scholarly journals The Different Faces of Insomnia

2021 ◽  
Vol 12 ◽  
Author(s):  
Ingo Fietze ◽  
Naima Laharnar ◽  
Volker Koellner ◽  
Thomas Penzel
Keyword(s):  
Sleep Problems ◽  
Early Morning ◽  
Research Topic ◽  
Clinical Routine ◽  
Medical Treatments ◽  
Sleep Maintenance ◽  
Comprehensive Literature Review ◽  
Symptom Stability ◽  
History Of ◽  
Insomnia Symptoms

Objectives: The identification of clinically relevant subtypes of insomnia is important. Including a comprehensive literature review, this study also introduces new phenotypical relevant parameters by describing a specific insomnia cohort.Methods: Patients visiting the sleep center and indicating self-reported signs of insomnia were examined by a sleep specialist who confirmed an insomnia diagnosis. A 14-item insomnia questionnaire on symptoms, progression, sleep history and treatment, was part of the clinical routine.Results: A cohort of 456 insomnia patients was described (56% women, mean age 52 ± 16 years). They had suffered from symptoms for about 12 ± 11 years before seeing a sleep specialist. About 40–50% mentioned a trigger (most frequently psychological triggers), a history of being bad sleepers to begin with, a family history of sleep problems, and a negative progression of insomnia. Over one third were not able to fall asleep during the day. SMI (sleep maintenance insomnia) symptoms were most frequent, but only prevalence of EMA (early morning awakening) symptoms significantly increased from 40 to 45% over time. Alternative non-medical treatments were effective in fewer than 10% of cases.Conclusion: Our specific cohort displayed a long history of suffering and the sleep specialist is usually not the first point of contact. We aimed to describe specific characteristics of insomnia with a simple questionnaire, containing questions (e.g., ability to fall asleep during the day, effects of non-medical therapy methods, symptom stability) not yet commonly asked and of unknown clinical relevance as yet. We suggest adding them to anamnesis to help differentiate the severity of insomnia and initiate further research, leading to a better understanding of the severity of insomnia and individualized therapy. This study is part of a specific Research Topic introduced by Frontiers on the heterogeneity of insomnia and its comorbidity and will hopefully inspire more research in this area.

Insomnia Symptom Severity is Associated with Increased Suicidality and Death by Suicide in a Sample of Patients with Psychiatric Disorders

SLEEP ◽  
2021 ◽  
Author(s):  
Zach Simmons ◽  
Gary Burlingame ◽  
Juergen Korbanka ◽  
Kevin Eastman ◽  
Douglas Thomas ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Suicidal Behavior ◽  
Symptom Severity ◽  
Suicide Attempts ◽  
Sleep Problems ◽  
Manner Of Death ◽  
Insomnia Symptom ◽  
History Of ◽  
Depressive Personality ◽  
Insomnia Symptoms

Abstract Study Objectives Insomnia is a risk factor for suicidal behavior including attempts and death by suicide. We investigated whether insomnia symptom severity was associated with suicidality and death by suicide in patients with psychiatric disorders. Methods The sample included 180 deceased patients with psychiatric disorders seen at Weber Human Services between 2008 and 2018 who completed the Outpatient Questionnaire-45.2 (OQ) prior to death. Insomnia symptom severity was assessed using item 41 from the OQ. Manner of death was determined by death records and autopsy reports. History of suicidality was determined through electronic medical records. Cases were grouped into 4 lifetime categories: non-suicidal (n=30), suicidal ideation (n=36), suicide attempt (n=95), and death by suicide (n=19). Demographic, medical, and psychiatric features of each group were compared using linear regression. Logistic regression was used to determine whether insomnia symptom severity was associated with lifetime suicidality severity grouping, adjusting for psychiatric disorders commonly linked to suicidality. Results Lifetime suicidality was associated with sleep problems, fatigue, headaches, and psychiatric disorders (i.e., depressive, personality, and trauma-related disorders). Referenced to the non-suicidal group, greater insomnia symptom severity was significantly associated with suicide attempts and death by suicide, with odds ratios (OR) of OR=2.67, p=0.011, and OR=5.53, p=0.002, respectively, even after adjusting important psychiatric diagnoses. Conclusions Results suggest that insomnia symptom severity endorsed during a clinical visit is associated with heightened suicidality, especially suicidal behavior. The presence of insomnia symptoms in patients with psychiatric disorders may indicate risk for suicide and is a target for suicide prevention.

