Journal articles: 'Sleep treatments'

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Kaplan, Katherine A. "Sleep and sleep treatments in bipolar disorder." Current Opinion in Psychology 34 (August 2020): 117–22. http://dx.doi.org/10.1016/j.copsyc.2020.02.001.

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Stein, Mark A., Margaret Weiss, and Laura Hlavaty. "ADHD Treatments, Sleep, and Sleep Problems: Complex Associations." Neurotherapeutics 9, no. 3 (June 21, 2012): 509–17. http://dx.doi.org/10.1007/s13311-012-0130-0.

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Cammaroto, Giovanni, Andrea Migliorelli, and Claudio Vicini. "OSA: Treatments beyond CPAP." Journal of Clinical Medicine 11, no. 19 (October 8, 2022): 5938. http://dx.doi.org/10.3390/jcm11195938.

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Brietzke, Scott E., Eric J. Kezirian, Erica R. Thaler, and B. Tucker Woodson. "Novel Sleep Apnea Surgical Treatments." Otolaryngology–Head and Neck Surgery 147, no. 2_suppl (August 2012): P34. http://dx.doi.org/10.1177/0194599812449008a87.

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Palesh, O., K. Mustian, J. Roscoe, G. Morrow, M. L. Perlis, B. Issell, T. K. Banerjee, and J. E. Delmore. "Prevalence and severity of sleep disturbance in 596 cancer patients: A URCC CCOP study." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 9016. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.9016.

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9016 Background: Sleep disturbance is a prevalent and, potentially, chronic problem among cancer patients, persisting for many months and years after treatments. As part of a multi-center longitudinal survey of patients beginning cancer treatments, we prospectively investigated the prevalence and severity of self-reported sleep disturbance. Methods: 596 Cancer patients (mean age=61; 66.4%=female) receiving chemotherapy and/or radiation (37.1%=chemotherapy, 40.1%=radiation therapy, 22.8%=both) from 17 NCI CCOPs reported whether they experienced any sleep disturbance using an 11-point Likert Scale (0 = “Not present” to 10 = “As bad as you can imagine”) prior to treatments, during treatments, and 6 months after finishing treatments. A side effect level 7 was considered “severe.” Results: Sleep disruption was reported by 31.9% (median=2; 10.6% severe) at baseline, 77.2% (median=4; 28.5% severe) during treatment and 65.1% (median=2; 15% severe) at 6 months post-treatment. Repeated-measures ANOVAs revealed statistically significant treatment group (chemotherapy, radiation, or both), age (< 61 or ≥ 61 yrs), and gender by time interactions (all p<0.05). Sleep disturbance was significantly higher among survivors in the two groups receiving chemotherapy, younger survivors, and women (all p<0.05). Sleep disruption increased from baseline to post-treatment and decreased from post-treatment to 6 months post-treatment (all p<0.05). There were no significant differences between baseline and 6 months post-treatment. Conclusions: These results show that difficulties with sleep increase during cancer treatment. Patients who are at higher risk for having sleep problems are women, younger patients, and patients undergoing chemotherapy. Supported by NCI Grants U10-CA37420 and R25-CA102618 No significant financial relationships to disclose.

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Khachatryan, Marine, Jenna Kay, and Sejal Jain. "704 The Association of Sleep Disorders in Patients with Chronic Pain Disorders." Sleep 44, Supplement_2 (May 1, 2021): A275. http://dx.doi.org/10.1093/sleep/zsab072.702.

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Abstract Introduction Sleep and pain are interrelated and have a bidirectional relationship. The study was performed to identify the impact of sleep disorders on pain perception. Methods The institutional review board approved the study. Patients evaluated in the Pain Clinic between 1/1/2014 and 12/31/2017 who had polysomnography done were identified by database search. Chart review identified demographics, initial pain score, pain treatments, sleep disorder diagnosis, treatments of sleep disorder and pain scores after sleep treatments. Numerical pain score (NPS) and insomnia severity index (ISI) were used as a measure of pain and sleep quality, respectively. The descriptive statistics were presented by percentages, mean and standard deviations. Regression analysis was performed between initial NPS and ISI. T-test compared change in NPS for compliant and non-compliant subjects, before and after sleep treatments. Linear regression model identified factors associated with changes in pain perception after sleep treatments. Results Of the 320 participants identified, complete data was available for 180 subjects. The average age was 55.9±13.9; 51.41% were female; 60.2% were Caucasian and 26.64% were Hispanic. Initial NPS was 8.8±1.7, average ISI was 15.00±6.41, average BMI was 35.4±10.2. Ninety-five percent had a diagnosis of obstructive sleep apnea (OSA), 27.81% had restless leg syndrome, and 7.19% had complex sleep apnea. Since most patients had OSA, details of positive airway pressure (PAP) treatments were also investigated. Of 84% of subjects treated with PAP, compliance data were available for 53%, which showed 69% (n=55) being complaint with PAP. Initial NPS correlated positively with ISI (R2: 0.064±0.024, p<0.01). No difference in NPS was found in groups based on compliance, before and after PAP treatments. Regression model identified that BMI was the most significant factor in the change in NPS following sleep treatment (R2: 0.083±0.034, p = 0.03). Conclusion The study identified that the severity of pain is associated with poor quality of sleep. While this study failed to identify improvement in pain perception after successful OSA treatment, limited number of subjects in our study were compliant with PAP treatment which may have impacted the results. Future prospective studies are needed to understand the complex association between improvement in sleep quality and pain perception. Support (if any):

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Mitteldorf, Darryl, and Jerrod Nelms. "Are prostate cancer treatments correlated to sleep distress?" Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 347. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.347.

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347 Background: Sleep distress associated with prostate cancer due to emotional issues like anxiety is well documented. But there have been no investigations focused on sleep distress correlated to specific types of prostate cancer treatments. Methods: During a ten day period in July, 2016, 963 men diagnosed with prostate cancer completed an online survey containing demographic and treatment history questions, the Pittsburg Sleep Quality Index (PSQI) and a current state of health self-assessment. The subjects were randomly chosen from the Malecare prostate cancer support network in the United States and completed the survey. 27% of survey subjects reported being initially diagnosed with Gleason 8 or higher. 42% reported using either androgen deprivation therapy, Zofigo, Xtandi or Xofigo within three months of our survey. Only 5% had been continually on active surveillance. We compiled the PSQI Component score and correlated the scores to a specific prostate cancer treatments, adjudicating for pre-existing conditions such as emotional disorders or apnea. We stratified for race, age, sexual orientation and if the subject had a sleep partner. Results: The PSQI handout says that a total score of 5 or greater indicates sleep distress worthy of consultation with a healthcare provider. Our investigation also considered a “4” to indicate poor sleep quality among participants. Only 398 (41.33%) of our participants scored less than 5 on the PSQI, while only 232 (24.09%) scored less than 4. From these statistics, we showed that over 75% of our study sample suffered sleep distress. However, our analysis failed to disclose significant correlations between specific types of prostate cancer treatments and extent of sleep distress. We did not see correlations regarding subject’s age, race, sleep co-habitation, time from diagnosis to survey and other treatment and demographic stratifications. Conclusions: Sleep distress is well established and broadly experienced by prostate cancer patients. Our study showed there is no advantage to any specific prostate cancer treatment in terms of sleep distress. We also found that severity and instances of sleep distress are distributed without significance across age, race, sexual orientation and time to treatment after diagnosis.

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Kaufmann, Christopher N., Mark W. Bondi, James D. Murphy, Xin Tu, and Alison A. Moore. "COGNITIVE TRAJECTORIES BEFORE AND AFTER SLEEP TREATMENT INITIATION IN U.S. OLDER ADULTS WITH SLEEP DISTURBANCE." Innovation in Aging 3, Supplement_1 (November 2019): S403—S404. http://dx.doi.org/10.1093/geroni/igz038.1499.

