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Drugs Inducing Insomnia As an Adverse Effect
2 Drugs Inducing Insomnia as an Adverse Effect Ntambwe Malangu University of Limpopo, Medunsa Campus, School of Public Health, South Africa 1. Introduction Insomnia is a symptom, not a stand-alone disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both" or the perception of poor quality sleep (APA, 1994). As an adverse effect of medicines, it has been documented for several drugs. This chapter describes some drugs whose safety profile includes insomnia. In doing so, it discusses the mechanisms through which drug-induced insomnia occurs, the risk factors associated with its occurrence, and ends with some guidance on strategies to prevent and manage drug- induced insomnia. 2. How drugs induce insomnia There are several mechanisms involved in the induction of insomnia by drugs. Some drugs affects sleep negatively when being used, while others affect sleep and lead to insomnia when they are withdrawn. Drugs belonging to the first category include anticonvulsants, some antidepressants, steroids and central nervous stimulant drugs such amphetamine and caffeine. With regard to caffeine, the mechanism by which caffeine is able to promote wakefulness and insomnia has not been fully elucidated (Lieberman, 1992). However, it seems that, at the levels reached during normal consumption, caffeine exerts its action through antagonism of central adenosine receptors; thereby, it reduces physiologic sleepiness and enhances vigilance (Benington et al., 1993; Walsh et al., 1990; Rosenthal et al., 1991; Bonnet and Arand, 1994; Lorist et al., 1994). In contrast to caffeine, methamphetamine and methylphenidate produce wakefulness by increasing dopaminergic and noradrenergic neurotransmission (Gillman and Goodman, 1985). With regard to withdrawal, it may occur in 40% to 100% of patients treated chronically with benzodiazepines, and can persist for days or weeks following discontinuation. -
Participant Guide
Participant Guide Get Enough Sleep Session Focus Getting enough sleep can help you prevent or delay type 2 diabetes. This session we will talk about: z Why sleep matters z Some challenges of getting enough sleep and ways to cope with them You will also make a new action plan! Tips: ✓ Go to bed and get up at the same time each day. This helps your body get on a schedule. ✓ Follow a bedtime routine that helps you wind down. Participant Guide: Get Enough Sleep 2 Jenny’s Story Jenny is at risk for type 2 diabetes. Her doctor asks her if she gets at least 7 hours of sleep each night. Jenny laughs. “Are you serious?” she asks. “I’m lucky if I get 5 hours.” Jenny usually doesn’t have much trouble falling asleep. But she often has to use the bathroom in the early morning. This gets her thinking about all the things she needs to do the next day. Plus, her husband’s breathing is loud. Both of these things make it hard for Jenny to fall back to sleep. She often lies awake for hours. These days, Jenny drinks less water and avoids caffeine in the evening. She makes a list of things to do the next day. Then she sets it aside. Jenny rarely needs to get up to use the bathroom during the night. If she does, she breathes deeply to help her get back to sleep. She also runs a fan to cover up the sound of her husband’s breathing. Jenny is closer to getting 7 hours of sleep a night. -
THE USE of MIRTAZAPINE AS a HYPNOTIC O Uso Da Mirtazapina Como Hipnótico Francisca Magalhães Scoralicka, Einstein Francisco Camargosa, Otávio Toledo Nóbregaa
ARTIGO ESPECIAL THE USE OF MIRTAZAPINE AS A HYPNOTIC O uso da mirtazapina como hipnótico Francisca Magalhães Scoralicka, Einstein Francisco Camargosa, Otávio Toledo Nóbregaa Prescription of approved hypnotics for insomnia decreased by more than 50%, whereas of antidepressive agents outstripped that of hypnotics. However, there is little data on their efficacy to treat insomnia, and many of these medications may be associated with known side effects. Antidepressants are associated with various effects on sleep patterns, depending on the intrinsic pharmacological properties of the active agent, such as degree of inhibition of serotonin or noradrenaline reuptake, effects on 5-HT1A and 5-HT2 receptors, action(s) at alpha-adrenoceptors, and/or histamine H1 sites. Mirtazapine is a noradrenergic and specific serotonergic antidepressive agent that acts by antagonizing alpha-2 adrenergic receptors and blocking 5-HT2 and 5-HT3 receptors. It has high affinity for histamine H1 receptors, low affinity for dopaminergic receptors, and lacks anticholinergic activity. In spite of these potential beneficial effects of mirtazapine on sleep, no placebo-controlled randomized clinical trials of ABSTRACT mirtazapine in primary insomniacs have been conducted. Mirtazapine was associated with improvements in sleep on normal sleepers and depressed patients. The most common side effects of mirtazapine, i.e. dry mouth, drowsiness, increased appetite and increased body weight, were mostly mild and transient. Considering its use in elderly people, this paper provides a revision about studies regarding mirtazapine for sleep disorders. KEYWORDS: sleep; antidepressive agents; sleep disorders; treatment� A prescrição de hipnóticos aprovados para insônia diminuiu em mais de 50%, enquanto de antidepressivos ultrapassou a dos primeiros. -
