Temazepam (Restoril, Sandoz Pharmaceuticals)

Temazepam is a benzodiazepine derivative indicated for the treatment of insomnia. Pharmacokinetic studies of the hard capsule formulation indicate that the mean time to peak is 2.99 hours and the mean elimination half-life is 14.7 hours. Sleep laboratory studies have demonstrated improvements in all sleep parameters except sleep onset latency. Clinically, patients report improvements in all sleep parameters including sleep onset latency. The efficacy of temazepam compares favorably with barbiturates, glutethimide, nitrazepam, lorazepam, oxazepam, and flurazepam. It has not been compared with diazepam in the clinical setting. Side effects include drowsiness, dizziness, and lethargy. The incidence of hangover effects from 15- and 30-mg doses is relatively low. Temazepam has no proven advantages over other benzodiazepine hypnotics. The major issues that need further clarification include temazepam's sleep induction properties and the relative incidence of hangover and rebound insomnia when compared with longer-acting benzodiazepines.

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Microclimate Thermal Management Using Thermoelectric Air-Cooling Duct System Operated at Five Incremental Powers and its Effect on Sleep Adaptation of the Occupants

Energies ◽

10.3390/en12193695 ◽

2019 ◽

Vol 12 (19) ◽

pp. 3695 ◽

Cited By ~ 1

Author(s):

Kashif Irshad ◽

Salem Algarni ◽

Mohammad Tauheed Ahmad ◽

Sayed Ameenuddin Irfan ◽

Khairul Habib ◽

...

Keyword(s):

Sleep Quality ◽

Cooling System ◽

Sleep Onset ◽

Air Cooling ◽

Sleep Onset Latency ◽

Onset Latency ◽

Test Room ◽

Environmentally Sustainable ◽

Highly Sensitive ◽

The Mean

In this study, the microclimate of the test room was regulated using thermoelectric air duct cooling system (TE-AD) operated at input powers-240 W, 360 W, 480 W, 600 W, 720 W, and 840 W, on subsequent nights. Fifteen (15) healthy male volunteers were recruited to sleep under these test conditions and their sleep quality was assessed by studying objective measures such as sleep onset latency (SOL), mean skin temperature and heart rate as well as subjective parameters like predicted mean vote (PMV) and predicted percentage of dissatisfied (PPD). There was a consistent improvement on all studied parameters when the power of the system was increased from 240 W to 720 W. The mean sleep onset latency time was reduced from (M = 40.7 +/− 0.98 min) to (M = 18.33 +/− 1.18 min) when the operating power was increased from 240 W to 720 W, denoting an improvement in sleep quality. However, increasing the power further to 840 W resulted in deteriorating cooling performance of the TE-AD system leading to an increase in temperature of the test room and reduction in sleep comfort. Analysis of subjective indices of thermal comfort viz. PMV and PPD revealed that subjects are highly sensitive towards variations in microclimate achieved by changing the operating power of the TE-AD. This device was also found to be environmentally sustainable, with estimated reduction in CO2 emission calculated to be around 38% as compared to the conventional air-conditioning.

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Sleep and Migraine: An Actigraphic Study

Cephalalgia ◽

10.1111/j.1468-2982.2004.00657.x ◽

2004 ◽

Vol 24 (2) ◽

pp. 134-139 ◽

Cited By ~ 58

Author(s):

O Bruni ◽

PM Russo ◽

C Violani ◽

V Guidetti

Keyword(s):

Motor Activity ◽

Migraine Without Aura ◽

Sleep Onset ◽

Cortical Activation ◽

Self Report ◽

Sleep Onset Latency ◽

Onset Latency ◽

Monitoring Period ◽

Sleep Parameters ◽

Migraine Group

The aim of the study was to evaluate sleep of children with migraine during the interictal period and the modifications of sleep which precede, are concomitant with, or follow migraine attacks. Eighteen patients with migraine without aura were compared with a group of 17 healthy age-matched children. Sleep parameters were monitored for two full weeks by means of actigraphs and self-report diaries. Headache diaries were also filled out in order to evaluate the occurrence and the characteristics of migraine attacks. Fifty-seven attacks were recorded during the monitoring period. During the interictal period, sleep parameters of children suffering from migraine did not differ from those of controls; only sleep onset latency was slightly prolonged in the migraine group. Timing of the attack affected nocturnal motor activity which presented the lowest values on the night preceding the attack, indicating a decrease in cortical activation during sleep preceding migraine attacks. Further studies should clarify if the observed reduction in nocturnal motor activity close to the attack is related to neurotransmitter imbalance.

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P121 Comparison of Actigraphy versus PSG and Perception of Sleep in Patients with Excessive Daytime Sleepiness

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.162 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A60-A61

Author(s):

T Roebuck ◽

E McDermott ◽

R Cuesta ◽

R Nguy ◽

M Spiteri ◽

...

