Management Of Sleep Disorders Research Articles

The Physiological and Pharmacological Roles of Melatonin and Pregabalin

Melatonin and pregabalin are two important compounds that are broadly used in the fields of physiological and medicinal sciences. Melatonin is a primary hormone mainly secreted by the pineal gland and plays an important role in regulating circadian rhythms, sleep-wake cycles, and neuroimmune processes. Its strong antioxidant anti-inflammatory and anti-apoptotic properties have protected it against a wide range of diseases, from cancer to neurological disorders. In this study, the synthesis of melatonin will be widely studied, mainly regarding its role in regulating circadian rhythms and sleep, and its possible therapeutic use in treating neurological diseases and inflammation-related disorders. Pregabalin is an analog of the neurotransmitter gamma-aminobutyric acid (GABA), with anticonvulsant, analgesic, and anxiolytic actions. Clinical practice has widely utilized it because studies indicate that it is useful in treating a variety of conditions: fibromyalgia, epilepsy, neuropathic pain, and generalized anxiety disorder. This article reviews aspects of the pharmacokinetics of pregabalin, its useful functions in pain treatment, and its impact on calcium channel regulation. The review also discusses indications of pregabalin in therapy, along with its possible side effects. This review article aims to consider the molecular processes underlying the activities of melatonin and pregabalin and their therapeutic potential for the management of sleep disorders, inflammation, and neurological diseases to future use of these compounds clinically.

Intersection of Sleep Disorders and Parkinson Disease: Unveiling the Bidirectional Relationship.

Patients with Parkinson's Disease (PD) frequently exhibit non-motor symptoms, particularly sleep disturbances. Sleep disorders in PD patients are intricately linked to the pathogenesis and progression of PD itself, exacerbating neurodegenerative processes and worsening patient quality of life. This review underscores the significance of sleep disorders in PD, highlighting their prevalence, impact on disease progression, and the bidirectional relationship between sleep disruption and neurodegeneration. It aims to enhance clinician awareness for better diagnosis and management of sleep-related comorbidities in PD. A comprehensive literature search was conducted in PubMed and Scopus using key terms such as "sleep disorders", "Parkinson's disease", "REM sleep behavior disorder", "restless legs syndrome", "insomnia", "obstructive sleep apnea", "excessive daytime sleepiness", "circadian rhythm disorders", "sleep and neurodegeneration". Sleep disorders are prevalent in PD affecting up to 90% of patients. Conditions such as insomnia, REM sleep behavior disorder, restless legs syndrome, obstructive sleep apnea, excessive daytime sleepiness, and circadian rhythm disorders are commonly reported. These disorders are linked to multifactorial biological mechanisms and are associated with more severe disease phenotypes. Of note, several evidence shows that sleep abnormalities may contribute to neuroinflammation and neurodegeneration, further accelerating the disease course. Sleep disturbances are critical non-motor symptoms in PD. Early diagnosis and tailored management of sleep disorders are essential for improving clinical outcomes and potentially offering neuroprotective benefits.

The interdisciplinary field of Sleep Medicine-time for dentists to sink their teeth into it!

Sleep Medicine has evolved into a highly multidisciplinary field over the last few decades, involving respiratory physicians, neurologists, cardiologists, ENT surgeons, psychiatrists and psychologists to name a few. It is within this highly multidisciplinary context that we have seen an increasing role for dentists in the recognition, diagnosis and management of select sleep disturbances and disorders. Over the last couple of decades, this growing role for dentists has seen the informal emergence of a new interdisciplinary field of Dental Sleep Medicine-a field that bridges medicine and dentistry as it pertains to the diagnosis and management of sleep disorders. This article describes this new field in terms of its history, the evolving scope of practice for dentists, the implications for education and training, and the importance of multidisciplinary care that optimises outcomes for patients.