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Abstract Sleep disturbances are associated with cognitive decline but it is not clear if initiation of sleep treatments mitigates decline. We used the 2006-2014 Health and Retirement Study. At each wave, participants were administered cognitive assessments and scores were summed (values=0-35; higher=better cognition). All participants also reported if, in the past two weeks, they had taken medications or used other treatments to improve sleep. Our sample (N=4,650) included individuals who at baseline were cognitively normal and untreated for sleep, and at any wave reported some sleep disturbance. We characterized cognitive performance over study period with comparisons before and after sleep treatment initiation. Between 2006-2014, participants exhibited declines in cognitive performance (B=-2.40; 95% CI=-2.73, -2.06; p<0.001) after controlling for confounders. Following sleep treatment, cognitive decline became less pronounced (interaction B=0.94; 95% CI=0.21, 1.67; p=0.013). Results suggest that in older adults with sleep disturbance, initiation of sleep treatment may slow cognitive decline.

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Cacciatore, Martina, Francesca G. Magnani, Matilde Leonardi, Davide Rossi Sebastiano, and Davide Sattin. "Sleep Treatments in Disorders of Consciousness: A Systematic Review." Diagnostics 12, no. 1 (December 31, 2021): 88. http://dx.doi.org/10.3390/diagnostics12010088.

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Sleep disorders are among the main comorbidities in patients with a Disorder of Consciousness (DOC). Given the key role of sleep in neural and cognitive functioning, detecting and treating sleep disorders in DOCs might be an effective therapeutic strategy to boost consciousness recovery and levels of awareness. To date, no systematic reviews have been conducted that explore the effect of sleep treatments in DOCs; thus, we systematically reviewed the existing studies on both pharmacological and non-pharmacological treatments for sleep disorders in DOCs. Among 2267 assessed articles, only 7 were included in the systematic review. The studies focused on two sleep disorder categories (sleep-related breathing disorders and circadian rhythm dysregulation) treated with both pharmacological (Modafinil and Intrathecal Baclofen) and non-pharmacological (positive airway pressure, bright light stimulation, and central thalamic deep brain stimulation) interventions. Although the limited number of studies and their heterogeneity do not allow generalized conclusions, all the studies highlighted the effectiveness of treatments on both sleep disorders and levels of awareness. For this reason, clinical and diagnostic evaluations able to detect sleep disorders in DOC patients should be adopted in the clinical routine for the purpose of intervening promptly with the most appropriate treatment.

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Bailey, Grace A., Emily K. Hubbard, Alfonso Fasano, Marina AJ Tijssen, Timothy Lynch, Kirstie N. Anderson, and Kathryn J. Peall. "Sleep disturbance in movement disorders: insights, treatments and challenges." Journal of Neurology, Neurosurgery & Psychiatry 92, no. 7 (March 19, 2021): 723–36. http://dx.doi.org/10.1136/jnnp-2020-325546.

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Sleep and circadian rhythm disturbances are central features of many movement disorders, exacerbating motor and non-motor symptoms and impairing quality of life. Understanding these disturbances to sleep is clinically important and may further our understanding of the underlying movement disorder. This review evaluates the current anatomical and neurochemical understanding of normal sleep and the recognised primary sleep disorders. In addition, we undertook a systematic review of the evidence for disruption to sleep across multiple movement disorders. Rapid eye movement sleep behaviour disorder has emerged as the most reliable prodromal biomarker for the alpha synucleinopathies, including Parkinson’s disease and multiple system atrophy, often preceding motor symptom onset by several years. Abnormal sleep has also been described for many other movement disorders, but further evidence is needed to determine whether this is a primary or secondary phenotypic component of the underlying condition. Medication used in the treatment of motor symptoms also affects sleep and can aggravate or cause certain sleep disorders. Within the context of movement disorders, there is also some suggestion of a shared underlying mechanism for motor and sleep pathophysiology, with evidence implicating thalamic and brainstem structures and monoaminergic neurotransmission. This review highlights the need for an understanding of normal and abnormal sleep within the movement disorder clinic, an ability to screen for specific causes of poor sleep and to treat sleep disturbance to improve quality of life. Key sleep disorders also act as important biomarkers and have implications in diagnosis, prognosis and the development of future therapies.

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Husak, Aubrey J., and Matthew J. Bair. "Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments." Pain Medicine 21, no. 6 (January 7, 2020): 1142–52. http://dx.doi.org/10.1093/pm/pnz343.

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Abstract Objective The objective of this review is to answer three questions: 1) How are chronic pain severity and pain duration affected in patients with chronic pain and sleep disturbances that occur simultaneously? 2) What are common comorbidities and pain-related symptoms seen in patients with chronic pain and sleep disturbances? and 3) What are potentially effective pharmacological and nonpharmacological treatment options for both conditions? Methods Ovid Medline and PubMed were searched. Search terms included sleep wake disorder, chronic pain, fibromyalgia, treatment outcome, psychotherapy, complementary therapies, and therapeutics. Studies that assessed outcomes between individuals with chronic pain and those with concurrent chronic pain and sleep disturbances were included. Randomized controlled clinical trials of treatments for both conditions were included. Results Sixteen studies indicated that patients with both chronic pain and sleep disturbances have greater pain severity, longer duration of pain, greater disability, and are less physically active than those without sleep disturbances. Patients with both conditions are more likely to have concurrent depression, catastrophizing, anxiety, and suicidal ideation. Thirty-three randomized controlled trials assessed treatment for both chronic pain and sleep disturbances. Pregabalin was the most frequently studied medication, showing improvement in pain and sleep symptoms. Cognitive behavioral therapy for insomnia showed long-term improvement in sleep for patients with chronic pain. Conclusions Individuals with chronic pain and sleep disturbances have greater symptom severity, longer duration of symptoms, more disability, and additional comorbidities. Pharmacological and nonpharmacological treatments may be useful in the treatment of concurrent chronic pain and sleep disturbances, but further study is needed.

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Ashare, Rebecca L., Caryn Lerman, Rachel F. Tyndale, Larry W. Hawk, Tony P. George, Paul Cinciripini, and Robert A. Schnoll. "Sleep Disturbance During Smoking Cessation: Withdrawal or Side Effect of Treatment?" Journal of Smoking Cessation 12, no. 2 (April 12, 2016): 63–70. http://dx.doi.org/10.1017/jsc.2016.11.

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Introduction: The nicotine–metabolite ratio (NMR) predicts treatment response and is related to treatment side effect severity. Sleep disturbance may be one important side effect, but understanding sleep disturbance effects on smoking cessation is complicated by the fact that nicotine withdrawal also produces sleep disturbance.Aims: To evaluate the effects of withdrawal and treatment side effects on sleep disturbance.Methods: This is a secondary analysis of data from a clinical trial (Lerman et al., 2015) of 1,136 smokers randomised to placebo (n = 363), transdermal nicotine (TN; n = 381), or varenicline (n = 392) and stratified based on NMR (559 slow metabolisers; 577 normal metabolisers). Sleep disturbance was assessed at baseline and at 1-week following the target quit date (TQD). We also examined whether sleep disturbance predicted 7-day point-prevalence abstinence at end-of-treatment (EOT).Results: The varenicline and TN groups exhibited greater increases in sleep disturbance (vs. placebo; treatment × time interaction; p = 0.005), particularly among those who quit smoking at 1-week post-TQD. There was a main effect of NMR (p = 0.04), but no interactions with treatment. TN and varenicline attenuated withdrawal symptoms unrelated to sleep (vs. placebo). Greater baseline sleep disturbance predicted relapse at EOT (p = 0.004).Conclusions: Existing treatments may not mitigate withdrawal-related sleep disturbance and adjunctive treatments that target sleep disturbance may improve abstinence rates.

