A Sleep Laboratory Evaluation of the Long-Term Efficacy of Zopiclone

1988 ◽  
Vol 33 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jonathan A.E. Fleming ◽  
Jean Bourgouin ◽  
Peter Hamilton
Keyword(s):  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Laboratory Evaluation ◽  
Sleep Study ◽  
Sleep Studies ◽  
Metallic Taste ◽  
Hypnotic Medication ◽  
Drug Free

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

scholarly journals Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

2019 ◽  
Vol 35 (4) ◽  
pp. 713-724
Author(s):  
Theresa Casey ◽  
Hui Sun ◽  
Helen J. Burgess ◽  
Jennifer Crodian ◽  
Shelley Dowden ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Delayed Onset ◽  
Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

scholarly journals Study of correlation between perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography before and after antidepressant therapy

2020 ◽  
Vol 8 (7) ◽  
pp. 2551
Author(s):  
Ganesh Ingole ◽  
Harpreet S. Dhillon ◽  
Bhupendra Yadav
Keyword(s):  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Antidepressant Treatment ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Architecture ◽  
Wake Time ◽  
Depressed Patients ◽  
Before And After

Background: A prospective cohort study to correlate perceived sleep disturbances in depressed patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy.Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of Depressive episode was made based on ICD-10 DCR. Psychometry, in the form of Beck Depressive inventory (BDI) and HAMD (Hamilton depression rating scale) insomnia subscale was applied on Day 1 of admission. Patients were subjected to sleep study on Day 03 of admission with Polysomnography. Patients were started on antidepressant treatment post Polysomnography. An adequate trial of antidepressants for 08 weeks was administered and BDI score ≤09 was taken as remission. Polysomnography was repeated post remission. Statistical analysis was performed using Kruskal Wallis test and Pearson correlation coefficient.Results: The results showed positive (improvement) polysomnographic findings in terms of total sleep time, sleep efficiency, wake after sleep onset, percentage wake time and these findings were statistically significant. HAM-D Insomnia subscale was found to correlate with total sleep time, sleep efficiency, wake after sleep onset, total wake time and N2 Stage percentage.Conclusions: Antidepressant treatment effectively improves sleep architecture in Depressive disorder and HAM-D Insomnia subscale correlates with objective findings of total sleep time, sleep efficiency, wake after sleep onset, total wake time and duration of N2 stage of NREM.

scholarly journals A study on sleep apnea in patients with abnormal sewda type of depression

2020 ◽  
pp. 1-8
Author(s):  
Aman Gul ◽  
Nassirhadjy Memtily ◽  
Pirdun Mijit ◽  
Palidan Wushuer ◽  
Ainiwaer Talifu ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Control Group ◽  
Poor Sleep ◽  
Sleep Structure ◽  
Maintenance Rate ◽  
Sleep Maintenance ◽  
Insomnia Symptoms

Objective: To preliminarily investigate the clinical features and PSG in abnormal sewda-type depressive insomnia. Methods: A total of 127 abnormal sewda-type depressive insomnia patients were evaluated with overnight PSG, and 32 normal participants were compared. Results: Patients with abnormal sewda-type depressive insomnia were compared with the control group; the sleep symptoms showed a long incubation period of sleep, low sleep maintenance rate, low sleep efficiency and poor sleep quality as well as daytime dysfunction. At process and continuity of sleep: Total sleep time, sleep efficiency, sleep maintenance rate in abnormal sewda-type depressive insomnia group were shorter than the control group. Wake after sleep onset, and sleep latency were longer than the control group. At sleep structure: N1 ratio and N2 ratio in depressive insomnia group were longer than the control group, N3 ratio and REM sleep ratio shorter than the control group. At REM index: REM latency, REM cycles, and REM sleep time were shorter than the control group. Conclusion: Insomnia symptoms in abnormal sewda-type depression comorbid insomnia patients were similar to the ordinary insomnia patients. The PSG characteristics had significant changes in sleep process, sleep structure and REM indicators. The severity of the abnormal sewda-type depression was closely related to REM indicators. Change of REM sleep characteristics may be the specificity, and these could be taken as reference in diagnosis and identification of abnormal sewda-type depressive insomnia.