Prevalence of sleep disorders and association with various occupations among Indian population aged ≥ 45 years: Insight from Longitudinal Ageing Study in India (LASI)

ABSTRACT Introduction: By scrutinizing the impact of job schedules, workplace culture and stress levels, our study aims to determine the prevalence of sleep disorders among various occupations and its associated factors. The findings promise to enhance the overall well-being, sleep quality and productivity in various occupational settings. Methods: This is an analytical cross-sectional study involving secondary data from the nationally representative Longitudinal Ageing Study in India (LASI Wave I 2017-18) of 35 Indian states and union territories with exception of Sikkim. The study included 59441 Indian volunteers who older than 45 years. Multivariable logistic regression analysis was conducted to study the association of sleep disorders among various occupations while accounting for other associated factors. Results: Prevalence of sleep disorders was higher among the females (12.66%), unemployed (13.34%), ≥ 60-yr age group (13.45%), those who lived in rural areas (12.35%), those who were illiterate (12.80%) and reported themselves to be widowed, separated or divorced (14.54%), people with no health insurance (11.74%), smokers (12.11%), without physical activity (12.67%) and also rated themselves as poor in the self-rated health status (26.77%). Alcohol consumption was not statistically significant factor for sleep disorders. Conclusions: There is an emerging need for targeted screening, prompt detection and early management of insomnia and other sleep disorders among the high-risk groups. Provision of accessible and affordable screening tools, training skills for early diagnosis at primary care level and/or proper referral services to higher centres form the cornerstone for adequate management of sleep disorders.

Therapeutic potential of Rosa roxburghii folium extract in insomnia treatment: a comprehensive evaluation of behavioral and neurochemical effects in a PCPA-induced mouse model.

Insomnia, a prevalent sleep disorder, detrimentally affects quality of life and is often challenging to manage with conventional treatments. This study delved into identifying and quantifying the main compounds by employing ultra-performance liquid chromatography-Q-Exactive-Orbitrap mass spectrometry, and further to evaluate the therapeutic potential of Rosa roxburghii folium (RRF) extract, with multiple pharmacological activities. Previous research had hinted at the efficacy of glycosides in influencing the γ-aminobutyric acid (GABAergic) system, which plays a pivotal role in sleep regulation. Utilizing a p-chlorophenylalanine-induced insomnia model in BALB/C mice, this investigation aimed to unravel the effects of various dosages of RRF extract on sleep quality and elucidated its mechanism of action. A total of 66 compounds in the RRF extract were analyzed. Behavioral assessments demonstrated notable enhancements in sleep duration and latency. Biochemical analyses further corroborated these findings, revealing modulation in neurotransmitter levels indicative of a potential mechanism through the GABAergic and serotoninergic pathways. Additionally, histological evaluations suggested anti-inflammatory and antioxidant effects of the RRF extract. The findings from this study underscored the therapeutic efficacy of RRF extract in combating insomnia, particularly highlighting its glycoside components' role. The extract's significant improvement in sleep duration and latency, alongside its modulation of neurotransmitter levels, showcases its potential as a natural remedy for insomnia. Through its action on the GABAergic and serotoninergic pathways, as well as its anti-inflammatory and antioxidant effects, RRF extract emerges as a promising candidate for insomnia treatment, offering a holistic approach to sleep disorder management. © 2024 Society of Chemical Industry.

The association between weight-adjusted waist index and sleep disorders in U.S. adults: results from NHANES 2005-2008.