Insomnia subtypes and clinical impairment in hospitalized children with autism spectrum disorder

Autism ◽  
2020 ◽  
pp. 136236132096752
Author(s):  
Briana J Taylor ◽  
Charles F Reynolds ◽  
Matthew Siegel
Keyword(s):  
Autism Spectrum Disorder ◽  
Children With Autism ◽  
Early Morning ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Maladaptive Behaviors ◽  
Hospitalized Children ◽  
Sleep Maintenance ◽  
Clinical Impairment ◽  
Insomnia Symptoms

Insomnia subtypes have not been characterized in severely affected youth with autism spectrum disorder. We examined indices of clinical impairment (i.e. length of hospital stay, autism severity, nonverbal intelligence quotient, and adaptive and maladaptive behaviors) across insomnia subtypes in 427 psychiatrically hospitalized children with autism spectrum disorder (mean age = 12.8 ± 3.4; 81.3% male). Multivariate analysis with Bonferroni adjustment tested for differences in clinical impairment across insomnia subtypes adjusting for age and sex. Per parent report, 60% (n = 257) of children had at least one form of insomnia. The distribution of subtypes was sleep onset (26.1%, n = 67), sleep maintenance (24.9%, n = 64), early morning waking (4.3%, n = 11), and combined (44.7%, n = 115). There was a significant multivariate effect of insomnia subtypes on clinical impairment (Pillai’s Trace = 0.25, F = 2.78, p < 0.001). Sleep maintenance and early morning waking were associated with longer hospital stays. Early morning waking was also associated with greater autism symptom severity. In general, children with sleep-maintenance or combined insomnias scored lower on adaptive behaviors and higher on maladaptive behaviors. Sleep-maintenance and combined insomnias appear to be more indicative of or consequential for impaired behavioral functioning. Lay abstract Insomnia subtypes are not well understood in the most severely affected children with autism spectrum disorder. We examined length of hospital stay, autism severity, nonverbal intelligence quotient, and behavioral functioning across insomnia subtypes in 427 psychiatrically hospitalized children with autism spectrum disorder (mean age = 12.8 ± 3.4; 81.3% male). Per parent report, 60% (n = 257) of children had at least one type of insomnia. The distribution of subtypes was difficulty falling asleep (26.1%, n = 67), difficulty staying asleep (24.9%, n = 64), early morning awakening (4.3%, n = 11), and multiple insomnia symptoms (44.7%, n = 115). Difficulty staying asleep and early morning awakenings were associated with longer hospital stays. Early morning awakening was also associated with higher autism symptom severity. In general, children with difficulty staying asleep or multiple insomnia symptoms scored lower on adaptive behaviors (e.g. communication, self-care, socialization) and higher on maladaptive behaviors (e.g. irritability, hyperactivity, emotional reactivity, and emotional dysphoria). Difficulty staying asleep or having multiple insomnia symptoms appears to be most strongly related to impaired behavioral functioning. Conversely, early morning awakenings may be more closely tied with autism spectrum disorder itself. Further research is needed regarding insomnia subtypes at the severe end of the autism spectrum.

scholarly journals Short Sleep Duration and Insomnia Symptoms were Associated with Lower Happiness Levels in Chinese Adults in Hong Kong

2019 ◽  
Vol 16 (12) ◽  
pp. 2079 ◽  
Author(s):  
Sheng Zhi Zhao ◽  
Man Ping Wang ◽  
Kasisomayajula Viswanath ◽  
Agnes Lai ◽  
Daniel Yee Tak Fong ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Duration ◽  
Sleep Problems ◽  
Early Morning ◽  
Population Based ◽  
Short Sleep Duration ◽  
Younger Adults ◽  
Study Objective ◽  
Short Sleep ◽  
Insomnia Symptoms

Study objective: To examine the association of sleep duration and insomnia symptoms with happiness. Methods: A random sample of 1691 Chinese adult (mean age 54 ± 20.1, male 51%) were interviewed in a population-based telephone survey. Happiness was measured by the subjective happiness scale (SHS) and the one-item global happiness index (GHI). Information on sleep included mean past seven-day sleep duration (<6 h, ≥6 to <8 h and ≥8 h) and insomnia symptoms: Difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), and early morning awakening (EMA). Adjusted beta-coefficient (β) of SHS and adjusted odds ratio (aOR) of GHI in relation to sleep problems were calculated. Interaction effects by age (18–65 vs. ≥65) and by sex were assessed. Results: Compared to ≥8 h of sleep, having <6 h of sleep had lower SHS (adjusted β −0.32, 95% CI −0.46 to −0.17) and GHI (aOR 0.54, 95% CI 0.38 to 0.78). The associations were stronger in younger adults and in women (p < 0.05). DIS, DMS, and EMA were associated with lower SHS (adjusted β ranged from −0.20 to −0.06) and GHI (aOR ranged from 0.57 to 0.89). Dose-response association between the number of insomnia symptoms and lower SHS was observed (p < 0.001). These associations were generally stronger in older adults and among women. Conclusions: Lower levels of happiness were observed, particularly in younger adults and females with short sleep duration and older adults and females with insomnia symptoms. Prospective studies are needed to confirm the findings and understand the mechanisms between sleep and happiness.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Hypnotherapy as an Adjunct to Medical Treatment: Highlighting Effectiveness and Identifying Barriers to Further Integrative Treatment

