Incidence Of Insomnia Research Articles

Incidence and correlates of insomnia and its impact on health-related quality of life among Chinese pregnant women: a cross-sectional study

ABSTRACT Objective The aims of this study were to examine the incidence and correlates of insomnia and its impact on health-related quality of life among Chinese pregnant women. Method A cross-sectional study was performed from November 2018 to April 2019 in a university-affiliated general hospital in Guangzhou, China. Seven hundred and seventeen pregnant women completed the 36-item Short-Form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), and the obstetric and sociodemographic data sheet. Findings 24.3% of the pregnant women suffered from insomnia. Compared with women without insomnia, those with insomnia had a significantly lower health-related quality of life during pregnancy. Maternal age, educational level, occupation, economic status, insurance coverage, gestational age, the woman’s relationship with her mother-in-law and anxiety were significantly associated with insomnia among pregnant women. Conclusion The incidence of insomnia among pregnant women is high, and insomnia is negatively correlated with health-related quality of life. Appropriate measures and practical therapeutic programmes should be provided to prevent the adverse effects of insomnia in pregnant women with advanced maternal age, lower education, lower economic status, unemployment, lack of insurance coverage, unsatisfied with their relationships with their mothers-in-law, and suffering from anxiety symptoms, especially in the third trimester.

Association of sudden sensorineural hearing loss with increased risk of insomnia: a nationwide population-based cohort study.

To evaluate the risk of insomnia in patients with sudden sensorineural hearing loss (SSNHL). A retrospective propensity score-matched cohort study was conducted using a nationwide representative sample from the National Sample Cohort 2002-2013 data from the Korea National Health Insurance Service. The SSNHL group (n = 631) included patients diagnosed with SSNHL between January 2002 and December 2005. The comparison group (4 controls for every patient with SSNHL, n = 2,524) was selected using propensity score matching, according to sociodemographic factors and the year of enrollment. Each patient was monitored until 2013. Survival analysis, log-rank test, and Cox proportional hazards regression models were used to calculate the incidence, survival rate, and hazard ratio (HR) of insomnia for each group. Among the 3,155 individuals included in the study population (male, 48.6%), the overall incidence of insomnia during the 11-year follow-up was 1.4-fold higher in the SSNHL group than in the non-SSNHL group (106.3 vs 138.3 per 10,000 person-years; adjusted HR, 1.38; 95% confidence interval [CI], 1.08-1.78). Moreover, the adjusted HRs for developing insomnia (depression, 3.33 [95% CI, 2.22-5.01]; anxiety, 1.78 [95% CI, 1.27-2.53]; tinnitus, 1.56 [95% CI, 1.2-2.03]; dizziness, 1.76 [95% CI, 1.27-2.44]) were higher in patients with comorbidities. This observational study suggests that SSNHL is associated with an increased incidence of insomnia. Specifically, findings from this study show that patients with tinnitus, depression, anxiety, and dizziness had a higher risk of developing insomnia than those without tinnitus, depression, anxiety, and dizziness. Yeo CD, Yeom SW, You YS, Kim JS, Lee EJ. Association of sudden sensorineural hearing loss with increased risk of insomnia: a nationwide population-based cohort study. J Clin Sleep Med. 2022;18(5):1335-1342.

Adaptation status and related factors in patients living with implantable cardioverter defibrillators.

An implantable cardioverter-defibrillator (ICD) is the only approach to treat patients with life-threatening ventricular arrhythmias. Adaptation and acceptance of ICD play an important role in the optimal treatment of the patients. The aim of this study was to determine adaptation status and related factors in patients living with ICDs. In this descriptive-analytical study, 148 patients referred to Kowsar Hospital in Shiraz and Farshchian Hospital in Hamedan city between July 2020 and September 2021 were included in the study. Patients' adjustment status was measured based on the mode of the Roy nursing model and using the Baecke physical activity questionnaire, Pittsburgh sleep quality, mini nutritional assessment (MNA) nutrition questionnaire, constipation scoring questionnaire, self-concept scale, and multidimensional scale of perceived social support (MSPSS). Patients had low physical activity and poor sleep quality. Negative self-concept in relation to the disease and adherence to physicians' recommendations was observed among patients. In addition, patients did not have optimal interpersonal communication. Multivariate regression findings showed that the number of years of device implantation and the number of shock discharges are effective factors in the incidence of insomnia and the negative self-concept of patients. Patients living with ICD did not adjust to the new conditions after placement of the device. Low level of physical activity and sleep disturbance and also negative self-concept about the disease and adherence to treatment was observed among the patients. Shock discharges and duration of the device implantation were associated with impaired self-concept and insomnia in the patients.