Sleep Apnea Sleep Apnea
Health and Safety Guidelines 1 Sleep Apnea Sleep Apnea Normally while sleeping, air is moved at a regular rhythm through the throat and in and out the lungs. When someone has sleep apnea, air movement becomes decreased or stops altogether. Sleep apnea can affect long term health. Types of sleep apnea: 1. Obstructive sleep apnea (narrowing or closure of the throat during sleep) which is seen most commonly, and, 2. Central sleep apnea (the brain is causing a change in breathing control and rhythm) Obstructive sleep apnea (OSA) About 25% of all adults are at risk for sleep apnea of some degree. Men are more commonly affected than women. Other risk factors include: 1. Middle and older age 2. Being overweight 3. Having a small mouth and throat Down syndrome Because of soft tissue and skeletal alterations that lead to upper airway obstruction, people with Down syndrome have an increased risk of obstructive sleep apnea. Statistics show that obstructive sleep apnea occurs in at least 30 to 75% of people with Down syndrome, including those who are not obese. In over half of person’s with Down syndrome whose parents reported no sleep problems, sleep studies showed abnormal results. Sleep apnea causing lowered oxygen levels often contributes to mental impairment. How does obstructive sleep apnea occur? The throat is surrounded by muscles that are active controlling the airway during talking, swallowing and breathing. During sleep, these muscles are much less active. They can fall back into the throat, causing narrowing. In most people this doesn’t affect breathing. However in some the narrowing can cause snoring. -
Towards a Passive BCI to Induce Lucid Dream Morgane Hamon, Emma Chabani, Philippe Giraudeau
Towards a Passive BCI to Induce Lucid Dream Morgane Hamon, Emma Chabani, Philippe Giraudeau To cite this version: Morgane Hamon, Emma Chabani, Philippe Giraudeau. Towards a Passive BCI to Induce Lucid Dream. Journée Jeunes Chercheurs en Interfaces Cerveau-Ordinateur et Neurofeedback 2019 (JJC- ICON ’19), Mar 2019, Villeneuve d’Ascq, France. hal-02108903 HAL Id: hal-02108903 https://hal.archives-ouvertes.fr/hal-02108903 Submitted on 29 Apr 2019 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. TOWARDS A PASSIVE BCI TO INDUCE LUCID DREAM JJC-ICON ’19 Morgane Hamon Emma Chabani Philippe Giraudeau Ullo Institut du Cerveau et de la Moelle épinière Inria La Rochelle, France Paris, France Bordeaux, France [email protected] [email protected] [email protected] April 29, 2019 ABSTRACT Lucid dreaming (LD) is a phenomenon during which the person is aware that he/she dreaming and is able to control the dream content. Studies have shown that only 20% of people can experience lucid dreams on a regular basis. However, LD frequency can be increased through induction techniques. External stimulation technique relies on the ability to integrate external information into the dream content. -
Obstructive Sleep Apnea in Adults? NORMAL AIRWAY OBSTRUCTED AIRWAY
American Thoracic Society PATIENT EDUCATION | INFORMATION SERIES What Is Obstructive Sleep Apnea in Adults? NORMAL AIRWAY OBSTRUCTED AIRWAY Obstructive sleep apnea (OSA) is a common problem that affects a person’s breathing during sleep. A person with OSA has times during sleep in which air cannot flow normally into the lungs. The block in CPAP DEVICE airflow (obstruction) is usually caused by the collapse of the soft tissues in the back of the throat (upper airway) and tongue during sleep. Apnea means not breathing. In OSA, you may stop ■■ Gasping breathing for short periods of time. Even when you are or choking trying to breathe, there may be little or no airflow into sounds. the lungs. These pauses in airflow (obstructive apneas) ■■ Breathing pauses observed by someone watching can occur off and on during sleep, and cause you to you sleep. wake up from a sound sleep. Frequent apneas can cause ■■ Sudden or jerky body movements. many problems. With time, if not treated, serious health ■■ Restless tossing and turning. problems may develop. ■■ Frequent awakenings from sleep. OSA is more common in men, women after menopause CLIP AND COPY AND CLIP Common symptoms you may have while awake: and people who are over the age of 65. OSA can also ■■ Wake up feeling like you have not had enough sleep, occur in children. Also see ATS Patient Information Series even after sleeping many hours. fact sheet on OSA in Children. People who are at higher ■■ Morning headache. risk of developing sleep apnea include those with: ■■ Dry or sore throat in the morning from breathing ■■ enlarged tonsils and/or adenoids through your mouth during sleep. -
Herbal Remedies and Sleep