Keyword(s):

Sleep Latency ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Onset Latency ◽

Activity Data ◽

Significant Difference ◽

Sleep Parameters ◽

Perception Of Sleep

Abstract Actigraphy is used as a validated measure of rest and sleep, however, there are reported differences in WASO in healthy individuals (Chinoy, 2021). Methods This study compares the sleep parameters from PSG with simultaneous overnight actigraphy on patients the night prior to MSLT. We also compare the actigraphy data collected on the week prior to the PSG with the patient’s sleep diary. 22 subjects, age 38.7 ± 3.1 years, BMI 23.5 ± 1.4 kg/m2, 40.1% male, 4 participants were treated with CPAP. Results WASO was found to be under estimated by actigraphy versus PSG (y=-0.957x+18.014, R2=0.51), there is an increase in underestimation beyond 18minutes. Our data also show on overestimation of sleep onset latency by actigraphy versus PSG when sleep latency is longer than 12 minutes (y=0.27x-12.04, R2=0.08). Total sleep time was perceived to be longer on the PSG night than the PSG data shows (y=0.68x-4.65, R2=0.21). Data demonstrated participants to overestimate their sleep period in their sleep diary compared to the actigraphy data (y=-0.87x+6.58, R2=0.21). T-tests showed a significant difference between WASO (minutes) detected by PSG and the actigraphy data (67.4 ± 8.9 vs 33.3 ± 3.9 p=0.0007). There were no other significant differences in the datasets. Conclusion Actigraphy uses activity data and light detection to estimate rest and sleep periods in wearers. Our data reflects expected differences reported in the literature of actigraphy data versus PSG due to the limitation of actigraphy being able to differentiate between sleep and motionless wakefulness.

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Melatonin in pediatric neurology

ORL ro ◽

10.26416/orl.33.4.2016.168 ◽

2016 ◽

Vol 4 (1) ◽

pp. 56-59

Author(s):

Raluca Ioana Teleanu ◽

Magdalena Sandu ◽

Eugenia Roza

Keyword(s):

European Union ◽

Food Safety ◽

Sleep Onset ◽

Sleep Onset Latency ◽

The European Union ◽

Onset Latency ◽

Entire Life ◽

Light Darkness ◽

Efficacy Studies ◽

Endogenous Melatonin

Melatonin is a hormone produced by the pineal gland during the night, as a response to the light-darkness variation. The endogenous melatonin levels have a cyclic evolution throughout the entire life. Various roles have been cited such as the in utero developement of the fetus through its action on the placenta, neurons and glial cells, a major role in the regulation of the cyrcadian rhythm, antioxidative, antiinflammatory roles, as well as celullar and umoral immunity modulation. In the European Union, exogenous melatonin has been evaluated by the European Food Safety Authority (EFSA) for reducing sleep onset latency and the conclusion was that it has efficacy studies in this regard.

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The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

Sleep and Vigilance ◽

10.1007/s41782-020-00105-5 ◽

2020 ◽

Vol 4 (2) ◽

pp. 167-176

Author(s):

Achim Elfering ◽

Christin Gerhardt ◽

Diana Pereira ◽

Anna Schenker ◽

Maria U. Kottwitz

Keyword(s):

Sleep Duration ◽

Sleep Onset ◽

Monday Morning ◽

Sleep Onset Latency ◽

Onset Latency ◽

Social Stressors ◽

Monday Effect ◽

Work Related ◽

Cognitive Failure ◽

Delayed Sleep

Abstract Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.

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193 Sleep Variability and Affect Dynamics Among College Students during COVID-19 Pandemic

SLEEP ◽

10.1093/sleep/zsab072.192 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A78-A78

Author(s):

Zahra Mousavi ◽

Jocelyn Lai ◽

Asal Yunusova ◽

Alexander Rivera ◽

Sirui Hu ◽

...

Keyword(s):