The detrimental effects of obesity on sleep disorders have garnered a lot of interest. The weight-adjusted waist index (WWI) is a newly developed anthropometric index calculated in terms of weight and waist circumference. The body mass index has been employed to evaluate obesity in the majority of studies that connect obesity to sleep disorders. This study seeks to investigate the correlation between WWI and sleep disorders among adults in the United States. This cross-sectional study was part of the National Health and Nutrition Examination Survey and included adults aged >20 from 2005 to 2008. This study investigated the linear relationship between sleep disorders and WWI using weighted binary logistic regression models. Nonlinear relationships were characterized using smooth curve fitting and threshold effects analyses. After that, based on variables like gender, age, marital status, diabetes, hypertension, and smoking, subgroup analyses were performed. Our study included 9869 participants who were at least 20 years old. Higher WWI was linked to greater odds of sleep disorders prevalence, according to weighted binary logistic regression (odds ratio = 1.15; 95% confidence interval, 1.10, 1.20). In subgroup analyses based on age, marital status, diabetes, hypertension, and smoking, this connection remained robust. However, there were notable differences in this connection depending on gender. Furthermore, a nonlinear correlation with inflection points between WWI and sleep disorders was shown using smooth curve fitting. The nonlinear association between WWI and sleep disorders has an inflection point of 8.1 cm/√kg, as indicated by the threshold effect analyses. A higher WWI exposure may elevate the odds of sleep disorder prevalence, underscoring the importance of considering WWI in the prevention and management of sleep disorders.

Portable polygraphic device (Somnocheck micro CARDIO®) provides accurate diagnostic information in psychiatric patients at risk for obstructive sleep apnoea: an observational cohort study

BackgroundSymptoms of obstructive sleep apnoea (OSA) overlap significantly with those of psychiatric disorders, making accurate diagnosis of OSA challenging within psychiatric settings. Diagnosing OSA in psychiatric patients is crucial because untreated OSA can exacerbate psychiatric symptoms, reduce treatment efficacy, and impair overall quality of life. This study aimed to determine the diagnostic accuracy of a readily accessible procedure for psychiatric patients in a real-world clinical setting by comparing the Somnocheck micro CARDIO® (SCm) portable cardiorespiratory polygraphy device with the gold standard polysomnography (PSG).MethodsThis observational cohort study included consecutive psychiatric patients at intermediate to high risk for OSA based on screening with the STOP-Bang questionnaire, admitted to a single tertiary care centre between June 1, 2016 and December 31, 2022. The Apnoea-Hypopnoea-Index (AHI), Apnoea-Index (AI), Oxygen-Desaturation-Index (ODI), and minimum oxygen saturation were measured sequentially by SCm and PSG.ResultsA total of 57 patients were analysed (median age 62.0 [Interquartile Range (IQR), 51.5–72.5] years; 34 [59.6%] men). Regarding AHI, no significant differences (AHI measured by PSG, median, 16.6 [IQR, 6.2–26.7] vs. AHI measured by SCm, median, 14.9 [IQR, 10.0-22.8]; p = 0.812; r = 0.71) were found between SCm and PSG. AI, ODI and minimum oxygen saturation differed significantly between SCm and PSG. Using optimised cut-off values (any OSA: AHISCm ≥ 9.25), SCm showed high sensitivity (0.894) and high specificity (0.800) for the diagnosis of OSA, with an area under the receiver operating characteristic curve of 0.877.ConclusionsThis study found that the SCm portable device was accurate in identifying psychiatric patients with OSA. AHI measurement by SCm provided reliable diagnostic performance in comparison with the gold standard polysomnography. These findings support the integration of polygraphic measurements into the routine sleep assessment of psychiatric patients. Early and accurate diagnosis of OSA in this population can significantly improve the management of both sleep disorders and psychiatric conditions, potentially enhancing overall treatment outcomes and quality of life for these patients.

Introducing a sleep disorder screening and management strategy for workers with future shift work requirements: a feasibility and acceptability study