Effectiveness of a Fitbit Based Sleep and Physical Activity Intervention in an Early Intervention Psychosis (EIP) Service

Purpose: Compared to levels in the general population, people with experiences of psychosis have poorer physical fitness, more sedentary behaviour, lower physical activity, more sleep problems, and a higher incidence of insomnia. The aim of the current study was to examine the feasibility and impact of an intervention with the goal of addressing these issues. Method: Design: intervention with outcome measure data collection, with no control group. Forty-nine early intervention psychosis (EIP) service patients took part in an intervention: provision of a Fitbit, Fitbit software apps, sleep hygiene, and physical activity guidance, and three discussion sessions with clinicians. The sample consisted of 29 males and 20 females, with age range of 17 - 54 years, and average age of 29.5 years. Measures used were Fitbit activity and sleep data, and self-rated Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS) and Positive and Negative Affect Schedule (PANAS). Results: WEMWBS scores significantly improved, with a medium effect size. PANAS negative affect (NA) dropped significantly. Analysis of Fitbit activity and sleep data yielded non-significant results. Conclusion: The intervention was acceptable to EIP patients and is feasible. Improvements in mental wellbeing and negative affect indicate the positive impact of the intervention on mental health. EIP services should consider assessing sleep quality and physical activity/exercise levels, and using this study’s intervention to promote wellbeing and mental health within recovery focused practice. Further research could be undertaken through a sufficiently powered randomised control trial (RCT) comparing this intervention and treatment as usual (TAU).

ANALISI FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN INSOMNIA PADA WANITA MENOPAUSE DI POSYANDU WILAYAH KERJA PUSKESMAS PUNTI KAYU TAHUN 2021

Menopausal women will experience several problems, one of which is sleep disorders (Insomnia). Insomnia is characterized by difficulty in initiating sleep. Various factors are thought to have a significant relationship with the occurrence of insomnia in postmenopausal women, including response to disease, lifestyle and anxiety levels. The purpose of this study was to determine the factors associated with the incidence of insomnia in postmenopausal women at the Posyandu in the Punti Kayu Palembang Health Centre in 2021. The research method used a survey Analytical by using design cross sectional, the sampling of this research used total sampling technique with a total sample of 63 people. Collecting data using a questionnaire sheet. The analysis used is analysis univariate and bivariat eusing testchi-square. The univariate results showed that 37 (58.7%) menopausal women experienced insomnia, 27 (42.9%) menopausal women, 27 (42.9%) postmenopausal women, and 33 (52.4%) menopausal women experienced poor lifestyle. anxiety as many as 30 (47.6%) postmenopausal women. ResultsIt is known that there is a relationship between response to disease and the incidence of insomnia in postmenopausal women with (p value = 0.000), there is a relationship between lifestyle and the incidence of insomnia in menopausal women with (p value = 0.000), there is a relationship between anxiety levels and the incidence of insomnia in menopausal women with (p value = 0.003). The conclusion of this study is that there is a relationship between response to disease, lifestyle, anxiety levels with the incidence of insomnia in postmenopausal women at the Posyandu in the Punti Kayu Health Centre in 2021. This study is expected to encourage postmenopausal women to maintain their health, change lifestyle habits and consume water, and reduce anxiety.

Efficacy and safety of Shumian capsules in treating insomnia: A systematic review and meta-analysis.