2021 ◽  
pp. 097206342110115
Author(s):  
Feryad A. Hussain
Keyword(s):  
Health Care ◽  
Medical Treatment ◽  
Health Care Services ◽  
Well Being ◽  
Medical Treatments ◽  
Care Services ◽  
Secondary Health Care ◽  
History Of ◽  
Clinical Hypnosis ◽  
The Mind

Integrative models of health care have garnered increasing attention over the years and are currently being employed within acute and secondary health care services to support medical treatments in a range of specialities. Clinical hypnosis has a history of working in partnership with medical treatments quite apart from its psychiatric associations. It aims to mobilise the mind–body connection in order to identify and overcome obstacles to managing symptoms of ill health, resulting in overall improved emotional and physical well-being. This article aims to encourage the use of hypnotherapy in physical health care by highlighting the effectiveness of hypnosis as an adjunct to medical treatment and identifying barriers preventing further integrative treatments.

scholarly journals Psychosocial Risk Factors and Other Than Honorable Military Discharge: Providing Healthcare to Previously Ineligible Veterans

2018 ◽  
Vol 183 (9-10) ◽  
pp. e532-e538 ◽  
Author(s):  
Eric B Elbogen ◽  
H Ryan Wagner ◽  
Mira Brancu ◽  
Nathan A Kimbrel ◽  
Jennifer C Naylor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleep Problems ◽  
Healthcare Delivery ◽  
Mental Healthcare ◽  
Drug Misuse ◽  
Social Characteristics ◽  
Research Education ◽  
Military Discharge ◽  
History Of ◽  
Potential Factors

Abstract Introduction In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. Materials and Methods N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study). Results Veterans with OTH discharges constituted 2.7% of our sample, approximating the estimated rate in the overall U.S. veteran population. Compared to veterans discharged under honorable conditions, veterans with OTH discharges were more likely to be younger and have greater odds of reporting family history of drug abuse and depression. Further, veterans with OTH discharges reported a lower level of social support and were more likely to be single, endorse more sleep problems, score higher on measures of drug misuse, have a history of incarceration, and meet diagnostic criteria for major depressive disorder. A subsequent matching analysis provided further evidence of the association between OTH discharge and two risk factors: drug misuse and incarceration. Conclusion These findings elucidate potential factors associated with veterans with OTH discharges, particularly substance abuse and criminal justice involvement. Results also indicate higher incidence of risk factors that often accompany suicidal ideation and should be a highlighted component of healthcare delivery to this vulnerable cohort of veterans.

scholarly journals Determining the Incidence of Complications and Their Causes after Stapedotomy in Patients with Otosclerosis

2019 ◽  
pp. 1-7
Author(s):  
Mohamad Mohseni ◽  
Ahmad Daneshi ◽  
Ali Mohamad Asghari ◽  
Saleh Mohebi ◽  
Sara Moradi
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Tympanic Membrane Perforation ◽  
Medical Treatments ◽  
Surgical Methods ◽  
Membrane Perforation ◽  
History Of ◽  
Effective Role ◽  
Surgical Treatments ◽  
Time Of Admission

