			Home About us Contact

Insomnia Patients (insomnia + patient)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Sleep-related attentional bias in patients with primary insomnia compared with sleep experts and healthy controls

JOURNAL OF SLEEP RESEARCH, Issue 2 2008
KAI SPIEGELHALDER
Summary Sleep-related attentional bias has been proposed to be an important factor in the development and maintenance of primary insomnia. In this study, a newly introduced mixed modality (visual auditory) task and an emotional Stroop task were used to investigate attentional processes in patients with primary insomnia, sleep experts and healthy controls (n = 20 per group). The sleep expert group served as second control group to control for effects of frequency of concept usage (FOCU). The results of the emotional Stroop task showed a sleep-related attentional bias in the insomnia group in comparison with the expert group. However, no significant differences were detected in the other group comparisons and in the mixed modality task. The difference between insomnia patients and sleep experts in the emotional Stroop task indicates that FOCU is not the underlying process of sleep-related attentional bias. Insomnia patients seem to be more emotionally, cognitively or procedurally affected by sleep-related stimuli than sleep experts. The findings suggest that a desensitization of sleep-related stimuli might be used therapeutically, thus extending the current cognitive behavioral treatments for primary insomnia. [source]

Cross-cultural validation of the Leeds sleep evaluation questionnaire (LSEQ) in insomnia patients

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2003
Ricardo Tarrasch
Abstract The Leeds sleep evaluation questionnaire (LSEQ) is a standardized self-reporting instrument comprising ten 100,mm visual analogue scales that pertain to the ease of getting to sleep (GTS), quality of sleep (QOS), ease of awakening from sleep (AFS) and alertness and behaviour following wakefulness (BFW). Although the LSEQ has been used in a variety of populations, published psychometric data on insomnia patients are limited. The LSEQ reliability and construct validity was evaluated in 396 French insomnia patients aged 55 years and over, who were treated with placebo (2 weeks) and melatonin (3 weeks). The results supported LSEQ internal consistency, reliability and construct validity with minor differences from those of the original English version. Then the internal consistency of the LSEQ was evaluated in 257 insomnia patients (age 20,80 years) in France and Israel who, following a 1 week placebo baseline, were randomized to placebo or melatonin treatment for 3 weeks. Cronbach's , and Pearson's r correlation coefficients for placebo and drug treatment conditions (p<0.001 for all) supported LSEQ internal consistency in different treatment and age groups and in different languages. It is concluded that the consistency, reliability and validity of the four LSEQ domains allows them to be singled out as independent outcome variables in cross cultural sleep research and clinical practice in adult and elderly patients with insomnia. Copyright © 2003 John Wiley & Sons, Ltd. [source]

The Effect of Insomnia Definitions, Terminology, and Classifications on Clinical Practice

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue S7 2005
Andrew D. Krystal MD
There is a need for newer, more clinically useful classifications for insomnia. Identification of specific subtypes of insomnia helps anchor research, allows for prediction of prognosis/course of the condition, and may allow for individualization of treatment. Existing classifications differ, and many terms remain inadequately defined, which leads to diagnostic confusion. Historically, insomnia has been classified according to symptom type, symptom duration, and underlying cause, but these classifications have not been based on evidence of their utility, and newer research suggests the need for change. Symptoms may include difficulty falling asleep, trouble staying asleep, and not feeling restored by sleep, although it has not been clear that it is possible to identify distinct subtypes of patients by symptom or that distinguishing symptom type affects the course of clinical treatment. Classification of insomnia by duration most commonly involves three categories: transient (no more than a few days), short-term (up to 3 weeks), and long-term (more than 3 weeks). This categorization is of uncertain utility and has been primarily based on nonempiric concerns about treatment with sedative-hypnotic medications for periods longer than several weeks. The subtyping of insomnia in terms of whether there is an identifiable underlying cause such as a psychiatric or medical illness was based on an unproven assumption that in most instances other disorders caused insomnia. Recent studies suggest the need to revisit these classification strategies. Evidence that symptom types typically overlap and change over time complicates the categorization of subjects by whether they have difficulty falling asleep or staying asleep or have nonrestorative sleep. New studies of the treatment of chronic insomnia change the perspective on duration of treatment and, as a result, classification of duration of disease. Two studies of nightly pharmacotherapy for insomnia including more than 800 insomnia patients have not identified any increase in the risks after 3 to 4 weeks of treatment. In addition, nonpharmacological treatments demonstrate long-lasting efficacy in patients with chronic insomnia, and the development of abbreviated cognitive-behavioral therapies, which are particularly well suited to primary care practice, have improved their applicability. Newer studies of the relationships between insomnia and associated medical and psychiatric conditions undermine the notion that insomnia is always a symptom and caused by an underlying condition. They suggest that, although it is important to identify and treat these conditions, this may not be sufficient to alleviate the insomnia, which may adversely affect the course of the associated disorder. As a result, treatment targeted specifically to the insomnia should be considered. All of these developments point to an increasing ability to tailor therapy to the particular needs of patients and to optimize the clinical management of insomnia. [source]