Sleep and insomnia

When heat disturbs the Liver, the Liver is unable to house the Hun (soul), and dream-disturbed sleep and insomnia may appear. 

Dream-disturbed sleep and insomnia use Long Gu (Mastodi fossilium ossis), Zhen Zhu Mu (Concha margaritifera usta) and Ci Shi... 

Insufficient sleep and insomnia have been identified as contributing to significant cardiovascular morbidity. The epidemic of obesity, diabetes, and metabolic syndrome may be attributed, at least partially, to sleep loss. Traffic accidents due to sleepiness are directly connected to sleep deprivation. OSA has been pointed out as causally related to hypertension. Depression gets better after insomnia is successfully treated with CBTI. Sleep disorders drive healthcare costs up. These findings represent a call to action make sleep evaluation and improvement a mission of modern society. A first step is happening now spread the news to educate the population. The next one is at its dawn offer affordable solutions to detect and improve sleep. Mobile technology has great potential to serve an important role in the fulfillment of this mission. 

Smith, Harold R., Cynthia L. Cornelia, and Birgit Hogl, eds. Sleep Medicine. New York Cambridge University Press, 2008. In-depth coverage of the phenomenon of sleep, its disorders and clinical sleep specialty areas, with index. Summers-Bremner, Eluned. Insomnia A Cultural History. London Reaction Books, 2010. Historical-cultural studies approach to the phenomenon of sleep and insomnia includes a bibliography. 

Pharmacological Profiles of Anxiolytics and Sedative—Hypnotics. Historically, chemotherapy of anxiety and sleep disorders rehed on a wide variety of natural products such as opiates, alcohol, cannabis, and kawa pyrones. Use of various bromides and chloral derivatives ia these medical iadications enjoyed considerable popularity early ia the twentieth century. Upon the discovery of barbiturates, numerous synthetic compounds rapidly became available for the treatment of anxiety and insomnia. As of this writing barbiturates are ia use primarily as iajectable general anesthetics (qv) and as antiepileptics. These agents have been largely replaced as treatment for anxiety and sleep disorders. 

The term pasaon flower is used to denote many of the approximately 400 species of the herb. F saon flower has been used in medicine to treat pain, anxiety, and insomnia. Some herbalists use the herb to treat symptoms of parkinsonism. F saon flower is often used in combination with other herbs , such a valerian, chamomile, and hops, for promoting relaxation, rest and sleep. Although no adverse reactions have been reported, large doses may cause CNS depression. The use of passion flower is contraindicated in pregnancy and in patientstaking the monoamine oxidase inhibitors (MAOIs). Fission flower contains coumarin, and the risk of bleeding may be increased when used in patientstaking warfarin and pasaon flower. 

BW, a 50-year-old woman with a history of osteoarthritis and hypothyroidism, presents to the clinic complaining of hot flashes, vaginal dryness, and insomnia. She states that she experiences approximately two hot flashes per day and is awakened from sleep at least three to four times a week in a "pool of sweat" requiring her to change her clothes and bed linens. Her symptoms began about 3 months ago, and over that time, they have worsened to the point where they have become very bothersome. On questioning, she states her last menstrual period was 1 year ago. 

Melatonin secretion is synchronized to the light/dark (LD) cycle, with a nocturnal maximum (in young humans, about 200 pg/ml plasma) and low diurnal baseline levels (about 10 pg/ml plasma). Studies have supported the value of the exogenous administration of melatonin in circadian rhythm sleep disorders, insomnia, cancer, neurodegenerative diseases, disorders of the immune function, and oxidative damage (Karasek et al. 2002 Pandi-Perumal et al. 2005, 2006 Srinivasan et al. 2005a,b, 2006 Hardeland et al. 2006). 

LY 156735 is a [1-substituted analog of melatonin that has greater bioavailability than melatonin (Nickelsen et al. 2002). It is in an earlier stage of clinical trials in initial trials, it reduced the sleep onset time in patients with moderate sleep-onset insomnia. Several other specific melatonin receptor agonists and antagonists are in development (Rivara et al. 2005 Zlotos 2005) and presumably will be clinically tested over the next few years. 

The importance of adenosine deaminase in the duration and intensity of sleep in humans has been noted recently (Retey et al. 2005). Animal studies suggest that sleep needs are genetically controlled, and this also seems to apply in humans. Probably, a genetic variant of adenosine deaminase, which is associated with the reduced metabolism of adenosine to inosine, specifically enhances deep sleep and slow wave activity during sleep. Thus low activity of the catabolic enzyme for adenosine results in elevated adenosine, and deep sleep. In contrast, insomnia patients could have a distinct polymorphism of more active adenosine deaminase resulting in less adenosine accumulation, insomnia, and a low threshold for anxiety. This could also explain interindividual differences in anxiety symptoms after caffeine intake in healthy volunteers. This could affect the EEG during sleep and wakefulness in a non-state-specific manner. 