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McLay, Laurie, Karyn France, Neville Blampied, Kate Danna, and Jolene Hunter. "Using Functional Behavioral Assessment to Develop a Multicomponent Treatment for Sleep Problems in a 3-Year-Old Boy With Autism." Clinical Case Studies 16, no. 3 (February 21, 2017): 254–70. http://dx.doi.org/10.1177/1534650116688558.

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A large number of children with autism spectrum disorder (ASD) and their families are affected by sleep disturbance. Given the concomitant negative effects of sleep problems, it is essential to identify effective treatments. This case study exemplifies the use of Functional Behavioral Assessment (FBA) to develop treatments for sleep problems in a 3-year old boy with ASD. A function-based, multicomponent intervention resulted in the elimination of nighttime breastfeeding, a reduction in the frequency of curtain calls, and the frequency and duration of nighttime awakenings, although not all gains were maintained at follow-up. This case study highlights the importance of FBA in the assessment of sleep problems for each individual, and the need to develop treatments that address the unique function of sleep disturbance for each individual. Further research into the assessment and treatment of sleep problems in children with ASD is required.

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Choi, Ji Ho. "Treatments for Adult Obstructive Sleep Apnea." Sleep Medicine Research 12, no. 1 (June 30, 2021): 9–14. http://dx.doi.org/10.17241/smr.2021.00913.

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Berro, Lais, C. Austin Zamarripa, Joseph Talley, Kevin Freeman, and James Rowlett. "134 Acute effects of methadone, buprenorphine or naltrexone on sleep-like parameters evaluated with actigraphy in male rhesus monkeys." Sleep 44, Supplement_2 (May 1, 2021): A54—A55. http://dx.doi.org/10.1093/sleep/zsab072.133.

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Abstract Introduction Opioid use disorder (OUD) is a significant public health problem, and it has been associated with the emergence of sleep disturbances. Effective treatment options for OUD exist, including medication-assisted therapy with methadone or buprenorphine. However, emerging evidence suggests that these treatments also may be associated with significant sleep impairment. The extent to which these effects are a result of the medication or an effect of chronic opioid use remains unknown. In the present study, we investigated the acute effects of methadone, buprenorphine or naltrexone in male rhesus monkeys in order to understand whether pharmacological treatment with these drugs per se would have deleterious effects on sleep. Methods Adult naïve male rhesus macaques (Macaca mulatta, n=5) maintained on a 12h/12h light/dark cycle were fitted with primate collars to which actigraphy monitors were attached. Actigraphy recording was conducted during baseline conditions and following acute injections of vehicle, methadone (0.03 – 1.0 mg/kg, i.m.), buprenorphine (0.01 – 1.0 mg/kg, i.m.) or naltrexone (0.03 – 1.0 mg/kg, i.m.) in the morning (10h, 4h after “lights on”) or in the evening (16:30h, 1.5h before “lights off”). Results Morning treatment with methadone or buprenorphine dose-dependently impaired sleep in rhesus monkeys, with at least one dose significantly increasing sleep latency and decreasing sleep efficiency. Evening treatment with methadone or buprenorphine also impaired sleep, with lower doses significantly inducing sleep alterations compared to morning treatments. The effects of buprenorphine on sleep was a biphasic function, with the highest doses not disrupting sleep. Treatment with naltrexone significantly improved sleep-like measures in rhesus monkeys, with evening treatments improving measures of both sleep latency and sleep efficiency. Conclusion Acute administration of methadone and buprenorphine induced marked sleep impairment in rhesus monkeys, even when the drugs were administered in the morning. Unexpectedly, acute administration of the opioid antagonist naltrexone significantly improved sleep-like measures. Our findings show that the currently available pharmacotherapies for OUD significantly affect sleep in naïve monkeys, and that opioid mechanisms yet to be determined may play a significant role in sleep-wake regulation. Support (if any) Supported by NIH grants DA049886 to L.F.B.; DA048586 to C.A.Z.; DA039167 to K.B.F.; DA011792, DA043204 and DA046778 to J.K.R..

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Miranda, Joyal, Souraya Sidani, Jose Côté, and Suzanne Fredericks. "A scoping review of insomnia treatments for people living with HIV." International Health Trends and Perspectives 1, no. 1 (April 4, 2021): 61–73. http://dx.doi.org/10.32920/ihtp.v1i1.1422.

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Abstract To date, little is known in terms of viable treatments for insomnia in people living with HIV. The primary aim of this scoping review is to identify non-pharmacological treatments for insomnia in people living with HIV (PLWH). A framework by Arksey and O’Malley was used to guide the conduct of this scoping review. Seven studies were identified. Three of the studies used cognitive-behavioral type of treatments versus physical or alternative types of treatment. The most effective treatments with the largest effect sizes were found to be cognitive-behavioral treatments for the sleep outcomes of sleep quantity (1.11-1.91) and sleep quality (1.11-1.91). This review found that cognitive behavioral interventions were found to be the most effective treatments for insomnia for PLWH. Further research would benefit from larger sample size studies in addition to focusing on the determinants of insomnia in PLWH in order to further provide a treatment that is focused on the needs of PLWH.

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McDonagh, Marian S., Rebecca Holmes, and Frances Hsu. "Pharmacologic Treatments for Sleep Disorders in Children: A Systematic Review." Journal of Child Neurology 34, no. 5 (January 23, 2019): 237–47. http://dx.doi.org/10.1177/0883073818821030.

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Sleep problems are common in children, especially those with neurodevelopmental disorders, and can lead to consequences in behavior, functioning, and quality of life. We systematically reviewed the efficacy and harms of pharmacologic treatments for sleep disorders in children and adolescents. We searched MEDLINE, Cochrane library databases, and PsycINFO through June 2018. We included 22 placebo-controlled randomized controlled trials (1-13 weeks’ duration), involving 1758 children (mean age 8.2 years). Single randomized controlled trials of zolpidem and eszopiclone in children with attention-deficit/hyperactivity disorder (ADHD) showed no improvement in sleep or ADHD ratings. Clinical Global Impression Improvement/Severity scores significantly improved with zolpidem ( P = .03 and P = .006, respectively). A single, small randomized controlled trial of diphenhydramine reported small improvements in sleep outcomes (8-10 minutes’ better sleep latency and duration) after 1 week. In 19 randomized controlled trials, melatonin significantly improved sleep latency (median 28 minutes; range 11-51 minutes), sleep duration (median 33 minutes; range 14-68 minutes), and wake time after sleep onset (range 12-43 minutes), but not number of awakenings per night (range 0-2.7). Function and behavior improvement varied. Improvement in sleep was greatest in children with autism or other neurodevelopmental disorders, and smaller in adolescents and children with chronic delayed sleep onset. Adverse events were infrequent with melatonin, but more frequent than placebo in children taking eszopiclone or zolpidem. These findings show that melatonin was useful in improving some sleep outcomes in the short term, particularly those with comorbid ASD and neurodevelopmental disorders. Other drugs and outcomes are inadequately studied.

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Zhang, Meng-Qi, Rui Li, Yi-Qun Wang, and Zhi-Li Huang. "Neural Plasticity Is Involved in Physiological Sleep, Depressive Sleep Disturbances, and Antidepressant Treatments." Neural Plasticity 2017 (2017): 1–16. http://dx.doi.org/10.1155/2017/5870735.