Sleep disorders are common, and largely undiagnosed in early-career workers. The combination of sleep disorders and shift work has implications for mental health, workplace safety, and productivity. Early identification and management of sleep disorders is likely to be beneficial to workers, employers and the community more broadly. We assessed the feasibility and acceptability of a tailored sleep disorder screening and management pathway for individuals with future shift work requirements. Paramedic students were invited to complete an online sleep health survey, which included validated sleep disorder screening questionnaires for insomnia, obstructive sleep apnea and restless legs syndrome. Participants were able to express interest in participating in a sleep monitoring and management study. Participants at risk for a sleep disorder were identified, contacted by the study physician (RJA), notified of their sleep disorder screening results and provided with information regarding management options. Feasibility of the screening and management pathways were determined by completion of the 12 week follow-up, and ability to engage with health services for diagnostic testing or treatment. Acceptability of these pathways was assessed with a semi-structured interview on completion of the study at 12 weeks. Screening was completed in thirty participants (mean age 22.5 ± 6.7, 63% female), 17 of whom were ‘at-risk’ for a sleep disorder and offered a management pathway. All participants engaged with the study physician (RJA), with 16 completing the study (94% completion rate). Three participants with excessive daytime sleepiness received feedback from the study physician (RJA) and no further care required. Of the remaining 14 participants, 11 (78%) engaged with health services after speaking with the study physician (RJA). Those who engaged with diagnostic and management services reported that a structured pathway with online screening was convenient and easy to follow. Facilitating screening and management of sleep disorders in students with future shift work requirements is both feasible and acceptable. These findings can inform the development of a preventive strategy for sleep disorders and ideally, a health services feasibility trial for future shift workers.

Sleep Disorders in Women: What Should a Gynecologist Know?

Women often face sleep disturbances during key life stages such as adolescence, pregnancy, postpartum period, and perimenopause, influenced by hormonal fluctuations and conditions like polycystic ovary syndrome (PCOS) and premenstrual syndrome (PMS). The goal is to explore women's sleep disorders as classified in the International Classification of Sleep Disorders-3 (ICSD-3). Through a literature review, this study assesses the management of sleep disorders in women, particularly focusing on the link between gynecological disease and sleep disorders. It scrutinizes landmark research in diagnosing and treating women's sleep disorders. Observations indicate that physiological changes during adolescence, pregnancy, postpartum, and perimenopause can cause sleep issues, commonly addressed by gynecologists. Conditions like PCOS and PMS are notably linked to increased sleep disorder occurrences. The conclusion underscores the importance of gynecologists' awareness of the heightened risk of sleep disturbances in women, who often present these issues during consultations.

Management of sleep disorders in females diagnosed with the polycystic ovarian syndrome: A systematic review

Management of sleep disorders in females diagnosed with the polycystic ovarian syndrome: A systematic review

The pulse of sleep: novel interventions in understanding the sleep-cardiovascular connection: a literature review.

Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD. The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included. Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP). Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.

Epigenetics and aging: relevance for sleep medicine.

Sleep disorders encompass a wide range of conditions with substantial individual variability. Epigenetics, the study of heritable changes beyond DNA sequence, offers a promising avenue for personalized medicine in this field. There is great potential of epigenetic markers for sleep disorder diagnosis and the development of epigenetic drugs for targeted treatment. Epigenetic age acceleration, a marker of biological aging, is linked to sleep disorders and comorbidities. Very importantly, this acceleration may be reversible with effective treatment. While the underlying mechanisms and assessment of clinical utility require further investigation, the potential of epigenetics in sleep medicine is recognized. Future research focused on closing knowledge gaps and clinical validation is crucial to translate these findings into practical applications, paving the way for more effective and personalized management of sleep disorders.

Association of sleep disorders with non-lab-based CVD risk score among Indian population aged above 45 years: insight from Longitudinal Aging Study in India

Background: Both sleep disorders and cardiovascular events have been found to increase with age. The current study aimed to find an association between the two. Methods: The current analysis used data from Longitudinal Aging Study in India (LASI) (1st) conducted from April 2017 to December 2018 with sleep disorder as the output variable. Non-lab-based CVD risk score, defined by the WHO (2019) was explanatory variable. Possible confounders were also included in the secondary analysis. Results: Sleep disorder was seen among 11.69%, higher in females, elderly >60 years, rural population, unemployed and those with limited physical activity and self-reported poor health. Increased CVD risk score was associated with higher odds of having sleep disorder [5-9: 1.19 (1.12-1.28), 10-19: 1.31 (1.22-1.40), 20-29: 1.24 (1.09-1.41)]. On stratified analysis, similar results were seen in males but showed higher odds in the highest risk score category in females. Conclusions: Recognition and management of sleep disorders, especially those with cardiovascular comorbidities and risk factors is important.

