Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation

Mai, Evelyn; Buysse, Daniel J.

doi:10.1176/foc.7.4.foc491

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…Insomnia affects between 10 and 30% of the population (Mai and Buysse, 2008;Roth, 2007) and can cause degradation in cognitive performance (Lamond et al, 2007). Benzodiazepine receptor agonist (BzRA) hypnotics such as zolpidem (ZOL) that are currently used to treat insomnia modulate the GABA A receptor and induce sleep through a general inhibition of neural activity.…”

Section: Introductionmentioning

confidence: 99%

The Dual Hypocretin Receptor Antagonist Almorexant is Permissive for Activation of Wake-Promoting Systems

Parks

Warrier

Dittrich

et al. 2015

Neuropsychopharmacol

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The dual hypocretin receptor (HcrtR) antagonist almorexant (ALM) may promote sleep through selective disfacilitation of wakepromoting systems, whereas benzodiazepine receptor agonists (BzRAs) such as zolpidem (ZOL) induce sleep through general inhibition of neural activity. Previous studies have indicated that HcrtR antagonists cause less-functional impairment than BzRAs. To gain insight into the mechanisms underlying these differential profiles, we compared the effects of ALM and ZOL on functional activation of wake-promoting systems at doses equipotent for sleep induction. Sprague-Dawley rats, implanted for EEG/EMG recording, were orally administered vehicle (VEH), 100 mg/kg ALM, or 100 mg/kg ZOL during their active phase and either left undisturbed or kept awake for 90 min after which their brains were collected. ZOL-treated rats required more stimulation to maintain wakefulness than VEH-or ALM-treated rats. We measured Fos co-expression with markers for wake-promoting cell groups in the lateral hypothalamus (Hcrt), tuberomammillary nuclei (histamine; HA), basal forebrain (acetylcholine; ACh), dorsal raphe (serotonin; 5HT), and singly labeled Fos + cells in the locus coeruleus (LC). Following SD, Fos co-expression in Hcrt, HA, and ACh neurons (but not in 5HT neurons) was consistently elevated in VEH-and ALMtreated rats, whereas Fos expression in these neuronal groups was unaffected by SD in ZOL-treated rats. Surprisingly, Fos expression in the LC was elevated in ZOL-but not in VEH-or ALM-treated SD animals. These results indicate that Hcrt signaling is unnecessary for the activation of Hcrt, HA, or ACh wake-active neurons, which may underlie the milder cognitive impairment produced by HcrtR antagonists compared to ZOL.

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Section: Introductionmentioning

confidence: 99%

The Dual Hypocretin Receptor Antagonist Almorexant is Permissive for Activation of Wake-Promoting Systems

Parks

Warrier

Dittrich

et al. 2015

Neuropsychopharmacol

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“…In a recent poll of the National Sleep Foundation, 64% of the respondents indicated that, within the past month, they had experienced at least one symptom of insomnia a few nights a week or more often, and 41% reported experiencing such symptoms every night or almost every night [1]. The individual and socioeconomic impact of insomnia is considerable: The consequences of poor sleep include impaired concentration and memory, heightened risk of accidents, increased risk of medical conditions such as cardiovascular disease, more frequent use of healthcare services, and augmented work absenteeism [2].…”

Section: Introductionmentioning

confidence: 99%

“…The pattern of their responses clearly suggested circadian variation in the experience of regrets: While regret frequency remained at comparatively low levels for most of the waking hours, a sharp rise occurred in the evening after going to bed. Furthermore, results revealed that the nocturnal rise of regrets substantially contributed to insomnia severity independently of other wellknown risk factors for late-life sleep disturbance, such as depression, sleep-interfering medical conditions, or medica-tions (for these risk factors, see [2]). Finally, as with young adults, rash-action-prone older adults were particularly likely to experience regrets at bedtime and were therefore at a higher risk for sleep disturbances.…”

Section: Introductionmentioning

confidence: 99%

The Nocturnal Return of Neglected Regrets: Deficits in Regret Anticipation Predict Insomnia Symptoms

Schmidt¹,

Linden²

2011

TOOSLPJ

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Abstract:Cognitive accounts of insomnia generally assume that excessive mental activity at bedtime constitutes a central impediment to the process of falling asleep, yet the affective aspects of this mental hyperactivity still remain largely unexplored. The present study explored whether failures in regret anticipation might lead to a rise of regret-related counterfactual thoughts and emotions at bedtime, thereby hindering or interrupting sleep. A sample of 105 undergraduate students completed the newly developed Regret Anticipation Failures Scale (RAFS), the Bedtime Counterfactual Processing Questionnaire (BCPQ), and the Insomnia Severity Index (ISI). Analyses revealed that both regret anticipation failures and bedtime counterfactual processing were related to insomnia severity and that the effect of regret anticipation failures on insomnia was mediated by the frequency of regret-related thoughts and emotions at bedtime. These findings reveal for the first time that failures in antecedent-focused emotion regulation may contribute to sleeping difficulties.

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“…onset, maintenance, and terminal), or factors that causes insomnia symptoms (e.g. daytime stress, anxiety, jetlag, and diet) [1], [2], [21]. Therefore, training sleep/wake detection models that are specified according to these categories based on a larger data set merits further exploration.…”

Section: Resultsmentioning

confidence: 99%

“…Insomnia is one of the most common sleep disorders, and epidemiological studies have estimated a prevalence of ~30% of the world population suffering from insomnia symptoms [1]. Many factors can lead to insomnia, such as increased age, hyperarousals, daytime stress events, and sympathetic activity during the night compared with healthy subjects [2], [3], [4].…”

Section: Introductionmentioning

confidence: 99%

Actigraphy-based sleep/wake detection for insomniacs

Long

Fonseca

Haakma

et al. 2017

2017 IEEE 14th International Conference on Wearable and Implantable Body Sensor Networks (BSN)

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Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation

Cited by 12 publications

References 29 publications

The Dual Hypocretin Receptor Antagonist Almorexant is Permissive for Activation of Wake-Promoting Systems

The Dual Hypocretin Receptor Antagonist Almorexant is Permissive for Activation of Wake-Promoting Systems

The Nocturnal Return of Neglected Regrets: Deficits in Regret Anticipation Predict Insomnia Symptoms

Actigraphy-based sleep/wake detection for insomniacs

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