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Depression, which is characterized by a pervasive and persistent low mood and anhedonia, greatly impacts patients, their families, and society. The associated and recurring sleep disturbances further reduce patient’s quality of life. However, therapeutic sleep deprivation has been regarded as a rapid and robust antidepressant treatment for several decades, which suggests a complicated role of sleep in development of depression. Changes in neural plasticity are observed during physiological sleep, therapeutic sleep deprivation, and depression. This correlation might help us to understand better the mechanism underlying development of depression and the role of sleep. In this review, we first introduce the structure of sleep and the facilitated neural plasticity caused by physiological sleep. Then, we introduce sleep disturbances and changes in plasticity in patients with depression. Finally, the effects and mechanisms of antidepressants and therapeutic sleep deprivation on neural plasticity are discussed.

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Scoralick, Francisca Magalhães, Einstein Francisco Camargos, Marco Polo Dias Freitas, and Otávio Toledo Nóbrega. "Outpatient treatment of sleep disorders in Alzheimer patients." Einstein (São Paulo) 13, no. 3 (May 1, 2015): 430–34. http://dx.doi.org/10.1590/s1679-45082015rw3021.

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Sleep disorders are common in patients with Alzheimer dementia and affect the quality of life of patients and of their caregivers. Despite the rising number of studies in the area, almost all of them are about non-pharmacological treatment. Our objective was to review the literature concerning pharmacological and non-pharmacological approaches to treat sleep disorders of elderly patients with Alzheimer dementia in the ambulatory setting. The treatments revised consisted of sleep hygiene and/or use of intense light coupled or not with use of melatonin, cholinesterase inhibitors, antipsychotics, hypnotics or antidepressants. In addition to the non-pharmacological measures, there is evidence that the use of trazodone may aid the treatment of sleep disorders of older individuals with Alzheimer dementia. More studies are necessary to examine the non-pharmacological and pharmacological treatments revised herein.

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Krupichka, K. S., M. V. Agaltsov, R. P. Myasnikov, and O. M. Drapkina. "Sleep-related breathing disorders in patients with heart failure: current aspects of treatment. Part II." Russian Journal of Cardiology 26, no. 4S (December 6, 2021): 4724. http://dx.doi.org/10.15829/1560-4071-2021-4724.

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The second part of the review highlights treatments for different types of sleep apnea in patients with heart failure. In both obstructive and central sleep apnea, ventilatory support during sleep takes a special place in treatment. Therefore, the review details the role of different ventilation modes (in particular, CPAP therapy and adaptive servo-ventilation), analyzes available evidence-based medicine data. The role of low-flow oxygen therapy, surgical treatment, implantable devices, specific therapy (theophylline, acetazolamide) in the treatment of central sleep apnea is also shown, and a novel method of treating central sleep apnea is considered — phrenic nerve stimulation.

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Marques, Daniel Ruivo, Ana Allen Gomes, Vanda Clemente, José Moutinho dos Santos, Gina Caetano, and Miguel Castelo-Branco. "Neurobiological Correlates of Psychological Treatments for Insomnia." European Psychologist 21, no. 3 (July 2016): 195–205. http://dx.doi.org/10.1027/1016-9040/a000264.

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Abstract. Sleep disorders and sleep disturbances are considered nowadays a major public health problem. Within sleep problems, insomnia is the most common health complaint. The maintenance of insomnia symptoms may lead to a clinical disorder – Insomnia Disorder (ID). A significant amount of literature has shown the efficacy and effectiveness of psychological treatments for ID. Often, the evaluation of therapeutic processes and outcomes focuses on subjective measures such as sleep diaries. In this work, we review the few published studies that evaluate modifications in neurobiological domain related to evidence-based psychological interventions, namely cognitive-behavioral therapy for insomnia (CBT-I). The search was carried out consulting Scopus, PubMed, and ISI Web of Knowledge databases. Only 12 studies were found. From the reviewed papers it was observed that the results are diverse, perhaps due to significant differences pertaining to the methodologies used. However, one interesting finding emerged: daytime experiments on insomnia comprising mainly cognitive tasks denoted hypofunction in ID patients, whereas nighttime experiments mainly associated with affective/emotional tasks denoted hyperarousal. We suggest that the study of the neural changes prompted by CBT-I is a major topic in the domain of psychotherapy and sleep medicine. Despite the scarce studies on neurobiological mechanisms of CBT-I, the results achieved until now are promising and should be taken into account in the future. Nonetheless, more research on this topic is needed.

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Gretler, Julie, Madeline Noland, Valerie Alipio Jocson, Marcel Chen, Christopher Dominguez, Beatriz Hernandez, Art Noda, et al. "443 Intervention Among PAP Users Newly Diagnosed with OSA Improves Long-term Adherence in Veterans with Sleep Apnea and PTSD." Sleep 44, Supplement_2 (May 1, 2021): A175. http://dx.doi.org/10.1093/sleep/zsab072.442.

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Abstract Introduction Obstructive sleep apnea (OSA) and PTSD are commonly comorbid in veterans. While PAP is the first line treatment for sleep apnea, adherence is low among veterans (Collen et al, 2012). Studies have shown early adherence predicts later adherence (Budhiraja et al, 2007). The current study investigates the impact of intervention on PAP adherence over time. Methods Thirty-seven veterans with comorbid OSA and PTSD from VA Palo Alto clinics were randomly assigned to either cognitive behavioral therapy (CBT-OSA) or an education arm and also received usual treatment at VA or outside clinics. Twenty-six completed the study. Participants received weekly, individual visits during the first four weeks of PAP treatment, three subsequent quarterly booster sessions, and a final visit at 12 months. PAP data was downloaded at each time-point; prior PAP use was coded. Results Significant mean differences in mask-on time between treatment arms after weekly treatments (Kinoshita et al., 2020) were not maintained at 12 months. Linear mixed modeling showed weekly improvement in mean mask-on time (minutes) over the treatment period (Education: estimate = 13.7, SE = 3.2, 95% CI 7.3, 20.1; CBT-OSA: estimate = 11.4, SE = 3.6, 95% CI 4.3, 18.5); no significant difference between arms (estimate = -2.3, SE = 4.7, 95% CI -11.5, 6.9). Newly diagnosed participants had significantly higher mean mask-on time than prior-PAP users at the end of weekly treatments (F[1, 35] = 17.86, p < 0.001) and at 12-months (F[1, 24] = 19.60, p < 0.001). Average mask-on time following weekly treatments was significantly correlated with average mask-on time at 12-months (r = 0.75; p < 0.001). Conclusion Consistent with prior research, findings suggest that newly diagnosed individuals benefit from weekly individual treatments, regardless of type, and maintain higher mask-on times at 12 months relative to prior PAP users. Early intervention when starting PAP treatment is important to support adherence, especially in patients with comorbid PTSD, a barrier to adherence in the veteran population. Support (if any) RR&D Merit Grant, Department of Veterans Affairs (Grant Number 1I01RX001799-01A2); Sierra Pacific MIRECC

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Puravath, F. M., T. Ash, R. Rottapel, C. Spadola, S. Bandana, M. Schonberg, S. Redline, and S. Bertisch. "0624 Voice of the Patient: A Patient-Centered Exploration of Factors Influencing Obstructive Sleep Apnea Care." Sleep 43, Supplement_1 (April 2020): A238—A239. http://dx.doi.org/10.1093/sleep/zsaa056.621.