Sleep disorders in patients with heart diseases - present knowledge

Abstract Introduction The problem of sleep disorders plays a significant role in the functioning of people in the contemporary world, particularly affecting cardiac patients. It entails a series of consequences that impact health. The study analyzed the occurrence of sleep disorders among cardiac patients. Purpose The project aimed to assess the available literature regarding described sleep disorders in patients with cardiovascular diseases and to analyze the impact of sleep disorders on the functioning of cardiac patients. Methods Materials available in PubMed and Google Scholar were analyzed using keywords such as "sleep disorders," "insomnia," "cardiovascular disease," "heart attack," "heart failure," "hypertension," "coronary artery disease" in various configurations. A comprehensive analysis of publications was conducted to identify studies on sleep disorders in cardiac patients, focusing on risk factors and management strategies for sleep problems in this patient group. Results Sleep disorders occur in cardiac patients and significantly affect their health. Sleep disorders also increase cardiovascular risk in healthy individuals. Sleep disorder management methods include problem recognition, lifestyle modifications, pharmacotherapy, and behavioral interventions. A crucial aspect of care appears to be the need for diagnosing sleep problems in cardiac patients and implementing integrated multidisciplinary care. Conclusions Sleep disorders pose a significant risk for cardiac patients, requiring an interdisciplinary therapeutic approach. Future research should assess the scale of sleep disorders in cardiac patients in Poland, as well as identify factors influencing sleep disorders in this patient group. Subsequently, treatment strategies and integrated care should be developed.

Diagnosis and management of common sleep disorders during the perinatal period.

The perinatal period is a critical phase in a woman's life characterized by significant physical, emotional, and societal changes. Sleep disorders such as insomnia, restless legs syndrome, obstructive sleep apnea, and poor sleep quality have been observed to increase in prevalence during the perinatal period. Given the harmful impact of sleep disturbances on the health of both mother and newborn, it is crucial to diagnose and treat them promptly. There is a paucity of literature on sleep problems during the perinatal period. This narrative review aimed to summarize the existing evidence and provide suggestions for promptly identifying and managing these disorders.

Decisional Needs of Veterans With Mild Traumatic Brain Injury Initiating Treatment for Insomnia Disorder and Obstructive Sleep Apnea.

We sought to elicit key informant (KI) perspectives regarding decisional needs of Veterans with mild traumatic brain injury (mTBI) who are initiating insomnia disorder and obstructive sleep apnea (OSA) treatment within the Veterans Health Administration (VHA) Polytrauma/TBI System of Care (PSC). Specifically, we sought to understand: (1) information regarding treatment options that Veterans with mTBI require in order to make an informed decision; and (2) values used to guide decision-making (ie, personally meaningful aspects of the decision used to compare treatment options). Nationwide VHA PSC sites. Clinicians included VHA providers and policymakers involved in the management of mTBI and/or sleep disorders in the VHA PSC (n =29). Veterans included those with a clinician-confirmed mTBI who received care for insomnia disorder and/or OSA within the past year (n =20). Semi-structured interviews with the 49 KIs were recorded and transcribed verbatim. Themes were identified using a descriptive and interpretive approach to qualitative analysis. Not applicable. Informational needs identified by both KI groups included information regarding outcomes and downsides of treatment, accessible delivery, treatment candidates, description of diagnosis, and level of commitment. Values used to guide decision-making for both insomnia disorder and OSA treatment included benefits, downsides, and availability of treatments. Values used to decide on insomnia treatments alone included time commitment, intrinsic management of sleep, beliefs regarding mental health treatment, and time course of benefit. Values used to decide on OSA treatment alone included intrusiveness of the treatment, appearance, and impact on bed partners. The current study revealed the decisional needs of Veterans with mTBI who are initiating sleep disorder treatment. Findings can inform the development of decision aids and other efforts aimed at promoting patient-centered management of comorbid mTBI and sleep disorders, thereby improving care quality and clinical outcomes.