Background:It is known to all that the incidence of insomnia is becoming higher and higher with the increase of people's life stress. To some extent, it has brought about bad effects on people's life, work, study, and health, such as mental exhaustion, low work efficiency, and mood irritability. Now there are medications and non-medications methods for insomnia. As one of the treatments for insomnia, western medicine is to prolong the sleeping time and improve the anxious mood. However, taking western medicine to treat insomnia can also be accompanied by some adverse reactions at the same time, such as drug dependence, an allergic reaction, and so on. Traditional Chinese medicine therapy is based on syndrome differentiation and holistic concept. Shumian capsules (SM) are a kind of proprietary Chinese medicine for insomnia, which have the effect of relieving depression and calming the mind. But there are no studies on the efficacy and safety of SM in the treatment of insomnia. Therefore, I will provide a systematic review and meta-analysis to evaluate the efficacy and safety of SM for insomnia.Methods:All the studies searched were from PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, and WanFang databases, and the studies types included in the analysis were all randomized controlled trials. All the retrieval contents were completed independently by 2 researchers, and a third reviewer would be involved when there existed any disagreement. The eligible studies were screened out according to the inclusion criteria and exclusion criteria, and some useful information was extracted and made into a feature table, including the year of the included studies, the age, and disease course of the participants in the studies and intervention methods, etc. Cochrane risk-of-bias tool was used to evaluate the quality of literature and meta-analysis was conducted by RevMan 5.4 software.Results:A total of 9 articles including 709 participants were included in the study after screening out. The primary outcomes of statistical analysis were cure rate and total effective rate, while the secondary outcomes included Pittsburgh sleep quality index score and incidence of adverse reactions. The results showed that Pittsburgh sleep quality index score of the SM group and Western medicine group were statistically significant (MD = –0.50, 95% confidence interval [CI] = [–0.78, –0.22], P = .0005). The total effective rate of the SM group was slightly higher than that of the Western medicine group, but there was no statistical significance (relative risk [RR] = 1.03, 95% CI = [0.95,1.13], P = .43).Conclusion:This meta-analysis provides evidence for the efficacy and safety of SM in the treatment of insomnia, and provides a new idea for the clinical treatment of insomnia. But more research is needed to support further evidence.

Time-Varying Insomnia Symptoms and Incidence of Cognitive Impairment and Dementia among Older US Adults

There is conflicting evidence regarding the association between insomnia and the onset of mild cognitive impairment (MCI) or dementia. This study aimed to evaluate if time-varying insomnia is associated with the development of MCI and dementia. Data from the Health and Retirement Study (n = 13,833) from 2002 to 2014 were used (59.4% female). The Brief Insomnia Questionnaire was used to identify insomnia symptoms compiled in an insomnia severity index, ranging from 0 to 4. In the analysis, participants’ symptoms could vary from wave-to-wave. Dementia was defined using results from the Health and Retirement Study (HRS) global cognitive assessment tool. Respondents were classified as either having dementia, MCI or being cognitively healthy. Cox proportional hazards models with time-dependent exposure using the counting process (start-stop time) were used for analysis. For each one-unit increase in the insomnia symptom index, there was a 5-percent greater hazard of MCI (HR = 1.05; 95% CI: 1.04–1.06) and dementia (HR = 1.05; 95% CI: 1.03–1.05), after fully adjusting. Using a nationally representative sample of adults aged 51 and older, this study found that time-varying insomnia symptoms are associated with the risk of MCI and dementia. This highlights the importance of identifying sleep disturbances and their change over time as potentially important risk factors for MCI and dementia.

Efficacy and safety of thalidomide in preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy: A multicenter, open-label, randomized controlled trial.

This multicenter clinical trial was designed to evaluate the efficacy and safety of thalidomide (THD) in preventing oral mucositis (OM) in patients with nasopharyngeal carcinoma (NPC) undergoing concurrent chemoradiotherapy (CCRT). Patients with locally advanced NPC were randomly assigned to either a THD group or a control group. All 160 patients received radical intensity-modulated radiotherapy plus cisplatin-based concurrent chemotherapy and basic oral hygiene guidance. Patients in the THD group received additional THD at the beginning of CCRT. The primary end points were the latency period and the incidence of OM. The secondary end points were mouth and throat soreness (MTS), weight loss, short-term efficacy, and adverse events. The median latency period of OM was 30 and 14 days in the THD and control groups, respectively (hazard ratio, 0.32; 95% confidence interval, 0.23-0.35; P < .0001). The incidence of OM and severe OM (World Health Organization grade 3 or higher) was significantly lower in the THD group than the control group (87.5% vs 97.5% [P = .016] and 27.5% vs 46.3% [P = .014], respectively). THD treatment also remarkably reduced the intensity of MTS and the degree of weight loss. In comparison with the control group, the incidence of nausea, vomiting, and insomnia was significantly decreased, whereas the incidence of dizziness and constipation was obviously increased in the THD group. The objective response rates 3 months after CCRT were similar between the groups. THD prolonged the latency period, reduced the incidence of OM, and did not affect the short-term efficacy of CCRT in patients with NPC. Oral mucositis is the most common complication of nasopharyngeal carcinoma during chemoradiotherapy; it decreases the patient's quality of life, and ideal mucosal protective agents are lacking. A few basic research and preclinical studies have shown that thalidomide may be an approach to ameliorating oral mucositis. The results of the current study confirm that thalidomide has a protective effect against oral mucositis in patients who have received chemoradiotherapy for nasopharyngeal carcinoma.