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Abstract Introduction Despite widely available efficacious treatments for obstructive sleep apnea (OSA), patients commonly report frustration in accessing and adhering to treatments. Sparse research has explored factors influencing OSA care from the patient perspective, which may limit provision of patient-centered care: care responsive to patient preferences, needs, and values. To this end, we conducted qualitative research to identify factors, voiced by patients, that influence OSA treatment initiation and adherence. Methods We performed semi-structured interviews with 15 patients previously diagnosed with OSA from Boston, MA and a national patient portal (MyApnea.Org). Patients were asked about barriers and facilitators to their diagnosis and treatment as well as about their preferences and values that informed their treatment decisions. Interviews were audio-recorded and transcribed. A qualitative content analysis was performed to identify themes. After developing a codebook, interviews were coded. Codes were then audited and finalized by study team consensus. Results Our sample was aged 25-74 years; 71% identified as female. Among participants, 57.1% identified as White, 14.3% Black, 14.3% Asian, and 14.3% Other. Major themes were broadly classified as (1) facilitators (provision of useful information on treatment options, participation in shared decision-making, continued clinician support); (2) barriers (inconvenience of treatment, difficulty of habit formation, treatment side effects, competing comorbid conditions); (3) motivators (value of improving chronic health, family support, positive treatment effects); (4) contextual factors (insufficient knowledge/awareness of OSA, navigating healthcare systems, access to informational resources). Awareness of OSA symptoms and treatments, and ongoing support were cited as the most common factors influencing the patient experience. Conclusion This formative research highlights that diverse factors impact the OSA evaluation and treatment patient experience. Further research should test interventions that promote effective patient-centered care for OSA, such as shared decision-making tools. Support Brigham and Women’s Hospital Research Institute Patient-Centered Comparative Effectiveness Research Center Grant

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Hockmeyer, T. R., and H. R. Rupp. "0495 Auricular Acupuncture Treatment Associated with Improved Self-Reported Sleep and Emotional Distress in Hispanic and Latino Immigrants: A Preliminary Report." Sleep 43, Supplement_1 (April 2020): A189—A190. http://dx.doi.org/10.1093/sleep/zsaa056.492.

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Abstract Introduction Hispanic and Latino immigrants face sociocultural stressors that may contribute to sleep disturbance. We investigated: 1. Whether Hispanic/ Latino immigrants with self-reported sleep disturbance showed improvements in sleep with auricular acupuncture; 2. If sleep effects were associated with emotional distress. Methods Emotional distress and sleep responses to auriculotherapy in Hispanic/ Latino adult immigrants were measured using Emotional Distress (ED), Athens Insomnia (AI), and Pittsburgh Sleep Quality Index (PSQI) scales completed Baseline, Mid (4 treatments), and Follow-up (8 treatments). Randomly assigned intervention was bi-weekly for 8 treatment sessions of 5 needles inserted bilaterally: Active Intervention [NADA protocol (Shen men, sympathetic autonomic, lung, liver and kidney points)] OR Sham Control (outer ear helix with no active points). Scores were compared between Groups (NADA or SHAM) and within (Pre-, Mid- and Post-treatment) sessions using Mixed-Model ANOVA; multiple linear regression assessed ED scores association with sleep. Results Ten Hispanic/ Latino female participants [NADA, N=5, mean (SD) age = 41 (14); SHAM, N =5; mean (SD) age = 42 (17)]. Anovas for the ASI, PSQI, and ED showed significant within-subjects effects (p’s < .05). Baseline; Mid; Follow-up Mean (SD) = AIS: 12.3 (8.9); 8.5 (6.9); 7.1 (12.8); PSQI: 10.9 (5.4); 8.9 (2.8); 7.6 (3.4); ED: 25.6 (50.4); 17.6 (26.7); 16.9 (29.8). Post-hoc t-tests were significant between Baseline/ Mid and Baseline/ Final for all measures (p’s < .05). Linear Regression showed significant association between ED and PSQI (R square = 0.25; p < .05): lower Emotional Distress associated with lower PSQI. Conclusion Auriculotherapy may improve sleep in Hispanic/ Latino immigrants after 4 treatments suggesting a novel, low-cost, easily implemented group treatment option for improving sleep in this community. Better sleep was associated with decreases in emotional distress supporting our hypothesis. Data collection continues and larger sample size will allow for increased power to detect between group differences. Support This research was made possible with thanks to the American Academy of Sleep Medicine (AASM) Humanitarian Award#:197-FP-18.

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Kerner, Hilit, Noah Samuels, Shlomi Ben Moshe, Ilanit Shalom Sharabi, and Eran Ben-Arye. "Impact of a patient-tailored complementary/integrative medicine programme on disturbed sleep quality among patients undergoing chemotherapy." BMJ Supportive & Palliative Care 10, no. 3 (July 14, 2017): e21-e21. http://dx.doi.org/10.1136/bmjspcare-2017-001351.

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ObjectivesThe present study examined the impact of a patient-tailored complementary/integrative medicine (CIM) programme on sleep quality in patients undergoing chemotherapy for breast and gynaecological cancer.MethodsStudy participants received standard supportive care, with or without weekly CIM treatments. Disturbed sleep quality was defined as a score of ≥4 on the Edmonton Symptom Assessment Scale (ESAS) or a score of ≥3 on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Adherence to integrative care was defined as attending ≥4 CIM treatments, with ≤30 days between each session.ResultsOf 388 eligible patients, 264 (68%) reported disturbed sleep quality. Baseline-to-follow up assessment (at 6 weeks) was optimal for 104 patients in the treatment group and for 76 controls, with 75 of treated patients found to be adherent to the CIM intervention. Sleep-related ESAS scores improved more significantly in treated patients (p=0.008), as did sleep-related concerns on EORTC (treatment group, p=0.026).ConclusionsA patient-tailored CIM programme may improve sleep quality and related concerns among patients with breast and gynaecological cancer undergoing chemotherapy. Further research is needed to better understand the impact of CIM on sleep quality in this patient population.Trial registration numberNCT01860365.

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Cartwright, Rosalind, Ruzica Ristanovic, Frank Diaz, David Caldarelli, and Gary Alder. "A Comparative Study of Treatments for Positional Sleep Apnea." Sleep 14, no. 6 (November 1, 1991): 546–52. http://dx.doi.org/10.1093/sleep/14.6.546.

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Jordan, Amy S., and Kristina Kairaitis. "Dreaming of New Obstructive Sleep Apnea Treatments." American Journal of Respiratory and Critical Care Medicine 205, no. 2 (January 15, 2022): 148–49. http://dx.doi.org/10.1164/rccm.202110-2236ed.

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Lamberg, Lynne. "Sleep Treatments Improve PTSD Symptoms in Vets." Psychiatric News 45, no. 18 (September 17, 2010): 5–23. http://dx.doi.org/10.1176/pn.45.18.psychnews_45_18_012.

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Montgomery, P. "Treatments for sleep problems in elderly people." BMJ 325, no. 7372 (November 9, 2002): 1049. http://dx.doi.org/10.1136/bmj.325.7372.1049.

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J. M. Cohen, Mitchell, Lynette A. Menefee, Karl Doghramji, Whitney R. Anderson, and Evan D. Frank. "Sleep in chronic pain: problems and treatments." International Review of Psychiatry 12, no. 2 (January 2000): 115–27. http://dx.doi.org/10.1080/09540260050007435.

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Staub, Cristina. "Concept of diverse sleep treatments in physiotherapy." European Journal of Physiotherapy 21, no. 3 (October 8, 2018): 177–84. http://dx.doi.org/10.1080/21679169.2018.1505948.

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Colaco, Brendon, Meghna P. Mansukhani, and Bhanu Prakash Kolla. "Severe sleep apnea resistant to all treatments." Sleep Medicine 33 (May 2017): 160–64. http://dx.doi.org/10.1016/j.sleep.2017.02.016.

