scholarly journals Enuresis: modern aspects of etiology, pathogenesis, psycho-, pharmaco-, physical therapy and phytotherapy (part 1)

The review (part 1) discusses modern views on the etiology, pathogenesis and clinical course of bedwetting in children. Enuresis is a common condition that causes significant disruption in critical areas of a child's life. Despite the existence of an international standard and clinical guidelines for the treatment of bedwetting, specialists do not have a single approach to the management of patients with enuresis. In order to systematize modern views on these issues, 73 sources were analyzed. The criteria for enuresis according to ICD-10 and DSM-5.0 and various approaches to classifying the types of enuresis are present in the review. The characteristics of simple, neurotic, endocrinopathic, epileptic, neuropathic and dysplastic forms of enuresis are given. The modern concepts of the pathophysiology of enuresis are analyzed. Connection between bedwetting and sleep problems, high levels of arousal in the cerebral cortex, fragmentation, and poor sleep quality are accentuated in the several analyzed studies. The changes in the autonomic nervous system and hemodynamics arising in connection with these disorders contribute to the excessive formation of urine and an increase in the activity of the bladder. Some patients have nocturia associated with circadian fluctuations in the level of vasopressin, which, however, does not always explain the occurrence of bedwetting. A number of analyzed studies have established a relationship between polyuria and changes in salt and water excretion. Other mechanisms of the pathogenesis of enuresis, concerning violations of the reservoir function of the urinary bladder during sleep, are also highlighted. Knowledge of the etiology and pathogenesis of enuresis helps doctors better understand the nature of a particular child's condition and, personalize treatment, based on modern protocols. The patient-centered approach to the treatment of enuresis is discussed in article, as well as sequence of therapeutic measures, including behavioral therapy, alarm-therapy and pharmacotherapy, and if indicated, also physical therapy and herbal medicine, a detailed analysis of which is presented in part 2 of the review.

2011 ◽  
Vol 33 (4) ◽  
pp. 312-326 ◽  
Author(s):  
Dolores Puterbaugh

Sleep problems are epidemic in the United States. Many adults complain of poor sleep yet engage in behaviors that are counterproductive to sleep. This article briefly reviews recent research on the treatment of insomnia and discusses application of mental health counseling strategies for treatment. Case studies illustrate the application of current research within counselor areas of expertise in cognitive behavioral therapy and behavioral counseling.


2016 ◽  
Vol 19 (5) ◽  
pp. 492-501 ◽  
Author(s):  
Marina B. Pinheiro ◽  
Kevin K. Ho ◽  
Manuela L. Ferreira ◽  
Kathryn M. Refshauge ◽  
Ron Grunstein ◽  
...  

Poor sleep quality is highly prevalent in patients with low back pain (LBP) and is associated with high levels of pain, psychological distress, and physical disability. Studies have reported a bidirectional relationship between sleep problems and intensity of LBP. Accordingly, effective management of LBP should address sleep quality. In addition, genetics has been found to significantly affect the prevalence of both LBP and insomnia. Our study aims to establish the feasibility of a trial exploring the efficacy of a web-based sleep quality intervention in people with LBP, with the genetic influences being controlled for. 30 twins (15 complete pairs) with subacute or chronic LBP (>6 weeks) will be recruited from the Australian Twin Registry. Participants will be randomly assigned to one of the two groups with each twin within a pair receiving either an interactive web-based sleep intervention based on cognitive behavioral therapy principles (intervention) or a web-based education program (control) for 6 weeks. The feasibility of the trial will be investigated with regard to recruitment rate, feasibility of data collection and outcome measure completion, contamination of intervention, acceptability and experience of intervention, and sample size requirement for the full trial. Patient outcomes will be collected electronically at baseline, immediately post-treatment, and at 3-months’ follow-up post-randomization. This trial employs a robust design that will effectively control for the influence of genetics on treatment effect. Additionally, this study addresses sleep quality, a significant but under-explored issue in LBP. Results will inform the design and implementation of the definitive trial.


Author(s):  
GVANTSA ARVELADZE ◽  
TEIMURAZ MIKELADZE

Sleep problems with behavioral origins occur in 20 to 30 percent of children and are especially common in children with medical, neurodevelopmental, or psychiatric disorders. Insomnia related to learned sleep onset associations is most common in infants and toddlers and is characterized by prolonged night waking, requiring parental intervention to restore sleep. It occurs when the child learns to associate falling asleep with specific experiences, such as being rocked or fed. Insomnia related to inadequate limit-setting is a disorder most common in children who are preschool-aged and older and is characterized by active resistance, verbal protests, and repeated demands at bedtime. Guidance to parents about healthy sleep practices helps to prevent sleep problems and is also an important first step in treatment. An integral part of the bedtime routine is the institution of a bedtime and sleep schedule that ensures a developmentally appropriate amount of sleep. A consistent nightly bedtime will help to set the circadian clock and enable the child to fall asleep more easily. Treatment of primary insomnia in older children and adolescents usually involves behavioral interventions that resemble those used in adults. Establishing a consistent sleep schedule is also important for older children and adolescents for whom poor sleep hygiene is a common cause of sleep problems. Pharmacologic therapy for the treatment of childhood insomnia is not a first-line treatment and should always be combined with behavioral therapy.


Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 578-578
Author(s):  
Adam Spira ◽  
Katie Stone

Abstract Sleep is a significant contributor to health and wellbeing across the lifespan, especially in later life. Poor sleep is common among older adults and can be both a risk factor for and consequence of numerous physical and mental health-related outcomes. In this symposium, we will present novel results from four studies that will advance understanding of the biological, psychological, and social factors that may contribute to or result from poor sleep in older adults. Specifically, Study 1 will present findings tying objectively measured sleep to performance on cognitive tasks administered using ecological momentary assessment (EMA) in the day-to-day lives of older adults with or without mild cognitive impairment (MCI). Study 2 will examine associations of personality dimensions and facets with insomnia symptoms in well-functioning older adults. Study 3 will examine psychological pathways linking parent-child relationships to subjective and objective sleep characteristics among older parents. Finally, study 4 will examine use patterns of cannabis for the treatment of sleep problems in older adults, and the ways in which this might differ from patients using cannabis for other reasons (e.g., pain). Together, this symposium will highlight novel links of an array of factors with sleep health in the aging population and their implications for prevention. Sleep, Circadian Rhythms and Aging Interest Group Sponsored Symposium.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yen-Ching Chang ◽  
Megan C. Chang ◽  
Yun-Jou Chang ◽  
Ming-De Chen

Abstract Background Sleep disruption is pervasive in people with schizophrenia, but few studies have explored their sleep experiences. This study aims to identify factors relevant to sleep problems and explore coping methods used by community-dwelling people with schizophrenia. Methods Eighteen participants with schizophrenia were recruited from three mental health centers in Taiwan. They completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) assessment. The Person-Environment-Occupation model offered a framework to assess factors related to sleep. Thematic analysis was used for the qualitative data analysis. Results Factors related to sleep were classified under person, environment, and occupation domains. The person domain included three subthemes: psychiatric symptoms, unpleasant emotions, and frustration about sleep. The environment domain included three subthemes: sensory intrusions from the environment, quality of bedding, and roommates. The occupation domain included sleep interruption and sleep preparation. There were notable discrepancies in sleep quality between the participants’ narratives and their PSQI global scores. Regarding coping methods for poor sleep, sleep medication was the primary strategy while some participants also used other strategies, such as modifying the environment, adjusting routines, or engaging in activities that improve sleep quality. Conclusions Psychiatric symptoms and nightmares were identified as unique sleep disruptions in people with schizophrenia, and poor economic status was also found to impact their sleep. The sleep quality of people with schizophrenia tends to be poor, as identified by the PSQI, even though they may have positive perceptions of their sleep quality. Our participants appeared to prefer to take hypnotics to address their sleep problems, which may be due to limited knowledge about alternatives. Mental health professionals are encouraged to receive training in the application of non-pharmacological approaches to support their clients’ issues related to sleep.


Author(s):  
Hannah Briony Thorne ◽  
Matthew Justus Rockloff ◽  
Sally Anne Ferguson ◽  
Grace Elizabeth Vincent ◽  
Matthew Browne

Gambling has significant costs to the community, with a health burden similar in scale to major depression. To reduce its impact, it is necessary to understand factors that may exacerbate harm from gambling. The gambling environment of late-night licensed venues and 24/7 online gambling has the potential to negatively impact sleep and increase alcohol consumption. This study explored gambling, alcohol, and sleep problems to understand whether there is a relationship between these three factors. Telephone interviews were conducted with a representative sample of Australian adults (n = 3760) combined across three waves of the National Social Survey. Participants completed screening measures for at-risk gambling, at-risk alcohol consumption, insomnia (2015 wave only), and sleep quality. There were small but significant positive correlations between problem gambling and alcohol misuse, problem gambling and insomnia, and problem gambling and poor sleep quality. A regression model showed that gambling problems and alcohol misuse were significant independent predictors of insomnia. A separate regression showed gambling problems (and not alcohol misuse) were a significant predictor of poor sleep quality, but only in one survey wave. Findings suggest that gambling, alcohol, and sleep problems are related within persons. Further research should examine the mechanisms through which this relationship exists.


Author(s):  
Yanlin Wang ◽  
Ping Jiang ◽  
Shi Tang ◽  
Lu Lu ◽  
Xuan Bu ◽  
...  

Abstract Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eivind Schjelderup Skarpsno ◽  
Tom Ivar Lund Nilsen ◽  
Paul Jarle Mork

AbstractSleep problems and regular leisure time physical activity (LTPA) are interrelated and have contrasting effects on risk of back pain. However, no studies have investigated the influence of long-term poor sleep quality on risk of back-related disability, or if LTPA modifies this association. The study comprised data on 8601 people who participated in three consecutive surveys over ~ 22 years, and who reported no chronic back pain at the two first surveys. Adjusted risk ratios (RRs) for back-related disability were calculated at the last survey, associated with the joint effect of changes in sleep quality between the two first surveys and meeting physical activity guidelines at the second survey. Compared to people with long-term good sleep, people with long-term poor sleep had nearly twice the risk of back-related disability (RR 1.92, 95% CI 1.48–2.49). There was no statistical interaction between sleep and LTPA but people who reported long-term poor sleep and meeting the physical activity guidelines had 35% lower risk of back-related disability compared to people with same level of sleep problems, but who not met the guidelines. These findings suggest that long-term poor sleep quality contributes to a substantially increased risk of chronic and disabling back pain irrespective of LTPA.


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