Sleep disorders and diabetes mellitus. Literature review and own data

The article presents analysis of current research on sleep disorders in patients with type 2 diabetes mellitus (T2DM). The mechanisms underlying the relationship between insomnia and glycemic control are complex, as both DM can cause sleep disorders and insomnia can worsen the course of diabetes. It is well known that both short (< 6 hours) and long (> 8 hours) sleep durations are associated with an elevated risk of diabetes development. The reported prevalence of sleep disorders in diabetes patients ranges between 28.0% and 59.1%. Our investigation performed in Lviv with the use of Pittsburgh Sleep Quality Index (PSQI) questionnaire, identified that 46.2% of T2DM patients experienced sleep disorders. A comprehensive literature review also unveils association between DM and diverse sleep disorders such as insomnia, circadian rhythm disturbances, obstructive sleep apnea (OSA), and restless legs syndrome (RLS). The article furnishes insights into the classification, diagnostic principles, and treatment modalities for these disorders. Referral of patients to sleep specialists for the management of sleep disorders and the integration of sleep hygiene into diabetes care can effectively mitigate symptoms, forestall DM complications, and enhance patients’ quality of life. Circadian molecules like nobiletin, REV‑ERB agonists, and CRY stabilizers have demonstrated efficacy in preclinical studies and hold potential for the development of novel treatments for conditions associated with circadian dysregulation. Considering the frequency of detection of sleep disorders in T2DM patients according to the modern literary sources and own research, the study of this problem is important for the development of an algorithm for the examination of such patients, namely the need for endocrinologists to pay attention to the sleep status of patients and, if necessary, to refer them to somnologists. Further investigation into the etiology of sleep disorders in T2DM patients and their correlation with carbohydrate metabolism indicators exhibits promise. It is imperative to explore avenues to address these causes by complementing the primary therapy for T2DM.

The dynamics of cyclic‐periodic phenomena during non‐rapid and rapid eye movement sleep

SummarySleep is a complex physiological state characterized by distinct stages, each exhibiting unique electroencephalographic patterns and physiological phenomena. Sleep research has unveiled the presence of intricate cyclic‐periodic phenomena during both non‐rapid eye movement and rapid eye movement sleep stages. These phenomena encompass a spectrum of rhythmic oscillations and periodic events, including cyclic alternating pattern, periodic leg movements during sleep, respiratory‐related events such as apneas, and heart rate variability. This narrative review synthesizes empirical findings and theoretical frameworks to elucidate the dynamics, interplay and implications of cyclic‐periodic phenomena within the context of sleep physiology. Furthermore, it invokes the clinical relevance of these phenomena in the diagnosis and management of sleep disorders.

Saudi Clinical Psychologists’ Competence in Sleep Disorders Management: A Comprehensive Perspective

Saudi Clinical Psychologists’ Competence in Sleep Disorders Management: A Comprehensive Perspective

Assessment and management of sleep disorders in shift workers: Challenges and considerations for general practice.

Shift work is characterised by displaced sleep opportunities and associated sleep disturbance. Shift workers often report sleepiness and other wake time symptoms associated with poor sleep. However, clinical sleep disorders are also prevalent in shift workers. Although prevalence rates are similar or higher in shift workers compared with the general population, help seeking in shift workers with sleep disorders is low. This article aims to provide general practitioners with a contemporary overview of the prevalence rates for sleep disorders in shift workers, to clarify the existing evidence relating to mental and physical health consequences of sleep disorders in shift workers and to highlight the need to consider undiagnosed sleep disorders before attributing sleep-related symptoms solely to workschedules. Symptoms of sleep loss associated with shift work overlap with symptoms experienced by individuals living with sleep disorders. Although >40% of middle-aged Australians live with a sleep disorder that requires investigation and management, symptoms in shift workers are often attributed to the work schedule and, as a result, might not be investigated for appropriate diagnosis and treatment. We argue that screening for sleep disorders in shift workers with sleep complaints should be a priority.