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Couch, Marion Everett, and Brent Senior. "Nonsurgical and Surgical Treatments for Sleep Apnea." Anesthesiology Clinics of North America 23, no. 3 (September 2005): 525–34. http://dx.doi.org/10.1016/j.atc.2005.02.007.

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Sato, Kiminori, Takao Mitsumasu, Minoru Hirano, Tatayu Kotorii, Tetsuro Sakamoto, and Takaharu Hayashida. "Surgical treatments for obstructive sleep apnea syndrome." Practica Oto-Rhino-Laryngologica 83, no. 6 (1990): 897–903. http://dx.doi.org/10.5631/jibirin.83.897.

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Smith, Neil, Robert Hill, Jane Marshall, Francis Keaney, and Shamil Wanigaratne. "Sleep Related Beliefs and their Association with Alcohol Relapse Following Residential Alcohol Detoxification Treatment." Behavioural and Cognitive Psychotherapy 42, no. 5 (June 28, 2013): 593–604. http://dx.doi.org/10.1017/s1352465813000465.

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Background: Alcohol dependence is known to impact upon sleep, and poor sleep has been shown to affect relapse rates following treatment for alcohol dependence. Aims: The aim of this study was to investigate the association between sleep problems and relapse in dependent drinkers in an inpatient setting. This was done by studying sleep related cognitions in individuals undergoing medically assisted alcohol withdrawal. Method: Sleep and sleep-related cognitions data were collected for 71 individuals undergoing detoxification treatment. Sleep was measured using sleep diaries and actigraph motion monitors. Participants completed sleep-related cognition questionnaires and were subject to telephone follow-up interviews. The results were then used to predict relapse rates 4 weeks after discharge. Results: Longer sleep onset latency recorded on the unit predicted relapse at 4 weeks. Higher dysfunctional beliefs about sleep were found to be associated with lower relapse rates. Conclusions: This study suggests that some dysfunctional beliefs about sleep may support recovery following discharge from treatment. The study further supports the need for tailored cognitive-behavioural treatments for sleep difficulties in this population to reduce relapse rates.

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Yennu, Sriram J., Cindy L. Carmack, Dave Balachandran, Janet L. Williams, Zhanni Lu, Minjeong Park, Kenneth R. Hess, Jewel Ochoa, and Eduardo Bruera. "Multimodal therapy for the treatment of sleep disturbance in patients with advanced cancer." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 185. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.185.

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185 Background: Poor sleep quality is frequent in patients with advanced cancer (62%), and is associated with a severe symptom distress and mortality. There are limited evidence based treatment options in advanced cancer patients.To obtain feasibility, preliminary estimates of the effects of various treatments [light therapy, melatonin, Methylphenidate] and combinations of treatments in multimodal therapy (MMT) to improve sleep quality, as measured by change in Pittsburg Sleep Quality Index (PSQI) scores from baseline to Day 15. We also examined MMT effects on FACT-G, insomnia - Insomnia severity index (ISI), actigraphy. Methods: Cancer patients with moderate sleep disturbance were eligible. Using a double-blind (patient, investigators) randomized factorial study design, eligible Pts were randomized into 1 of the 8 arms of the study which included all possible combinations of the interventions (light therapy, melatonin, and methylphenidate) and/or their corresponding placebo treatments for a duration of 2 weeks. All patients received 3 sessions of standardized CBT. Linear regression analysis was used to assess treatment effects. Results: 84% (54/ 64) randomized Pts were evaluable. At baseline, median (IQR) total PSQI was 13 (12, 15); and ISI was 18 (14, 21). There were no differences in the demographics and baseline sleep quality between groups. The adherence rates for light therapy, melatonin, and methylphenidate were 93%, 100%, and 100% respectively. Light therapy had moderate effects on sleep quality (effect size .43, P=0.017). No significant differences in ISI, FACT-G scores, and objective sleep variables between groups. There were no significant difference in adverse events by groups (P=.97). Conclusions: MMT interventions to treat sleep disturbance were feasible. Light therapy provided the best signal for improvement in sleep quality, and should proceed to large randomized control trials. Clinical trial information: NCT0168029. [Table: see text]

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Ohayon, M. M., A. D. Krystal, J. Black, C. M. Shapiro, S. Sullivan, T. J. Swick, and C. C. Wells. "0774 Factors Associated With The Continuous Use Of Psychotropic Treatments For Narcolepsy." Sleep 43, Supplement_1 (April 2020): A294—A295. http://dx.doi.org/10.1093/sleep/zsaa056.770.

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Abstract Introduction Narcolepsy is a debilitating disorder characterized by excessive sleepiness and cataplexy episodes. There is no cure for this disease. Current treatments focus on controlling the symptoms with CNS stimulants for sleepiness and antidepressants and/or CNS depressants for cataplexy. This study examines the factors that can contribute to the cessation of narcolepsy treatment. Methods The study includes 291 narcoleptic individuals who were interviewed twice, approximately five to seven years apart, in Wave 1 (W1) and Wave 2 (W2). Telephone interviews were conducted with the help of the Sleep-EVAL system; narcolepsy individuals were initially evaluated and diagnosed by a Sleep Specialist. Results At W1, 49.2% of narcoleptic individuals were taking a CNS stimulant; at W2, 37% of narcoleptic individuals were taking a CNS stimulant. The use was chronic (i.e., present at W2 and W1) for 52.7% of the W2 subjects. CNS depressants were used by 19.1% at W1 and 17% at W2. Of the W1 subjects, 67.6% still reported using CNS depressants at W2. In terms of antidepressants, 38.6% and 29.6% of subjects reported using these medications at W1 and W2 respectively. Of those taking antidepressants at W2, 58.9% reported chronic use (ie, were also on antidepressants at W1). At least one of the aforementioned medication classes was used by 72% of participants at W1 and 56.1% at W2. Chronicity of nocturnal awakenings (RR: 2.7), the frequency of cataplexy episodes (RR: 2.3) and the chronicity of hypnopompic hallucinations (RR: 2.8) were associated with long-term use of narcolepsy treatment. Conclusion Narcolepsy treatments are mostly taken to long term. Some narcoleptics individuals were able to reduce or stop treatment either because the intensity of symptoms decreased or because they developed coping mechanisms to deal with the symptoms. Support NIH (R01NS044199), the Arrillaga Foundation and Jazz Pharmaceuticals Inc.

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Marin, Lorena, Armand Guàrdia, Alexandre González-Rodríguez, José Haba-Rubio, Mentxu Natividad, Elena Bosch, Noelia Domínguez, and José Antonio Monreal. "Sleep Disturbances in At-Risk Mental States and First Episode of Psychosis: A Narrative Review on Interventions." Clocks & Sleep 5, no. 2 (April 29, 2023): 249–59. http://dx.doi.org/10.3390/clockssleep5020020.

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Sleep disturbances are a common yet often overlooked symptom of psychosis that can drastically affect the quality of life and well-being of those living with the condition. Sleep disorders are common in people diagnosed with schizophrenia and have significant negative effects on the clinical course of the illness and the functional outcomes and quality of life of patients. There is a limited number of studies addressing this question in first-episode psychosis (FEP). In this narrative review, we aimed to provide an overview of sleep disorders in populations with FEP and at-risk mental states (ARMS). The review was focused on the various treatments currently used for sleep disorders, including both non-pharmacological and pharmacological treatments. A total of 48 studies were included. We found that sleep disturbances are associated with attenuated psychotic symptoms and other psychopathological symptoms in ARMSs. The association of sleep disturbances with the transition to psychosis has been poorly investigated. Sleep disturbances have an impact on the quality of life and the psychopathological symptoms of people suffering from FEP. The non-pharmacological treatments include cognitive behavioral therapy for insomnia, bright light therapy, cognitive restructuring techniques, sleep restriction therapy, basic sleep hygiene education, and the provision of portable sleep trackers. Other treatments include antipsychotics in acute phases and melatonin. The early intervention in sleep disturbances may improve overall prognosis in emerging psychosis populations.