HERBAL REMEDIES AND SLEEP • Some people use herbal remedies to treat sleep problems. They may choose this in preference to sleeping pills. • There have been studies on some of these herbs. However, not all of them have been conducted properly. For some herbs, there is virtually no evidence to show whether they are effective or not. • The most frequently studied herbs are Valerian, Kava, Hops, Chamomile, and Passionflower. However, there is little convincing evidence to suggest that they work well for improving sleep. • Some herbal remedies have been associated with adverse health effects. Note: All words that are underlined relate to topics in the Sleep Health Foundation Information Library at www.sleephealthfoundation.org.au 1. Why try herbs to help your sold by a specific manufacturer for a certain time-period. Trials testing effectiveness are expensive, and without a patent, companies may not sleep? be able to recover their costs through guaranteed sales, even if the herb has potential. However, there have been studies of some herbs About 40% of people use alternative or complementary medicines at used for insomnia and anxiety. Here we focus on herbs where least occasionally, and 4.5% use them to treat sleep problem. Some reasonable information exists from clinical research trials. people who are concerned about using sleeping pills will turn to herbal remedies to help them sleep (see our page on Sleeping Tablets). Melatonin is not a herbal remedy (for more information see Melatonin). 3. What does the evidence say about herbs helping sleep? 2. Has the effectiveness of herbs In the table below, we look at the effectiveness of eight herbal remedies in treating sleep problems as treatments of insomnia. -
Current and Experimental Therapeutics of Insomnia
133 CURRENT AND EXPERIMENTAL THERAPEUTICS OF INSOMNIA DANIEL J. BUYSSE CYNTHIA M. DORSEY 15% (4,5). Epidemiologic studies point to a consistent set of risk factors for insomnia. These include a previous history INSOMNIA: DEFINITIONS, IMPACT, AND of insomnia, increasing age, female gender, psychiatric DIAGNOSIS symptoms and disorders, medical symptoms and disorders, impaired activities of daily living, anxiolytic and hypnotic Definition of Insomnia Symptoms and medication use, and low socioeconomic status. The increas- Disorders ing prevalence of insomnia with age may be explained in large part by increasing comorbidity with medical and psy- Insomnia can refer to either a symptom or clinical disorder. chiatric disorders and medication use. The incidence of in- The symptom of insomnia is the subjective complaint of somnia also increases with age and is greater in women than difficulty falling or staying asleep, poor quality sleep, or men. On the other hand, remission of insomnia decreases inadequate sleep duration, despite having an adequate op- with age and is less common in women. Together, preva- portunity for sleep. Two points in this definition deserve lence, incidence, and remission data indicate that insomnia specific attention. First, insomnia is a subjective complaint is often a chronic condition. Between 50% and 80% of not currently defined by laboratory test results or a specific individuals with insomnia at baseline have a persistent com- duration of sleep or wakefulness. Second, the insomnia plaint after follow-up intervals of 1 to 3.5 years (1,6–8). symptom occurs despite the individual having adequate op- portunity to sleep. This distinguishes insomnia from sleep deprivation, which has different causes, consequences, and Impact of Insomnia clinical presentations. -
Insomnia in Adults
New Guideline February 2017 The AASM has published a new clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults. These new recommendations are based on a systematic review of the literature on individual drugs commonly used to treat insomnia, and were developed using the GRADE methodology. The recommendations in this guideline define principles of practice that should meet the needs of most adult patients, when pharmacologic treatment of chronic insomnia is indicated. The clinical practice guideline is an essential update to the clinical guideline document: Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307–349. SPECIAL ARTICLE Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults Sharon Schutte-Rodin, M.D.1; Lauren Broch, Ph.D.2; Daniel Buysse, M.D.3; Cynthia Dorsey, Ph.D.4; Michael Sateia, M.D.5 1Penn Sleep Centers, Philadelphia, PA; 2Good Samaritan Hospital, Suffern, NY; 3UPMC Sleep Medicine Center, Pittsburgh, PA; 4SleepHealth Centers, Bedford, MA; 5Dartmouth-Hitchcock Medical Center, Lebanon, NH Insomnia is the most prevalent sleep disorder in the general popula- and disease management of chronic adult insomnia, using existing tion, and is commonly encountered in medical practices. Insomnia is evidence-based insomnia practice parameters where available, and defined as the subjective perception of difficulty with sleep initiation, consensus-based recommendations to bridge areas where such pa- duration, consolidation, or quality that occurs despite adequate oppor- rameters do not exist. -
