Insomnia in neurological diseases

Abstract

Insomnia is defined as difficulties of initiating and maintaining sleep, early awakening and poor subjective sleep quality despite adequate opportunity and circumstances for sleep with impairment of daytime performance. These components of insomnia – namely persistent sleep difficulties despite of adequate sleep opportunity resulting in daytime dysfunction - appear secondary or co-morbid to neurological diseases. Comorbid insomnia originates from neurodegenerative, inflammatory, traumatic or ischemic changes in sleep regulating brainstem and hypothalamic nuclei with consecutive changes of neurotransmitters. Symptoms of neurological disorders (i.e motor deficits), co-morbidities (i.e. pain, depression, anxiety) and some disease-specific pharmaceuticals may cause insomnia and/or other sleep problems.This guideline focuses on insomnias in headaches, neurodegenerative movement disorders, multiple sclerosis, traumatic brain injury, epilepsies, stroke, neuromuscular disease and dementia.The most important new recommendations are: Cognitive behavioral therapy (CBTi) is recommended to treat acute and chronic insomnia in headache patients. Insomnia is one of the most frequent sleep complaints in neurodegenerative movement disorders. Patients may benefit from CBTi, antidepressants (trazodone, doxepin), melatonin and gaba-agonists. Insomnia is a frequent precursor of MS symptoms by up to 10 years. CBTi is recommended in patients with MS, traumatic brain injury and. Melatonin may improve insomnia symptoms in children with epilepsies. Patients with insomnia after stroke can be treated with benzodiazepine receptor agonists and sedating antidepressants. For patients with dementia suffering from insomnia trazodone, light therapy and physical exercise are recommended.

Correlation Between Insomnia And Primary Headache In Final-Year Students Of Nursing

“…According to the published articles, this study supports research (Mayer et al, 2021;Smitherman et al, 2018) that found a correlation between poor sleep and primary headaches, particularly migraine without aura and TTH. According to this study, 48.9% of the study sample who had TTH also had primary headaches, making up 67.8% of those with poor sleep quality.…”

Inhibition of Microglial Activation by Amitriptyline and Doxepin in Interferon-β Pre-Treated Astrocyte–Microglia Co-Culture Model of Inflammation

“…Even if doxepin and amitriptyline are not considered as a first choice for the treatment of depression, they offer further valuable effects concerning symptoms of insomnia, neuropathic pain, chronic headache and spastic pain in combination with sleep and anxiety disorders, which can occur in patients with MS together with additional symptoms of depression [ 28 , 29 , 30 , 31 , 72 ]. The advantage of the old antidepressants is that they are not selective, as with the modern serotonin re-uptake inhibitors, but have more effects.…”

The modulation of emotional memory consolidation by dream affect

“…Participants were included in the study if they reported: (a) being aged 18-35 years old, (b) not suffering from a sleep disorder (e.g., insomnia) or psychiatric disorder (e.g., PTSD, major depression or substance use disorder), (c) not taking medication for such disorders, (d) being regular sleepers, sleeping between 7 and 9 h a night, (e) not suffering from any medical or neurological condition (e.g., head injury) known to influence sleeping, dreaming or emotional and cognitive functioning, (f) having access to a laptop/computer, phone and a stable internet connexion. Criteria (a)-(e) are all known to influence, sleep, emotional memory processing or dreaming (Krystal, 2012;Cherdieu et al, 2014;Park et al, 2015;Conte et al, 2021;Mayer et al, 2021).…”