Currently the safety and efficacy of 20 is being evaluated in a Phase II study. The program is focused on the evaluation of the sleep induction and maintenance in insomnia patients but also will attempt to demonstrate orexin antagonists effects on improved sleep and side effect profiles compared to current GABAa receptor modulators. 

Eplivanserin (39) is a 5-HT2A antagonist initially developed for a broader spectrum of psychiatric disorders but that has been tested recently for insomnia. Within this latter indication, phase II studies showed benefits in sleep maintenance, but not in induction [9]. Compound 39 is currently in phase III, to assess the efficacy for the treatment of sleep maintenance insomnia, evaluating both sleep and daytime functioning [96]. 

The sleep disorders fall into four main categories (1) insomnia, (2) hypersomnia, (3) parasomnias, and (4) sleep schedule disorders. Insomnia is the most common sleep problem. It is simply defined as poor sleep and can be manifested by difficulty falling asleep, difficulty staying asleep, waking up too early, or waking up in the morning without feeling refreshed. 

Insomnia is not so much a diagnosable illness as a symptom. Simply put, insomnia is poor sleep, and there are a number of ways that the quality of sleep can be diminished. Although it may be tempting to identify insomnia by counting the number of hours spent sleeping, insomnia is much more than that. Insomnia is the experience of a poor quality sleep characterized by any of the following having difficulty... 

For reasons that are not entirely clear, insomnia is also more common in women than men. There are particular times when a woman is especially vulnerable to insomnia, including pregnancy, the transition into menopause, and the premenstrual phase of the menstrual cycle. This, of course, suggests that it is changes in the female reproductive system that somehow alter sleep. Depression and anxiety are also more common in women at these times, and insomnia is a common symptom of these psychiatric illnesses. 

Sleep disturbance Lovastatin and simvastatin may interfere with sleep, causing insomnia, whereas pravastatin does not appear to disturb sleep. 

CNS- Dizziness vertigo headache overactivity hyperreflexia tremors muscle twitching mania hypomania jitteriness confusion memory impairment sleep disturbances including hypersomnia and insomnia weakness myoclonic movements fatigue drowsiness restlessness overstimulation including increased anxiety, agitation and manic symptoms. 

Tremors of the hands and sleep disturbances in the form of vivid dreams, nightmares, and insomnia have been reported in association with the use of amiodarone. Ataxia, staggering, and impaired walking have been noted. Peripheral sensory and motor neuropathy or severe proximal muscle weakness develops infrequently. Both neuropathic and myopathic changes are observed on biopsy. Neurological symptoms resolve or improve within several weeks of dosage reduction. 

A significant advantage of the benzodiazepines over other central nervous system depressants (e.g., the barbiturates) is that they possess a much greater separation between the dose that produces sleep and the dose that produces death. This increased margin of safety has been one of the major reasons benzodiazepines have largely replaced the barbiturates and other types of sedative-hypnotics in the treatment of anxiety and insomnia. In addition, benzodiazepine aclministration is associated with few side effects. 

There is less therapeutic experience with the newer zaleplon than with zolpidem. Zaleplon has a rapid onset and a half-life of approximately 1 hour. It is extensively metabolized by aldehyde dehydrogenase, so that less than 1% of a dose is excreted unchanged. Because of its rapid onset of action and short biological half-life, zaleplon is well suited for treatment of sleep onset insomnia. Its short half-life often does not ensure a full 8 hours of sleep. 

Walsh, J.K., Poliak, C.P., Scharf, M.B., Schweitzer, P.K., and Vogel, G.W. (2000) Lack of residual sedation following middle-of-the-night zaleplon administration in sleep maintenance insomnia. Clin Neuropharmacol 23 17—21. 

There have been three randomized clinical trials and multiple case reports and open-label trials with the tricyclic antidepressants (TCAs) in PTSD, although only one study of childhood PTSD (Southwick et al., 1994) has been reported. Robert et al. (1999) reported the use of low-dose imipramine (1 mg/kg) to treat symptoms of ASD in children with burn injuries. In this study, 25 children ages 2 to 19 years were randomized to receive either chloral hydrate or imipramine for 7 days. Ten of 12 subjects receiving imipramine experienced from half to full remission of ASD symptoms, whereas 5 of 13 subjects responded to chloral hydrate. Sleep-related flashbacks and insomnia appeared to be particularly responsive to treatment. 

Trials of different modified-release formulations of zaleplon, zolpidem, and a similar selective GABA hypnotic, indiplon, are ongoing. These versions may help improve the sleep of those patients who have sleep maintenance insomnia or early-morning awakening. 

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