Association between Insomnia and Irritable Bowel Syndrome among Adolescents in South Korea: A Quantitative Cross-Sectional Study

Insomnia refers to having difficulty sleeping even when given the opportunity and environment to sleep. Irritable bowel syndrome is a functional bowel disease that is accompanied by abdominal pain and irregular defecation but not organic lesions. Although insomnia and irritable bowel syndrome are pathophysiologically related, studies on their relationship among adolescents are lacking. This study aimed to determine the prevalence of insomnia and irritable bowel syndrome among adolescents and the association between them. In May 2021, a survey was conducted among high school adolescents from Daegu Metropolitan City, South Korea, using the Korean version of the Insomnia Severity Index and the Rome IV diagnostic criteria for irritable bowel syndrome. Data were analyzed using chi-square and Mann–Whitney tests and logistic regression analyses. The incidence of insomnia (Insomnia Severity Index score ≥ 10) was 18.4% (n = 74) while that of irritable bowel syndrome was 10.7% (n = 43). Irritable bowel syndrome was strongly associated with an increased incidence of insomnia (odds ratio = 3.30, 95% confidence interval: 1.66–6.53). Therefore, the association between insomnia and irritable bowel syndrome has relevance in the treatment of insomnia in adolescents.

Impact of the COVID-19 Pandemic on Patients with Gastrointestinal Cancer Undergoing Active Cancer Treatment in an Ambulatory Therapy Center: The Patients' Perspective.

Background: The mortality risk increases greatly in patients with cancer if they are infected with severe acute respiratory syndrome coronavirus 2. The new American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) guidelines for the COVID-19 pandemic suggested modifications to the standards of care to reduce harm from treatment. However, it is unclear whether these changes suit the wishes of patients. Methods: We conducted a survey of patients with gastrointestinal cancer who were undergoing active chemotherapy in our ambulatory therapy center between 17 August and 11 September 2020. The survey comprised 18 questions on five topics: patient characteristics, lifestyle changes, disturbance in their psychological health, thoughts on the cancer treatment, and infection control in the hospital. Results: Among the 63 patients who received the questionnaire, 61 participated in the study. The COVID-19 pandemic has led to changes in their lifestyles and substantially impacted their psychological wellbeing. The incidence of anxiety and insomnia has considerably increased during the pandemic. However, female patients and patients aged 70 years or older reported no notable differences. There was no significant difference in the responses to the questions regarding thoughts on the cancer treatment. Conclusion: Our study revealed that the COVID-19 pandemic has substantially impacted patients’ lifestyles and psychological wellbeing. However, most patients preferred to continue their usual treatment without any change to their treatment plan. It is important to involve the patient in the decision-making process when formulating treatment goals.

The effect and safety of ropinirole in the treatment of Parkinson disease: A systematic review and meta-analysis.

