group B), we observed similarity in relation to (1) number of 5 to 8 hours sleepping (A 92.9% x 90.5% B), (2) change the hours of sleepping on the weekends (A 81.9% x 79.5% B), and (3) reduction of sleepping hours after the entrance into College (A 81.9% x 78.6% B). With regard to the report of "stress and anxiety”, we observed statistically significant difference between the groups (A 100% x 88% B, p < 0.03). Conclusion: The change in lifestyle imposed on joining a new school learning model, generates anxiety and loss of sleep hours among students. The development of resilience and adaptation to change, both individual and institutional, may have been responsible to varying degrees of stress.

scholarly journals Optimal nocturnal sleep duration to maintain health-related quality of life in male collegiate athletes: a cross-sectional study

2021 ◽  
Author(s):  
Yuko Morita ◽  
Taeko Sasai-Sakuma
Keyword(s):  
Quality Of Life ◽  
Sleep Duration ◽  
Collegiate Athletes ◽  
Good Health ◽  
Health Related Quality ◽  
Sleep Habits ◽  
Nocturnal Sleep ◽  
Related Quality ◽  
Health Related

Abstract Background: This study investigated the optimal nocturnal sleep duration required by collegiate athletes to maintain physical and mental health, compared with non-athlete students. Methods: In this cross-sectional study, a questionnaire survey was conducted to assess demographic variables, lifestyle and sleep habits, and health-related quality of life in 298 collegiate students (non-athletes, n = 158; athletes, n = 140). Physical component summary and mental component summary were assessed by using a Short-Form 8 Health survey, and participants with good physical as well as mental component summary scores were considered to have a good health-related quality of life. To confirm an association between nocturnal sleep length and good health-related quality of life, logistic regression analyses were conducted in non-athlete students and collegiate athletes separately. Subsequently, receiver operating characteristics curve analyses were performed for detection of the cut-off points for nocturnal sleep duration sufficient to maintain good health-related quality of life in both collegiate athletes and non-athlete students. Results: The average nocturnal sleep duration was 7 hours 4 minutes among collegiate athletes, and 75.7% of them had a worse physical component summary. The cut-off point for nocturnal sleep duration in collegiate athletes was 7.98 hours (area under the curve: 0.69, P = 0.013, sensitivity: 85.5%, specificity: 56.2%), which was longer than the cut-off of 6.58 hours for non-athlete students. Conclusion: Collegiate athletes required longer nocturnal sleep than non-athlete students. Nevertheless, their habitual nocturnal sleep duration was shorter compared to their optimal duration; around 80% of them faced chronic insufficient sleep. Improving sleep habits and sleep education is important in maintaining their good health-related quality of life.

scholarly journals Prevalence, Correlations, and Impact of Sleep Disturbance in Chinese Meningioma Patients

2021 ◽  
Author(s):  
Dandan Zhang ◽  
Jing Wang ◽  
Xixi Gu ◽  
Zhifeng Gu ◽  
Liren Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Short Form ◽  
Binary Logistic Regression ◽  
Anxiety And Depression ◽  
Newly Diagnosed ◽  
Chi Square Analysis

Abstract Purpose Sleep disturbance is common in meningioma patients and may lead to disease aggravation and decreases health-related quality of life (HRQoL). However, the sleep quality of meningioma patients newly diagnosed and ready for surgery has not been well clarified in China. This study aims to evaluate the prevalence, correlates, and impact of sleep disturbance among Chinese meningioma patients. Methods In this cross-sectional study, meningioma patients were recruited from the Affiliated Hospital of Nantong University from January 2020 to November 2020. A series of questionnaires were applied: the 0–10 Numerical Rating Scale (NRS), the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Epworth Sleepiness Scale (ESS), the Short-Form 36 (SF-36), the Pittsburgh Sleep Quality Index (PSQI). Independent samples t test, Mann-Whitney U test, chi-square analysis, Pearson/Spearman correlation, and binary logistic regression were used to analyze the data. Results 100 meningioma patients completed the questionnaires. Sleep disturbance affected 43% of the meningioma patients and was linked to many concomitant symptoms, such as headache, fatigue, anxiety and depression. Binary logistic regression indicated that fatigue and headache were predictors of sleep disturbance in meningioma patients. Meanwhile, severe sleep disturbance led to lower quality of life. Conclusions These findings demonstrated that a considerable number of meningioma patients newly diagnosed and ready for surgery suffered from sleep disturbance, potentially contributing to impair HRQoL. Medical personnel should pay more attention to meningioma patients with sleep disturbance and take effective measures to improve sleep quality, with the ultimate goal to improve their HRQoL.

Management of Asthma during Pregnancy: Optimizing Outcomes and Minimizing Risk

2018 ◽  
Vol 39 (01) ◽  
pp. 029-035 ◽  
Author(s):  
Michael Schatz ◽  
Jennifer Namazy
Keyword(s):  
Quality Of Life ◽  
Perinatal Outcomes ◽  
Pregnant Patient ◽  
Medical Problems ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Adverse Perinatal Outcomes ◽  
Maternal Quality Of Life ◽  
Maternal Quality

AbstractPregnancy may be complicated by new onset or preexisting asthma. This article reviews diagnosis and management of asthma in the pregnant patient. Special attention is paid to the challenges in diagnosis and management of this condition during pregnancy. Asthma is one of the most common potentially serious medical problems to complicate pregnancy, and asthma may adversely affect both maternal quality of life and perinatal outcomes. Asthma may adversely affect both maternal quality of life and, perinatal outcomes. Pregnant asthmatics have been shown to be at an increased risk of adverse perinatal outcomes. Optimal management of asthma during pregnancy is thus important for both mother and baby. This article provides an update on the available literature regarding the safety of commonly used asthma medications during pregnancy.

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