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Carroll, Judith. "Biological Aging in Breast Cancer Survivors and the Role of Sleep." Innovation in Aging 5, Supplement_1 (December 1, 2021): 297. http://dx.doi.org/10.1093/geroni/igab046.1155.

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Abstract Although cancer treatments can prolong life, they may lead to long-term changes in physical health and well-being. The lasting symptoms experienced after cancer treatment include greater fatigue, pain, cognitive complaints, and functional decline. Cancer and its related cytotoxic treatments are proposed to directly altering biological aging pathways. Our recent findings support this hypothesis, suggesting that women with breast cancer exposed to therapy have alterations in indicators of biological aging, including elevated DNA damage, reduced telomerase activity, and more rapid epigenetic aging. There was variability in risk for signs of biological aging, and given the high prevalence of sleep problems among breast cancer survivors, we sought to examine whether healthy sleep might be protective. Results suggest that those with good sleep quality had less accelerated biological aging than those with sleep problems. Results point to healthy sleep as a modifiable target to protect women with breast cancer from experiencing biological aging.

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Alvarez Astorga, A., L. Gallardo Borge, H. de la Red Gallego, A. Alonso Sánchez, S. Gómez Sánchez, C. Noval Canga, E. Mayor Toranzo, S. Cepedello Pérez, L. Rodriguez Andrés, and T. Ballesta Casanova. "Emerging treatments options for narcolepsy throughout a case." European Psychiatry 33, S1 (March 2016): S594. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2215.

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BackgroundNarcolepsy is a neurological disorder characterized by disturbances in REM sleep. The symptoms that the patient could present are excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. Its etiology is unknown. Currently, there is established pharmacotherapy for symptomatic treatment, which are often unsatisfactory.ObjectiveReview of new treatments for narcolepsy based on recent advances about its ethiopathogenesis.MethodSeventy-five year-old female with a personal history of arterial hypertension and obstructive sleep apnea syndrome. The patient presented several episodes of abrupt muscular weakness, nightmares, sleep paralysis and excessive daytime sleepiness. Diagnosed of narcolepsy and treated with methylphenidate immediate-release (IR) 10 mg, alprazolam 1 mg, and trazodone 100 mg with good response.ResultsDue to persistent symptoms, treatment was modified to osmotic-release oral system (OROS) – methylphenidate resulting on a substantial weight loss (12 kg) and persistence of symptoms. Another methylphenidate preparations were unsuccessfully tested. Currently she continues treatment based on methylphenidate release-release and she improved significantly though she sometimes presented daytime sleepiness.DiscussionRecent studies have shown that a loss of the hypothalamic neuropeptide hypocretin causes Narcolepsy with cataplexy and that an autoimmune mechanism may be responsible for this loss (related to HLA DQB*0602). Pathophysiology of narcolepsy without cataplexy is less understood.Although amphetamines and its derivatives are the mainstay of management, therapies that involve hypocretine seems to be hopeful (intranasal, peripherical or hipocretin cell transplantation). Monotherapy with GHB, H3 antagonist receptors, TRH analogs and immunotherapy are also being studied.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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De Franciscis, Pasquale, Anna Conte, Antonio Schiattarella, Gaetano Riemma, Luigi Cobellis, and Nicola Colacurci. "Non-hormonal Treatments For Menopausal Symptoms and Sleep Disturbances: A Comparison Between Purified Pollen Extracts and Soy Isoflavones." Current Pharmaceutical Design 26, no. 35 (October 16, 2020): 4509–14. http://dx.doi.org/10.2174/1381612826666200721002022.

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Background: Besides hot-flushes, sleep disturbances increase around menopause, impacting on the quality of life. When hormone replacement therapy is contraindicated, it is necessary to provide alternative treatments. Objectives: This study aimed to observe the effects of an herbal remedy from pollen extracts and soy isoflavones for menopausal complaints, particularly on sleep disorders. Methods: A six-month prospective observational study was performed in women in natural menopause suffering from menopausal symptoms and sleep disturbances. Three groups were compared: 57 women receiving two tablets/ day containing herbal remedy from pollen extracts (group A), 60 women receiving one tablet/day containing isoflavones 60 mg (group B), 47 women not receiving any treatment (group C). At 3 (T3) and 6 months (T6), the daily number of hot-flushes, Kupperman index for menopausal symptoms, the Pittsburgh Sleep Quality Index (PSQI) test were assessed. Results: Both groups A and B showed a significant improvement of hot flushes (p<0.001) and Kuppermann Index (p<0.001) from T0 to T3 and from T0 to T6. No significant differences between treatment groups were found at T3, while at T6 group A showed greater decrease of daily hot flashes and better improvement of Kupperman Index as compared to group B (respectively, -48.8% versus -18.4% and -24.4% versus -15.4%; p<0.001). Improvement of global sleep quality was more evident in the pollen treated group compared to isoflavones group at both three (-24.7% versus -9.3%, p<0.001) and six (-52.9% vs -4.0%; p<0.001) months, mainly for the scores related to subjective sleep quality, sleep latency and habitual sleep efficiency. Conclusions: Non-hormonal treatments can effectively be used in symptomatic menopausal women: among these, after six months of treatment, pollen extracts might achieve a better improvement of hot flushes, sleep disturbances and menopause-related symptoms than soy isoflavones. Herbal remedy from pollen extracts is mainly effective when the quality of sleep is the most disturbing complaint.

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McCullough, Lindsay M., Zin Mar Htun, James J. Herdegen, and Alejandra C. Lastra. "0603 Novel Treatments Should Be Considered For Patients with Narcolepsy." Sleep 42, Supplement_1 (April 2019): A240. http://dx.doi.org/10.1093/sleep/zsz067.601.

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Wootten, Christopher T., Sivakumar Chinnadurai, and Steven L. Goudy. "Beyond adenotonsillectomy: Outcomes of sleep endoscopy-directed treatments in pediatric obstructive sleep apnea." International Journal of Pediatric Otorhinolaryngology 78, no. 7 (July 2014): 1158–62. http://dx.doi.org/10.1016/j.ijporl.2014.04.041.

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Videnovic, Aleksandar, Yo-El S. Ju, Isabelle Arnulf, Valérie Cochen-De Cock, Birgit Högl, Dieter Kunz, Federica Provini, et al. "Clinical trials in REM sleep behavioural disorder: challenges and opportunities." Journal of Neurology, Neurosurgery & Psychiatry 91, no. 7 (May 13, 2020): 740–49. http://dx.doi.org/10.1136/jnnp-2020-322875.

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The rapid eye movement sleep behavioural disorder (RBD) population is an ideal study population for testing disease-modifying treatments for synucleinopathies, since RBD represents an early prodromal stage of synucleinopathy when neuropathology may be more responsive to treatment. While clonazepam and melatonin are most commonly used as symptomatic treatments for RBD, clinical trials of symptomatic treatments are also needed to identify evidence-based treatments. A comprehensive framework for both disease-modifying and symptomatic treatment trials in RBD is described, including potential treatments in the pipeline, cost-effective participant recruitment and selection, study design, outcomes and dissemination of results. For disease-modifying treatment clinical trials, the recommended primary outcome is phenoconversion to an overt synucleinopathy, and stratification features should be used to select a study population at high risk of phenoconversion, to enable more rapid clinical trials. For symptomatic treatment clinical trials, objective polysomnogram-based measurement of RBD-related movements and vocalisations should be the primary outcome measure, rather than subjective scales or diaries. Mobile technology to enable objective measurement of RBD episodes in the ambulatory setting, and advances in imaging, biofluid, tissue, and neurophysiological biomarkers of synucleinopathies, will enable more efficient clinical trials but are still in development. Increasing awareness of RBD among the general public and medical community coupled with timely diagnosis of these diseases will facilitate progress in the development of therapeutics for RBD and associated neurodegenerative disorders.