Sleep Patterns and Affect Dynamics Among College Students during COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Zahra Mousavi ◽  
Jocelyn Lai ◽  
Katharine Simon ◽  
Alexander P. Rivera ◽  
Asal Yunusova ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Longitudinal Design ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Onset Latency ◽  
Sleep Patterns ◽  
Daily Lives ◽  
Affect Dynamics

BACKGROUND Sleep disturbance is a transdiagnostic risk factor so prevalent among young adults it is considered a public health epidemic, exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant. OBJECTIVE In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic. METHODS College student participants (N=20, 65% female) wore an Oura ring continuously for 3-months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE), and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment (EMA) using a mobile health app to evaluate positive (PA) and negative affect (NA), and COVID-worry once per day. RESULTS Participants with higher SOL and TST on the prior day had lower PA the next day. Further, higher average TST across the 3-month period predicted lower average PA. TST variability predicted higher affect variability across all affect domains. CONCLUSIONS Fluctuating sleep patterns are associated with affect dynamics at daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health.

scholarly journals 0497 Rebound Insomnia During Discontinuation of Chronic Hypnotic Use

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A190-A190
Author(s):  
G Koshorek ◽  
J Verkler ◽  
T Roth ◽  
T Roehrs
Keyword(s):  
Clinical Trial ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Study Medication ◽  
Rebound Insomnia ◽  
Dsm V ◽  
Hypnotic Medication ◽  
Choice Period ◽  
Trial Participants

Abstract Introduction Rebound insomnia refers to worsened sleep relative to baseline on 1-2 nights after discontinuation of active hypnotic medication. Rebound is typically assessed using a placebo substitution. We assessed rebound in an on-going “blinded” clinical trial in which people with insomnia are instructed to discontinue their study medication (i.e., no-pill) after 6 months of nightly use. Methods DSM-V diagnosed people with insomnia (n=31, 26 females), aged 26-61 yrs, with a polysomnographic sleep efficiency of ≤85%, no other sleep disorders, unstable medical or psychiatric diseases or drug dependency completed the clinical trial. Participants were randomized to zolpidem XR (12.5 mg), eszopiclone (3 mg) or placebo nightly for 6 months (blinded groups A: n=11, B: n=9, C: n=11). After 6 months, over a 2-week choice period, they were given the instruction to discontinue their nightly hypnotic use with an opportunity, if necessary, to self-administer either 1, 2, or 3 capsules of their assigned medication (zolpidem XR 6.25 mg, 6.25 mg, placebo; eszopiclone 2 mg, 1 mg, placebo as capsules 1, 2 and 3 respectively; or 3 placebos). On baseline and the14 discontinuation nights, sleep was recorded and scored by actigraphy for sleep efficiency (SE), sleep latency (LAT) and wake after sleep onset (WASO). Results Relative to the baseline night, on the first discontinuation night there was no difference in SE, LAT, and WASO. Fifteen subjects stopped taking study medication when told to discontinue and 16 subjects took study medication on one night or more. While not differing on baseline or night 1, on night 14 the last study night the medication users had a lower SE (75.9 vs 87.7 %, p&lt;.0.004) and a longer LAT (61.5 vs 14.5 min, p&lt;0.05). Conclusion Difficulty discontinuing hypnotic use is not specifically related to rebound insomnia. We reported in a companion abstract those with insomnia and hyperarousal, defined by MSLT, are those with difficulty discontinuing hypnotic use and as shown here slept poorly on the last study night. Support NIDA, grant#: R01DA038177 awarded to Dr. Roehrs

scholarly journals Jactatio capitis nocturna with persistence in adulthood: case report