Emerging Adults ◽

Sleep Duration ◽

Sleep Onset ◽

Positive And Negative Affect ◽

Sleep Onset Latency ◽

Deep Sleep ◽

Onset Latency ◽

Sleep Patterns ◽

Light Sleep ◽

Affect Dynamics

Abstract Introduction Sleep disturbance is a transdiagnostic risk factor that is so prevalent among emerging adults it is considered to be a public health epidemic. For emerging adults, who are already at greater risk for psychopathology, the COVID-19 pandemic has disrupted daily routines, potentially changing sleep patterns and heightening risk factors for the emergence of affective dysregulation, and consequently mood-related disturbances. This study aimed to determine whether variability in sleep patterns across a 3-month period was associated with next-day positive and negative affect, and affective dynamics, proximal affective predictors of depressive symptoms among young adults during the pandemic. Methods College student participants (N=20, 65% female, Mage=19.80, SDage=1.0) wore non-invasive wearable devices (the Oura ring https://ouraring.com/) continuously for a period of 3-months, measuring sleep onset latency, sleep efficiency, total sleep, and time spent in different stages of sleep (light, deep and rapid eye movement). Participants reported daily PA and NA using the Positive and Negative Affect Schedule on a 0-100 scale to report on their affective state. Results Multilevel models specifying a within-subject process of the relation between sleep and affect revealed that participants with higher sleep onset latency (b= -2.98, p<.01) and sleep duration on the prior day (b= -.35, p=.01) had lower PA the next day. Participants with longer light sleep duration had lower PA (b= -.28, p=.02), whereas participants with longer deep sleep duration had higher PA (b= .36, p=.02) the next day. On days with higher total sleep, participants experienced lower NA compared to their own average (b= -.01, p=.04). Follow-up exploratory bivariate correlations revealed significant associations between light sleep duration instability and higher instability in both PA and NA, whereas higher deep sleep duration was linked with lower instability in both PA and NA (all ps< .05). In the full-length paper these analyses will be probed using linear regressions controlling for relevant covariates (main effects of sleep, sex/age/ethnicity). Conclusion Sleep, an important transdiagnostic health outcome, may contribute to next-day PA and NA. Sleep patterns predict affect dynamics, which may be proximal predictors of mood disturbances. Affect dynamics may be one potential pathway through which sleep has implications for health disparities. Support (if any):

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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia

Behaviour Change ◽

10.1017/bec.2020.18 ◽

2020 ◽

pp. 1-15

Author(s):

Allie Peters ◽

John Reece ◽

Hailey Meaklim ◽

Moira Junge ◽

David Cunnington ◽

...

Keyword(s):

Sleep Disorders ◽

Treatment Effect ◽

Sleep Onset ◽

Sleep Efficiency ◽

Health Concern ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Subjective Sleep ◽

Sleep Parameters

Abstract Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.

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0004 TS-142: A Novel and Potent Dual Orexin Receptor Antagonist with Sleep-Promoting Effects in Rats

SLEEP ◽

10.1093/sleep/zsaa056.003 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A2-A2

Author(s):

D Kambe ◽

H Hikichi ◽

Y Tokumaru ◽

M Ohmichi ◽

Y Konno ◽

...

Keyword(s):

Receptor Antagonist ◽

Half Life ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Orexin A ◽

Pharmacokinetic Profiles ◽

Orexin Receptors ◽

Elimination Half ◽

Emg Electrodes

Abstract Introduction The orexin system plays a pivotal role in regulating sleep and wakefulness, thus, orexin receptors (OX1 and OX2 receptors) have gained much attention as promising therapeutic targets for the treatment of insomnia. We synthesized a novel and potent dual orexin receptor antagonist (DORA), ORN0829 (investigation code name as TS-142), which was designed to have short-acting effects. Here we report pharmacological and pharmacokinetic profiles of ORN0829 in rats. Methods The antagonistic activities of ORN0829 were assessed using calcium mobilization assays. Ala-orexin A-induced [Ca2+]i response was measured with CHO-K1 cells stably expressing human/rat orexin receptor. Rats implanted the EEG/EMG electrodes were orally administrated ORN0829 at doses of 1, 3 or 10 mg/kg at the dark onset and sleep-wake stages were inspected visually. In addition, pharmacokinetic profiles of ORN0829 were investigated in rats. Results ORN0829 inhibited Ala-orexin A-increased [Ca2+]i response with a Kb of 0.67/0.44 nmol/L (for human/rat OX1 receptor), and with a Kb of 0.84/0.80 nmol/L (for human/rat OX2 receptor), respectively, indicating that ORN0829 is a potent DORA with no species differences. ORN0829 dose-dependently increased total sleep time and reduced sleep onset latency at doses of 1, 3 and 10 mg/kg. Importantly, the ORN0829 levels in plasma and cerebrospinal fluid rapidly reached a maximum concentration, and decreased with an elimination half-life of less than 1 h. Conclusion The present study indicates that ORN0829 is a novel and potent DORA with sleep-promoting effects, and that it exhibits ideal pharmacokinetic profiles (rapid absorption and short half-life) in rats. A phase 2a study of TS-142 using patients with insomnia has been completed, which is presented in a separate poster. Support Taisho Pharmaceutical. Co., Ltd.

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1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽

10.1093/sleep/zsaa056.1247 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A477-A477

Author(s):

Kamal Patel ◽

Bianca J Lang

Keyword(s):

Daytime Sleepiness ◽

Sleep Latency ◽

Sleep Onset ◽

Sleep Time ◽

Multiple Sleep Latency Test ◽

Sleep Onset Latency ◽

Onset Latency ◽

Obstructive Sleep ◽

Falling Asleep ◽

Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

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