Background:It is necessary to conduct a meta-analysis of the clinical randomized controlled trials (RCTs) on ropinirole in the treatment of Parkinson disease (PD), to explore the effects and safety of ropinirole, and to provide a theoretical basis for clinically safe and rational drug use.Methods:RCTs on the effectiveness and safety of ropinirole in the treatment of PD were searched. We searched Dutch medical literature database, Pubmed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Knowledge Service Platform up to December 15, 2020. The Cochrane risk bias assessment tool was used to evaluate the quality of the included literature, and the RevMan5.3 software was used for meta-analysis.Results:A total of 12 RCTs with 3341 patients were included. The changes of Parkinson Disease Rating Scale Part II score (mean difference = –2.23, 95% confidence interval [CI] –2.82 to –1.64) and Parkinson Disease Rating Scale Part III scores (mean difference = –4.93, 95%CI –5.25 to –4.61) in the ropinirole group was significantly lower than that in the control group. The incidence of dizziness (odd risk [OR] = 1.85, 95%CI 1.50–2.28), nausea (OR = 2.17, 95%CI 1.81–2.59), vomiting (OR = 2.73, 95%CI 1.47–5.09), and lethargy (OR = 2.19, 95%CI 1.39–3.44) in the ropinirole group was significantly higher than that in the control group (all P < .05), and there were no significant differences in the incidence of headache (OR = 1.14, 95%CI 0.79–1.65) and insomnia (OR = 1.06, 95%CI 0.72–1.55) were found between 2 groups (all P > .05).Conclusions:Ropinirole can help improve the ability of daily living and exercise function of PD patients, but it will increase the incidence of related adverse reactions, which needs to be further confirmed by subsequent large-scale, high-quality RCTs.

Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020).

Study ObjectivesHigh rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018).MethodsData were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments.ResultsThe sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety, and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress.ConclusionsThe COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the COVID-19.

Insomnia incidence in myocardial infarction with and without obstructive coronary arteries

Abstract Background Insomnia can either be a primary problem or it may be associated with other psychological conditions, ranging from anxiety to depression. Some studies have reported that pts with MINOCA (myocardial infarction with non-obstructive coronary arteries) have more emotional disorders than the rest of pts with myocardial infarction (MI). However, a relationship with insomnia has not been yet described. The aim of this study is to compare insomnia levels between patients with MINOCA and the rest of MI patients using a validated scale: Insomnia Severity Index (ISI) (Figure 1). Methods We performed an analytical and observational study in which all consecutive MI pts from July 2017 to December 2020 were recruited. We used the latest definitions of MINOCA according to the 2020 ESC Guidelines. A group of experts reviewed all MINOCA cases in order to exclude those who did not fulfil criteria. Therefore, takotsubo syndrome and pts with myocarditis were excluded. ISI questionnaire was completed by each patient during admission. Total score ranges from 0 to 28 points. Depending on the final score, pts could have no clinically significant insomnia (0–7 points), subthreshold insomnia (8–14 points), clinical insomnia of moderate severity (15–21 points) and severe clinical insomnia (22–28 points). Follow up analysis included major adverse cardiovascular events (MACE: cardiovascular readmission, myocardial reinfarction, stroke and death from any cause). Survival analysis is based on Cox regression. Median follow-up was 25±23 months. Results From a total of 413 consecutive MI pts, 244 (59%) completed the questionnaire. Of them, 32 (13%) were MINOCA pts. There were no statistically significant differences in insomnia levels between both groups (Table 1). Even in absolute terms, both groups presented same mean levels: MINOCA mean value 7.6±6 points vs rest of MI 7.7±6 points, p=0.8. When separated by sex, women in the MI group had higher punctuation levels than men (24% of moderate clinical insomnia in women vs 8.9% of men, p=0.03). Punctuation in ISI questionnaire showed no significant differences in MACE in MINOCA pts (HR 0.9, CI 95% (0.7–1.2)), nor in the rest of MI pts (HR 0.9, CI 95% (0.9–1.03)). Conclusions Levels of insomnia were similar in MINOCA pts than in the rest of MI pts. Follow up showed no differences in MACE between both groups regarding insomnia according to ISI. Women had higher punctuation levels than men, with more clinical insomnia in a moderate grade. Subjective emotions could lead to mistaken findings, making it necessary to use ISI questionnaire or other objective validated scales to correctly study some disorders and their distribution in different populations. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Society of Cardiology Table 1. Insomnia severity indexFigure 1. ISI Questionnaire

Evaluation of habitual sleep and factors influencing it in patients awaiting acute or planned abdominal surgery

Background and aims: This study aimed to clarify the incidence and severity of habitual sleep disturbances in patients undergoing surgery. Methods: A survey was conducted to collect data in a cohort of patients awaiting abdominal surgery. The Insomnia Severity Index score was used as primary measurement, while the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index scores were used as secondary measurements. Findings: Overall, 119 patients were included in the analysis. The habitual sleep in the study cohort revealed high incidence of sleep difficulties and insomnia. Female sex and incidence of anxiety and depression were significantly related to all three scores, while age and employment were associated with Epworth Sleepiness Scale and Insomnia Severity Index scores, respectively. Conclusions: Female sex, experiencing depression or anxiety had severe negative impact on sleep in patients scheduled for elective or planned surgery. The prevalence of sleep problems in patients should be considered for optimising sleep to improve rehabilitation and reduce stress associated with surgery.