1998 ◽  
Vol 56 (3B) ◽  
pp. 655-657 ◽  
Author(s):  
ROSANA S.C. ALVES ◽  
FLÁVIO ALÓE ◽  
ADEMIR B. SILVA ◽  
STELLA M. TAVARES
Keyword(s):  
Movement Disorder ◽  
Sleep Onset ◽  
Nrem Sleep ◽  
Sleep Time ◽  
Efficiency Index ◽  
Rhythmic Movement ◽  
Head Movements ◽  
Sleep Study ◽  
Related Disorder ◽  
Rhythmic Movement Disorder

Rhythmic movement disorder, also known as jactatio capitis nocturna, is an infancy and childhood sleep-related disorder charactherized by repetitive movements occurring immediately prior to sleep onset and sustained into light sleep. We report a 19-year-old man with a history of headbanging and repetitive bodyrocking since infancy, occurring on a daily basis at sleep onset. He was born a premature baby but psychomotor milestones were unremarkable. Physical and neurological diagnostic workups were unremarkable. A hospital-based sleep study showed: total sleep time: 178 min; sleep efficiency index 35.8; sleep latency 65 min; REM latency 189 min. There were no respiratory events and head movements occurred at 4/min during wakefulness, stages 1 and 2 NREM sleep. No tonic or phasic electromyographic abnormalities were recorded during REM sleep. A clinical diagnosis of rhythmic movement disorder was performed on the basis of the clinical and sleep studies data. Clonazepam (0.5 mg/day) and midazolam (15 mg/day) yielded no clinical improvement. Imipramine (10 mg/day) produced good clinical outcome. In summary, we report a RMD case with atypical clinical and therapeutical features.

Actigraphy findings and cancer-related fatigue (CRF) in advanced cancer patients treated with methylphenidate (MP) and nursing telephone intervention (NTI).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20528-e20528 ◽  
Author(s):  
Eduardo Bruera ◽  
Sriram Yennurajalingam ◽  
Dave Balachandran ◽  
Nikhil S Padhye ◽  
Janet L. Williams ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Interaction Effect ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Cancer Type ◽  
Telephone Intervention ◽  
Advanced Cancer Patients ◽  
Time Activity

e20528 Background: There are limited studies about actigraphic sleep, wakefulness, activity and fatigue and treatment in advanced cancer patients. The objective of this study was to evaluate the changes in the nocturnal sleep/rest, and daytime wake/activity and subjective measures of fatigue before and after treatment with MP+/- NTI. Methods: A subset of patients from a previous reported placebo and control telephone intervention (CTI) controlled RCT of MP and/or NTI for CRF were reviewed. Subjective and objective assessments were analyzed at Day-8 and Day-15 as a result of treatment with MP and/or NTI or their control arms. Actigraphic sleep measures assessed were total sleep time (TST), sleep efficiency, and wake after sleep onset (WASO). Additionally, activity (mean day-time activity), and fatigue (FACIT-F, ESAS-Fatigue item) were included in the multivariate analysis. Results: A total of 60 (MP=30, Placebo=30; NTI=35; CTI=25) patients were evaluated. The median age was 56, 62% were female; most common cancer type was breast 13/60(22%). The baseline mean FACIT-F subscale, ESAS Fatigue item, TST, WASO, sleep efficiency and day-time activity were 22.4 (9.33), 6.5(1.74), 437(162.4), 139(121.4), 71(16.4), 202(438). Multivariate outcomes at Day-8 showed significant change from baseline (η2=0.38, p<0.001) and interaction effect between MP and NTI (η2=0.26, p=0.015). WASO had an interaction effect (β=-101.4, p=0.009), an MP effect (β=80.4, p=0.002) and reduction in time (β=-52.1, p=0.003). FACIT-F and ESAS-Fatigue item showed improvement in time (β=6.9, p=0.010; β=-2.4, p<0.001). Conclusions: WASO was significantly lower in patients receiving methylphenidate and nursing telephone intervention. Further larger studies are needed to validate these findings.