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Faber, Jorge, Carolina Faber, and Ana Paula Faber. "Obstructive sleep apnea in adults." Dental Press Journal of Orthodontics 24, no. 3 (June 2019): 99–109. http://dx.doi.org/10.1590/2177-6709.24.3.099-109.sar.

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ABSTRACT Introduction: Obstructive Sleep Apnea and Hypopnea Syndrome (OSAS) is a highly prevalent disease with serious consequences for the patients’ lives. The treatment of the condition is mandatory for the improvement of the quality of life, as well as the life expectancy of the affected individuals. The most frequent treatments provided by dentistry are mandibular advancement devices (MAD) and orthognathic surgery with maxillomandibular advancement (MMA). This is possibly the only treatment option which offers high probability of cure. Objective: The present article provides a narrative review of OSAS from the perspective of 25 years of OSAS treatment clinical experience. Conclusion: MADs are a solid treatment option for primary snoring and mild or moderate OSAS. Patients with severe apnea who are non-adherent to CPAP may also be treated with MADs. Maxillomandibular advancement surgery is a safe and very effective treatment option to OSAS.

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Sparasci, Davide, Ilenia Napoli, Lorenzo Rossi, Ricardo Pereira-Mestre, Mauro Manconi, Giorgio Treglia, Laura Marandino, et al. "Prostate Cancer and Sleep Disorders: A Systematic Review." Cancers 14, no. 7 (March 31, 2022): 1784. http://dx.doi.org/10.3390/cancers14071784.

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Prostate cancer (PCa) treatment involves multiple strategies depending on the disease’s stage. Androgen deprivation therapy (ADT) remains the gold standard for advanced and metastatic stages. Sleep quality has been suggested as being additionally influenced also by local radiotherapy, prostatectomy and androgen-receptor (AR)-targeted agents. We performed a systematic review exploring the landscape of studies published between 1 January 1990 and 31 July 2021, investigating sleep disturbances in PCa patients receiving active treatments, including the influence of hormonal therapy on sleep quality as a factor affecting their quality of life. Out of 45 articles identified, 16 studies were selected, which recruited patients with PCa, undergoing active treatment in either a prospective longitudinal or cross-sectional study. Development of sleep disorders or changes in sleep quality were reported in 14 out of 16 trials included. Only five trials included objective measurements such as actigraphy, mostly at one time point and without a baseline assessment. Limitations to be addressed are the small number of existing trials, lack of randomized trials and heterogeneity of methodologies used. This systematic review outlines the lack of prospective trials investigating sleep disorders, with a rigorous methodology, in homogeneous cohorts of PCa patients. Future trials are needed to clarify the prevalence and impact of this side effect of PCa treatments.

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Vaitaitis, Gisela M., and David H. Wagner. "Are we aiming to miss in translational autoimmunity treatments?" F1000Research 7 (November 6, 2018): 1754. http://dx.doi.org/10.12688/f1000research.16894.1.

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Autoimmunity treatments, fruitfully pioneered in mouse models, can be disappointing or result in immunosuppression and opportunistic infections in translational trials. Many possible reasons exist, but one major, overlooked reason may be the treatment timing in relation to circadian oscillations of the immune system. Mice and humans both have immunological circadian clocks and experience the same circulatory oscillations of immune cells with regards to their sleep/wake phases, but have opposite sleep/wake phases with regard to the daylight cycle. Therefore, researchers mainly study mice and potential autoimmunity treatments during the murine sleep/rest phase, which is when pro-inflammatory mediators and more adaptive immune cells are prevalent in the circulation. In translational trials, however, treatment administration happens primarily during a patient’s wake/activity phase, during the daytime, which is when more local and acute immune responses are active in the circulation. Therefore, we believe that the most opportune window for autoimmunity treatment may be missed in translational trials. Shifting the timing, and adjusting dosing to target only immune cells that are active at that time, may result in higher success with minimized immunosuppression or toxicities.

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Vaitaitis, Gisela M., and David H. Wagner. "Are we aiming to miss in translational autoimmunity treatments?" F1000Research 7 (January 8, 2019): 1754. http://dx.doi.org/10.12688/f1000research.16894.2.

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Autoimmunity treatments, fruitfully pioneered in mouse models, can be disappointing or result in immunosuppression and opportunistic infections in translational trials. Many possible reasons exist, but one major, overlooked reason may be the treatment timing in relation to circadian oscillations of the immune system. Mice and humans both have immunological circadian clocks and experience the same circulatory oscillations of immune cells with regards to their sleep/wake phases, but have opposite sleep/wake phases with regard to the daylight cycle. Therefore, researchers mainly study mice and potential autoimmunity treatments during the murine sleep/rest phase, which is when pro-inflammatory mediators and more adaptive immune cells are prevalent in the circulation. In translational trials, however, treatment administration happens primarily during a patient’s wake/activity phase, during the daytime, which is when more local and acute immune responses are active in the circulation. Therefore, we believe that the most opportune window for autoimmunity treatment may be missed in translational trials. Shifting the timing, and adjusting dosing to target only immune cells that are active at that time, may result in higher success with minimized immunosuppression or toxicities.

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Iordăchescu, Diana-Antonia, Corina-Ioana Paica, Elena Otilia Vladislav, Ana-Ilinca Ilie, Corina Gică, Gheorghe Peltecu, Anca Maria Panaitescu, and Nicolae Gică. "PRENATAL MATERNAL SLEEP." Romanian Medical Journal 68, no. 2 (June 30, 2021): 169–73. http://dx.doi.org/10.37897/rmj.2021.2.7.

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Pregnancy affects women's sleep in many ways. Physical and emotional difficulties, especially towards the end of pregnancy, can lead to sleep disorders. Several studies suggest associations between sleep quality and high blood pressure, diabetes and depression. Sleep deprivation affect both mother and fetus. Sleep disorders are associated with low birth weight, intrauterine growth restriction, premature birth and cesarean births. This paper is a review based on information from the literature. The analysis was limited to articles and guidelines in English published between January 1, 2000 and May 1, 2020 on PubMed, ScienceDirect and Google Scholar using the following keywords: sleep, pregnancy, depression, anxiety, mental health, sleep disorders, pregnant women, interventions, treatment. In this review, we discuss the characteristics of prenatal maternal sleep, hormonal changes during pregnancy and their effects on sleep, the effects of changing sleep patterns on the pregnant woman, and the interventions needed to optimize sleep quality. According to the literature, sleep disorders are significant risk factors for mood disorders. Knowing sleep changes and their effects is useful for informing mothers. Consideration of non-pharmacological treatments and interventions such as cognitive-behavioral therapy, mindfulness therapy and relaxation exercises can be effective in optimizing the quality of sleep in pregnant women.

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Molen, Yara Fleury, Luciane Bizari Coin Carvalho, Lucila Bizari Fernandes do Prado, and Gilmar Fernandes do Prado. "Insomnia: psychological and neurobiological aspects and non-pharmacological treatments." Arquivos de Neuro-Psiquiatria 72, no. 1 (January 2014): 63–71. http://dx.doi.org/10.1590/0004-282x20130184.

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Abstract:

Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning) and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature). From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.

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Journal articles on the topic 'Sleep treatments'

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