The Association between Smartphone Addiction and Insomnia Incidence in Students of the Faculty of Medicine Udayana University Batch of 2020 during the Coronavirus Disease-19 Pandemic

BACKGROUND: The use of smartphones is increasing in the coronavirus disease (COVID-19) pandemic for various purposes, this encourages smartphone addiction. In addition, the incidence of insomnia has also increased in the pandemic era. AIM: This study was conducted to find an association between smartphone addiction and the incidence of insomnia, especially among students of the Faculty of Medicine, Udayana University. METHOD: This research is a descriptive-analytic study with the cross-sectional method, using two main questionnaires, Smartphone Addiction Scale-Short Version, and Insomnia Severity Index. Questionnaires were distributed using Google forms and then collected and analyzed using software SPSS version 25. RESULT: Overall the total research respondents with the inclusion criteria in this study amounted to 364 people. The results showed that 212 respondents (58.24%) had a high level of smartphone addiction and 152 respondents (41.76%) had a low level of smartphone addiction. In addition, 187 respondents (51.37%) experienced mild insomnia, 87 respondents (23.9%) experienced moderate insomnia, 13 respondents (3.57%) experienced severe insomnia, and 77 respondents (21.15%) did not experience insomnia. Based on the results of data analysis, it was found that smartphone addiction had a significant relationship (p = 0.002) with weak and positive correlation (r = 0.162) to the incidence of insomnia. CONCLUSION: It was found that the majority of respondents experienced high levels of smartphone addiction and mild insomnia. Another finding suggests the higher addiction to the smartphones, the more severe insomnia suffered.

Psycho-Socio-Juridic Review Of Lockdown And Work From Home Policies On Psychological Symptoms In Productive Groups And Strategic Solutions Of National Economy

Covid-19 pandemic has a significant impact on all strategic aspects of human life. The influential aspects are the health, economic and socio-cultural. The Covid-19 pandemic creates a dilemma for the Government to find the best way to benefit from various sectors efficiently. One of them is the implementation of lockdown and work from home to reduce the spread of Covid-19, but this has an impact on the emergence of various psychological disorders and the balance of the economic balance which tends to be negative. The focus of this research is to reveal the impact of the Covid-19 pandemic and lockdown and Work From Home policies on psychological symptoms and to find the best alternative solutions in terms of the economic sector. This research consists of 2 main parts, namely survey research and research that examines the problems based on sociology with qualitative methods with the type of normative juridical research. The results of this study reveal that during the Covid-19 pandemic period caused a 39.1% incidence of insomnia, 12.1% incidence of depression, and 26.3% incidence of anxiety from various levels. Still, there was no strong relationship and correlation between existing policies such as Work From Home, income, layoffs, spiritual, psychological symptoms. A literature review reveals the most effective way to bridge these three aspects (health, economy, and psychology) is by applying the form of shifting or taking turns by dividing into a minimum of 2 teams, namely a minimum of 14 days of work and a minimum of 14 days for independent isolation at home.

Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant.

IntroductionInsomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment.MethodsThis retrospective cohort study analyzed Optum Clinformatics Data Mart claims data (Jan 2010–Dec 2018). Patients with ≥ 2 insomnia diagnosis claims and ≥ 1 prescription for suvorexant were included. Prevalent and incident insomnia patients were analyzed separately. The change in the trends of HCRU and costs were examined for 12 months before and 12 months after suvorexant initiation. An interrupted time series (ITS) analysis was conducted to assess the level and slope changes. Subgroups of patients with mental health comorbidities were examined.ResultsThe study included 18,919 and 5939 patients in the prevalent and incident insomnia cohorts, respectively. For the prevalent cohort, mean (SD) age was 64.5 (14.1) years, 65% were female, 74% had Medicare Advantage coverage, and 61% had a Charlson comorbidity index score ≥ 1. Characteristics for the incident cohort were similar. The ITS results suggested that the trend for monthly total healthcare cost (THC) was increasing before suvorexant initiation (US$52.51 in the prevalent cohort, $74.93 in incident insomnia cohort), but, after suvorexant initiation, the monthly total cost showed a decreasing trend in both cohorts. The decrease in slope for THC after suvorexant initiation were $72.66 and $112.07 per month in the prevalent and incident cohorts, respectively. The monthly trends in HCRU rates also decreased. The subgroup analysis showed that decreases were 1.5–3 times greater for patients with mental health comorbidities.ConclusionsIn this real-world study, suvorexant initiation was associated with immediate and continued decreases in HCRU and costs in insomnia patients. Further research is needed to understand the effect of suvorexant initiation on direct medical costs as well as costs associated with lost productivity in other real-world settings.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-021-01891-8.

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study.

Background: Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment.Methods: Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture (N = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event.Results: Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio HR = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were HR = 0.28 (adjusted) for males and HR = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were HR = 0.22 (adjusted) for individuals 18 to 39 years of age, HR = 0.31 (adjusted) for individuals 40 to 59 years of age, HR = 0.28 (adjusted) for those 60 to 79 years of age, and HR = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted HR = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted HR = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted HR = 0.42), the basal ganglia (adjusted HR = 0.22), the radiation crown (adjusted HR = 0.42), the diencephalon (adjusted HR = 0.20), or multiple partial strokes (adjusted HR = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, P = 0.000).Limitations: First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions.Conclusion: Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.

Efficacy and safety of Tian Meng oral liquid for the treatment of insomnia: A protocol for systematic review and meta-analysis.

Background:The incidence of insomnia is very high and seriously affects the lives of its patients. Long-term insomnia can induce other diseases and even cause sudden death. Tian Meng oral liquid is a type of Chinese patent medicine that has been used in the clinical treatment of insomnia and has certain clinical effects. However, its wide application is limited by the lack of evidence-based medical evaluation.Methods:Using retrieval strategies, randomized controlled trials on Tian Meng oral liquid for insomnia were obtained from China National Knowledge Infrastructure, WanFang, Chinese Scientific Journals Database PubMed, Embase, and Cochrane Library, regardless of publication date or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using RevMan 5.3 and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated.Results:This study aims to evaluate the efficacy and safety of Tian Meng oral liquid in the treatment of insomnia and to provide a more reasonable option for clinical medication.Conclusion:Our findings will provide a strong basis for the effectiveness and safety of Tian Meng oral liquid in the treatment of insomnia.

Practical guidelines for the treatment of chronic nonspecific low back pain and comorbid chronic insomnia: clinical observation

A clinical case of a patient with chronic nonspecific low back pain and comorbid chronic insomnia is described, and a modern approach to the management of this patient category is shown. So-called yellow flags - factors that contribute to the central sensitization of pain - lead to chronicity of LBP. In the presented clinical case we identified the most common "yellow flags”: insomnia, pain catastrophizing, restrictive ”pain” behavior, anxiety. In practice, they often ignore the aforementioned factors, determine only the presence of back pain and prescribe analgesic therapy, which does not allow for an effective result.Insomnia is prevalent among patients with LBP, occurring in 47-64% of cases. With the COVID-19 pandemic among the population, the incidence of insomnia, anxiety and depression has increased. To date, the identification and treatment of these disorders is particularly relevant in the management of patients with chronic nonspecific LBP.The patient was treated, which included non-drug and drug methods and complied with Russian and foreign clinical guidelines on the therapy of chronic nonspecific LBP and on the therapy of chronic insomnia. Non-drug treatment consisted of educational talks, recommendations on daily activity and sleep hygiene, cognitive-behavioral therapy, mindfulness, relaxation, and therapeutic gymnastics. The listed methods were aimed at reducing pain catastrophizing, physical and social activation of the patient. The nonsteroidal anti-inflammatory drug dexketoprofen was used as pharmacotherapy according to a step-by-step regimen. After 5 days of therapy pain relief was observed, after 3 months of therapy back pain regressed, sleep normalized, mood improved. This therapeutic approach showed its effectiveness and safety in the treatment of chronic nonspecific LBP and comorbid chronic insomnia.