Introduction: In order to treat the symptoms of otosclerosis, various surgical and medical treatments are suggested. Surgical treatments are the choice. This study aimed to determine the incidence of vertigo and its cause in Iran, and the present study focused on this issue. Methods: This was a prospective cohort study carried out on patients with otosclerosis undergoing stapedotomy referred to Rasoul Akram hospital, Tehran during 2017-18. The patients aged below 18 or those who had a history of vertigo were excluded. Diapasonic and audiometric tests were carried out. The follow-ups included the time of admission (the day after surgery) for the presence of vertigo using visual analogue scale and diapasonic tests, one week after surgery using visual analogue scale and diapasonic tests, and one month after surgery using visual analogue scale and audiometry. The data were imported to SPSS v.22 software and analyzed. Results: The surgical complications that occurred after stapedotomy for patients in this center were as follows: 12.1%of subjects had vertigo one day after surgery, 8.6% had vertigo one week later, and 1.7% had vertigo one month later, thus, the frequency of vertigo was reduced overtime. Meanwhile, 91.4% of the patients had a better sense of hearing and only 1.7% suffered from tympanic membrane perforation. In 8.6% of subjects, there was a disturbance in the taste. Tinnitus was only observed in 5.2% of the surgical patients in this center. Among women, vertigo was higher one day and one week after surgery. Logistic regression showed that age is significant predictor of dizziness one day after surgery (OR: 1.37, P=0.03). Conclusion: According to the results, the frequency of vertigo was decreased overtime. In this study, it was found that the complications of stapedotomy surgery were less than other surgical methods, but those who were older had significantly higher vertigo a week and one day after surgery indicating effective role of age on postoperative complications. Those who underwent surgery by tympanomeatal method had a better vertigo one day and one week after surgery.

scholarly journals Factors associated with violence against women following the COVID-19 lockdown in France: Results from a prospective online survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257193
Author(s):  
William Peraud ◽  
Bruno Quintard ◽  
Aymery Constant
Keyword(s):  
Psychological Distress ◽  
Violence Against Women ◽  
Online Survey ◽  
Snowball Sampling ◽  
Prospective Survey ◽  
Social Media Networks ◽  
History Of ◽  
The Impact ◽  
Unwanted Sexual Contact ◽  
Insomnia Symptoms

Background The aim of this research was to investigate the impact of the first COVID-19 lockdown (March 17th—May 11th 2020) on violence against women in France. Methods A prospective survey was conducted online between April 2th 2020 and July 5th 2020. Female respondents were recruited from social media networks using the snowball sampling method. Data were collected three times: during (2–19 April) and at the end (11–25 May) of the first lockdown, and following the first lockdown (20 June– 05 July). Sociodemographic variables, lockdown living conditions, financial impact of COVID, and history of psychiatric disorder were evaluated, together with changes in psychological distress over the lockdown period, and the risk of being assaulted post lockdown. Results Psychological distress was elevated and remained stable for most of the 1538 female respondents during lockdown. More than 7% of women were affected by physical or sexual violence post lockdown. Unwanted sexual contact accounted for the majority of abuse, but physical and sexual assault were also prevalent. The risk of being abused was higher for participants who had changed anxiety/insomnia symptoms over the lockdown period, and a history of abuse. Discussion Women who experienced changes in anxiety/insomnia symptoms during the COVID-19 lockdown were at higher risk than others of being assaulted post lockdown, especially when they were already socially vulnerable. While social and psychological factors accounting for these changes warrant further investigation, communication and preventive measures during pandemics should include initiatives tailored to women more vulnerable to violence.

scholarly journals Insomnia and the late nineteenth-century insomniac: the case of Albert Kimball

2020 ◽  
Vol 10 (3) ◽  
pp. 20190074 ◽  
Author(s):  
Matthew Beaumont
Keyword(s):  
Nineteenth Century ◽  
Sleep Problems ◽  
Urban Society ◽  
Late Nineteenth Century ◽  
The Enlightenment ◽  
Victorian Period ◽  
The Usa ◽  
History Of ◽  
Late Nineteenth ◽  
The Individual

This article explores the emergence, in late nineteenth-century Britain and the USA, of the ‘insomniac’ as a distinct pathological and social archetype. Sleeplessness has of course been a human problem for millennia, but only since the late-Victorian period has there been a specific diagnostic name for the individual who suffers chronically from insufficient sleep. The introductory section of the article, which notes the current panic about sleep problems, offers a brief sketch of the history of sleeplessness, acknowledging the transhistorical nature of this condition but also pointing to the appearance, during the period of the Enlightenment, of the term ‘insomnia’ itself. The second section makes more specific historical claims about the rise of insomnia in the accelerating conditions of everyday life in urban society at the end of the nineteenth century. It traces the rise of the insomniac as such, especially in the context of medical debates about ‘neurasthenia’, as someone whose identity is constitutively defined by their inability to sleep. The third section, tightening the focus of the article, goes on to reconstruct the biography of one exemplary late nineteenth-century insomniac, the American dentist Albert Kimball, in order to illustrate the claim that insomnia was one of the pre-eminent symptoms of a certain crisis in industrial and metropolitan modernity as this social condition was lived by individuals at the fin de siècle .

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