Insomnia

Buysse, Daniel J.

doi:10.1001/jama.2013.193

Cited by 811 publications

(610 citation statements)

References 53 publications

(75 reference statements)

Supporting

Mentioning

584

Contrasting

Unclassified

Order By: Relevance

“…131 As reviewed by Buysse 132 and Morin and Benca, 7 the effi cacy of Cognitive Behavioral Th erapy for Insomnia for the treatment of insomnia has been demonstrated. Although these approaches make eff orts toward reducing cognitive and emotional arousal, there has also been a call for therapies that target physiologic hyperarousal across the night and day.…”

Section: Unit Of Analysis Evidence For This Perspective In Pathophysimentioning

confidence: 99%

The Pathophysiology of Insomnia

Levenson

Kay

Buysse

2015

Chest

Self Cite

289

147

View full text Add to dashboard Cite

Insomnia disorder is characterized by chronic dissatisfaction with sleep quantity or quality that is associated with diffi culty falling asleep, frequent nighttime awakenings with diffi culty returning to sleep, and/or awakening earlier in the morning than desired. Although progress has been made in our understanding of the nature, etiology, and pathophysiology of insomnia, there is still no universally accepted model. Greater understanding of the pathophysiology of insomnia may provide important information regarding how, and under what conditions, the disorder develops and is maintained as well as potential targets for prevention and treatment.The aims of this report are (1) to summarize current knowledge on the pathophysiology of insomnia and (2) to present a model of the pathophysiology of insomnia that considers evidence from various domains of research. Working within several models of insomnia, evidence for the pathophysiology of the disorder is presented across levels of analysis, from genetic to molecular and cellular mechanisms, neural circuitry, physiologic mechanisms, sleep behavior, and self-report. We discuss the role of hyperarousal as an overarching theme that guides our conceptualization of insomnia. Finally, we propose a model of the pathophysiology of insomnia that integrates the various types of evidence presented.

show abstract

Section: Unit Of Analysis Evidence For This Perspective In Pathophysimentioning

confidence: 99%

The Pathophysiology of Insomnia

Levenson

Kay

Buysse

2015

Chest

Self Cite

289

147

View full text Add to dashboard Cite

show abstract

“…In the present study MTrP injection into the gastrocnemius muscle was effective in relieving the pain of NCCs, corresponding with the results of a study by Prateepavanich et al 14 Insomnia is a clinical condition characterized by difficulty initiating or maintaining sleep, accompanied by symptoms such as irritability or fatigue during wakefulness. 26 In general, painful conditions and sleep disturbance may influence each other, 27,28 and nocturnal episodes of pain in particular are reported to change sleep architecture, induce phases of arousal, and even trigger awakening. 29 Hawke et al 2 showed that NCCs had a substantial connection with reduced quality of sleep and, by extension, affected health-related quality of life.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Myofascial Trigger Point Injections on Nocturnal Calf Cramps

Kim

Yoon

2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Background: The purpose of this study was to elucidate the effects of injection at trigger points on pain and sleep disturbance in patients with nocturnal calf cramps (NCCs).Methods: Patients with NCCs that occurred at least once per week and who had myofascial trigger points (MTrPs) on the gastrocnemius muscles were enrolled in the study for 9 months. At the first visit (T0), we measured the intensity of NCC pain on an 11-point numeric rating scale, recorded the frequency of NCCs, and calculated the Insomnia Severity Index (ISI). We then checked for MTrPs on the gastrocnemius muscles and injected 1-2 mL of 0.25% lidocaine into each of the trigger points. At 1 (T1), 2 (T2), and 4 (T3) weeks after the first visit, we repeated the process performed at T0.Results: Twelve patients completed the treatment schedule and attended the follow-up visits. Mean values of the numeric rating scale pain score, frequency of cramps, and ISI declined significantly at T1, T2, and T3 compared with baseline (all P < .01). Of 12 patients, 10 had clinical insomnia before treatment, and this number decreased significantly to 3 patients at T2 and 1 patient at T3 (P ‫؍‬ .012 and P ‫؍‬ .001, respectively).Conclusions: These preliminary data show that injection at MTrPs in patients with NCCs not only alleviated pain and reduced the frequency of cramps but also lessened the severity of insomnia as measured by the ISI. A larger randomized controlled trial is needed to confirm these findings and determine whether the effect lasts over the long term. (J Am Board Fam Med 2015;28:21-27.)

show abstract

“…1 The high prevalence of chronic insomnia among patients with chronic pain has been well-established, with reported rates of insomnia as high as 88% in this population. 2,3 Independently, sleep and pain are known to be associated with a host of negative consequences including decreased quality of life, mood disturbance, impaired quality of social interactions, dependence on medication, and cognitive dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments

Mundt

Crew

Krietsch

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Methods: Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. Results: At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps < 0.05). Compared to PSG, actigraphic estimates were higher for SOL and lower for WASO (ps < 0.05). Repeated measures ANOVAs were conducted for the CBT-I group (n = 15), and significant method by time interactions indicated that the assessment methods differed in their sensitivity to detect treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps < 0.05). Conclusions: Actigraphy was generally more concordant with PSG than with diaries, which are the recommended assessment for diagnosing insomnia. However, actigraphy showed greater sensitivity to treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. Keywords: insomnia, fibromyalgia, chronic pain, assessment, actigraphy, polysomnography, cognitive behavioral therapy, clinical trial Citation: Mundt JM, Crew EC, Krietsch K, Roth AJ, Vatthauer K, Robinson ME, Staud R, Berry RB, McCrae CS. Measuring treatment outcomes in comorbid insomnia and fibromyalgia: concordance of subjective and objective assessments. J Clin Sleep Med 2016;12(2):215-223. I NTRO DUCTI O NChronic insomnia is a primarily subjective disorder that is defined by self-reported difficulty falling asleep, staying asleep, awakening too early, or experiencing sleep that is routinely non-restorative and accompanied by at least one of many possible daytime impairments (e.g., mood disturbance, daytime sleepiness, fatigue or malaise).1 The high prevalence of chronic insomnia among patients with chronic pain has been well-established, with reported rates of insomnia as high as 88% in this population.2,3 Independently, sleep and pain are known to be associated with a host of negative consequences including decreased quality of life, mood disturbance, impaired quality of social interactions, dependence on medication, and cognitive dysfunction. However, these consequences are often exacerbated in chronic pain patients with comorbid insomnia. [...

show abstract

Insomnia

Cited by 811 publications

References 53 publications

The Pathophysiology of Insomnia

The Pathophysiology of Insomnia

The Effects of Myofascial Trigger Point Injections on Nocturnal Calf Cramps

Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments

Contact Info

Product

Resources

About