Links between sleep and body mass index in bipolar disorders: An exploratory study

2015 ◽  
Vol 30 (1) ◽  
pp. 89-93 ◽  
Author(s):  
C. Boudebesse ◽  
P.-A. Geoffroy ◽  
C. Henry ◽  
A. Germain ◽  
J. Scott ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Bipolar Disorders ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Onset Latency ◽  
Cross Sectional ◽  
Sleep Parameters

AbstractStudy objectives:Obesity and excess bodyweight are highly prevalent in individuals with bipolar disorders (BD) and are associated with adverse consequences. Multiple factors may explain increased bodyweight in BD including side effects of psychotropic medications, and reduced physical activity. Research in the general population demonstrates that sleep disturbances may also contribute to metabolic burden. We present a cross-sectional study of the associations between body mass index (BMI) and sleep parameters in patients with BD as compared with healthy controls (HC).Methods:Twenty-six French outpatients with remitted BD and 29 HC with a similar BMI completed a 21-day study of sleep parameters using objective (actigraphy) and subjective (PSQI: Pittsburgh Sleep Quality Index) assessments.Results:In BD cases, but not in HC, higher BMI was significantly correlated with lower sleep efficiency (P = 0.009) and with several other sleep parameters: shorter total sleep time (P = 0.01), longer sleep onset latency (P = 0.05), higher fragmentation index (P = 0.008), higher inter-day variability (P = 0.05) and higher PSQI total score (P = 0.004).Conclusions:The findings suggest a link between a high BMI and several sleep disturbances in BD, including lower sleep efficiency. Physiological mechanisms in BD cases may include an exaggeration of phenomena observed in non-clinical populations. However, larger scale studies are required to clarify the links between metabolic and sleep-wake cycle disturbances in BD.

scholarly journals P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A48-A48
Author(s):  
N Lovato ◽  
G Micic ◽  
L Lack
Keyword(s):  
Sleep Duration ◽  
Cognitive Behaviour Therapy ◽  
Sleep Onset ◽  
Past Research ◽  
Severity Index ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Pre Treatment

Abstract Introduction Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment. Method Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up. Results CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment. Discussion CBTi responsiveness did not differ as a function of objective SE.

Association Between Accelerometer and Parental Reported Weekend and Weekday Sleeping Patterns and Adiposity Among Preschool-Aged Children

2021 ◽  
Vol 4 (3) ◽  
pp. 266-273
Author(s):  
Bridget Coyle-Asbil ◽  
Hannah J. Coyle-Asbil ◽  
David W.L. Ma ◽  
Jess Haines ◽  
Lori Ann Vallis
Keyword(s):  
Total Sleep Time ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Older Children ◽  
Racially Diverse ◽  
Sex Effect ◽  
Healthy Development ◽  
The Difference ◽  
Waking Up

Sleep is vital for healthy development of young children; however, it is not understood how the quality and quantity vary between the weekends and weekdays (WE–WD). Research focused on older children has demonstrated that there is significant WE–WD variability and that this is associated with adiposity. It is unclear how this is experienced among preschoolers. This study explored: (a) the accuracy of WE–WD sleep as reported in parental logbooks compared with accelerometers; (b) the difference between WE and WD total sleep time, sleep efficiency, and timing, as assessed by accelerometers; and (c) the association between the variability of these metrics and adiposity. Eighty-seven preschoolers (M = 46; 4.48 ± 0.89 years) wore an accelerometer on their right hip for 7 days. Parents were given logbooks to track “lights out” times (sleep onset) and out of bed time (sleep offset). Compared with accelerometers, parental logbook reports indicated earlier sleep onset and later sleep offset times on both WEs and WDs. Accelerometer-derived total sleep time, sleep efficiency, and onset/offset were not significantly different on the WEs and WDs; however, a sex effect was observed, with males going to bed and waking up earlier than females. Correlation analyses revealed that variability of sleep onset times throughout the week was positively correlated with percentage of fat mass in children. Results suggest that variability of sleep onset may be associated with increased adiposity in preschool children. Additional research with larger and more socioeconomically and racially diverse samples is needed to confirm these findings.

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