Sleep Self-Care
University of California, Berkeley 2222 Bancroft Way Berkeley, CA 94720 SLEEP SELF-CARE All of us have trouble sleeping from time to time. This is perfectly normal. Sleep problems (also known as insomnia) are often triggered by sudden life changes that lead to increased stress. For instance, following the death of a loved one, a car accident or a promotion to a new job, many people experience difficulties getting a good night’s sleep. This normal response to stress usually lasts for a short time, rarely longer than a week or two. However, some people have chronic problems sleeping which do not seem to go away. If you are one of these people, or you are having temporary insomnia, this Self-Care Guide should help. It will give you some general information about sleep, as well as provide a number of helpful suggestions to aid those with sleep problems. Read it carefully, as many common sleep problems are caused by one’s own habits, and by adopting some of the following sleep-promoting behaviors, most people can get a good night’s rest without the aid of drugs. Taking sleeping pills is not the answer! For people whose only complaint is I can’t sleep well or I can’t get to sleep easily, taking sleeping pills may do more harm than good. Most authorities recommend against the regular use of sedative drugs (like Valium, Dalmane, Librium and barbiturates) for the following reasons: ! Sedatives change nervous system activities during sleep; for example, they may reduce the normal periods of dreaming. -
Herbs a T a Glance: Valerian
Valerian This fact sheet provides basic information about the herb valerian—common names, uses, potential side effects, and resources for more information. Valerian is a plant native to Europe and Asia; it is also found in North America. Valerian has been used as a medicinal herb since at least the time of ancient Greece and Rome. Its therapeutic uses were described by Hippocrates, and in the 2nd century, Galen prescribed valerian for insomnia. Common Names—valerian, all-heal, garden heliotrope Latin Name—Valeriana officinalis What It Is Used For • Valerian has long been used for sleep disorders and anxiety. • Valerian has also been used for other conditions, such as headaches, depression, irregular heartbeat, and trembling. How It Is Used The roots and rhizomes (underground stems) of valerian are typically used to make supplements, including capsules, tablets, and liquid extracts, as well as teas. What the Science Says • Research suggests that valerian may be helpful for insomnia, but there is not enough evidence from well-designed studies to confirm this. • There is not enough scientific evidence to determine whether valerian works for anxiety or for other conditions, such as depression and headaches. • Recent NCCAM-funded research on valerian includes studies on the herb’s effects on sleep in healthy older adults and in people with Parkinson’s disease. Side Effects and Cautions • Studies suggest that valerian is generally safe to use for short periods of time (for example, 4 to 6 weeks). • No information is available about the long-term safety of valerian. • Valerian can cause mild side effects, such as headaches, dizziness, upset stomach, and tiredness the morning after its use. -
Brain Computer Interface for Sleep Apnea Detection
Special Issue - 2020 International Journal of Engineering Research & Technology (IJERT) ISSN: 2278-0181 NCAIT - 2020 Conference Proceedings Brain Computer Interface for Sleep Apnea Detection Poorvitha H R1, Aishwarya K Gowda2, Kavya K B2, Nayana R2 Vivekananda Institute of Technology Gudimavu, Kumbalagodu Post, Kengeri Hobli, Bengaluru – 560 074 Abstract - A brain-computer interface (BCI) is the varied phases of sleep and may be a crucial step in a interface method that someone to deliver instructions and shot to assist doctor within the designation and medical messages to a automated gadget, via way of means of care of connected sleep obstruction. using person mind activity. An electroencephalogram (EEG), mounted BCI became related with a synthetic gadget to command a home automation application. It provides an alternative to built-in interface and control. It is a digital surroundings shape that enters the body’s everyday prepared pathways, which might be neuromuscular output passage. Sleep apnea is personification of sickness which occurs during sleep, which impacts the human fitness via way of means of blockage in respiratory for positive period of time. The prognosis is critical that's viable via way of means of the perceiving of apnea episodes the use of electroencephalogram (EEG) reports. EEG is an adjustable decomposition for the identifying of apnea events using EEG signals. EEG plays an essential role in identifying the sleep apnea by recognizing and producing the brain neurons activities. The EEG sign dataset is filtered, the purified EEG sign is subjected for sub-band separation and 5 frequency bands inclusive of Gamma, Beta, Alpha, Theta, and Delta.