Somnological Aspects of Puberty
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Sleep and Its Disorders: Is the Problem
38 ISSN 0049-6804. «Врачеб. дело». 2017, № 1–2 ОБЗОР ЛИТЕРАТУРЫ 43. Williams G. R., Duncan Bassett J. H. Local control of thyroid hormone action: role of type 2 deiodinase Deiodinases: the balance of thyroid hormone // J. of Endocrinol. – 2011. – Vol. 209. – P. 261–272. 44. Wittmann G., Harney J. W., Singru P. S. et al. Inflammation-inducible type 2 deiodinase expres- sion in the leptomeninges, choroid plexus, and at brain blood vessels in male rodents // Endocri- nology. – 2014. – Vol. 155. – P. 2009–2019. 45. Yu J., Koenig R. J. Induction of type 1 iodothyronine deiodinase to prevent the nonthyroidal illness syndrome in mice // Endocrinol. – 2006. – Vol. 147, N 7. – Р. 3580–3585. СУЧАСНІ УЯВЛЕННЯ ПРО СИНДРОМ НЕТИРЕОЇДНОЇ ПАТОЛОГІЇ В КЛІНІЧНІЙ ПРАКТИЦІ Н. О. Абрамова, Н. В. Пашковська (Чернівці) Будь-які гострі та хронічні захворювання, що втягують у патологічний процес весь організм, можуть викликати порушення обміну тиреоїдних гормонів на фоні відсутності супутньої патології щитоподібної залози, гіпофіза та (або) гіпоталамуса. Такі порушення називають «син- дромом нетиреоїдної патології» (СНТП), або «синдромом низького Т3», і зустрічаються у 70 % госпіталізованих. У даному огляді ми розглянули етіологію, патогенез та частково шляхи корекції синдрому нетиреоїдної патології. Ключові слова: синдром нетиреоїдної патології, синдром низького Т3, порушення обміну тиреоїдних гормонів. CURRENT VIEWS ON NONTHYROIDAL ILLNESS SYNDROME IN CLINICAL PRACTICE (REVIEW) N. O. Abramova, N. V. Pashkovska (Chernivtsi, Ukraine) Higher State Educational Establishment of Ukraine «Bukovinian State Medical University» Any acute and chronic diseases that involve the whole organism into pathological process, can cause violation of thyroid hormones metabolism against a background of absence of concomitant diseases of thyroid gland, pituitary gland or hypothalamus. -
Sleepiness the Wheel
SLEEPINESS AT THE WHEEL WHITE PAPER SLEEPINESS AT THE WHEEL WHITE PAPER Sleepiness at the Wheel WHITE PAPER PREFACE Improving road safety is a priority of the French Government. Among the various causes of road accidents, one of them is especially common on motorways: lack of alertness, which leads to inattention and sleepiness. Lack of alertness is responsible for one in three collisions resulting in deaths on the motorway network, although it is the safest of all road networks! This phenomenon is not fully grasped by the public. Therefore, it is essential to gain knowledge and raise the publics’ awareness as regards sleepiness at the wheel. In more general terms, sleepiness at the wheel remains underestimated both socially and culturally speaking, which is a major issue for road safety and public health. This white book, put together by the French Motorway Companies (ASFA) and the National Institute of Sleep and Vigilance (INSV), presents the most recent knowledge on the subject at both the French and European levels and provides a number of recommendations. By contributing to a better understanding of sleepiness at the wheel, this work will help promote the implementation of new prevention strategies, to further reduce the number of victims on the road. Our objective is to cut down to less than 2000 the number of deaths per year on French roads by 2020. Manuel VALLS French Minister of Interior ASFA and INSV would like to express their deep thanks to the panel of European sleep experts who author this book. Most of them also participate in the research on traffic accidents associated with sleepiness in their own country and thus have contributed to enrich our knowledge and proposals for preventing from the consequences of sleepiness at the wheel. -
Sleep, Its Attributes, Deprivation & Hygiene: a Recapitulation
Review Article Annals of Sleep Medicine Research Published: 21 Jun, 2019 Sleep, Its Attributes, Deprivation & Hygiene: A Recapitulation Priyanka Malhotra* Nursing in Mental Health Nursing From PGIMER, Chandigarh, India Presently working as Nursing Tutor, AIIMS, Rishikesh, India Abstract Sleep is a biological and behavioral phenomenon that has been studied from many different perspectives. Today it is clear that sleep quantity and quality is related to the development of chronic diseases and even mental disorders. However, many people ignore their sleep habits and fail to take active steps to adopt sleep hygiene practices preferring instead to relay on non-prescribed or prescribed pharmacological products. As a result of the potential consequences of sleep deprivation, health care professionals should be vigilant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption. Keywords: Sleep; Sleep deprivation; Sleep hygiene Introduction Almost every night we are engaging ourselves in a sound sleep. However, pattern of sleep and its features vary from person to person. Various body functions such as metabolism, appetite, cardiovascular system, and immune system has been maintained and regulated by sleep. Hence, for the optimum level of health, sleep is an important factor [1,2]. Sleep is a state of reduced consciousness that is relatively easy to reverse. A normal healthy sleep is distinguish by good quality, appropriate time and regularity, enough duration and without any sleep disorder and disturbance [3]. Attributes of Normal Sleep OPEN ACCESS The stages of sleep have historically been divided into one stage of Rapid Eye Movement (REM) sleep and four stages (Stages 1-4) of Non-Rapid Eye Movement (NREM) sleep that are characterized *Correspondence: by increasing sleep depth. -
Polymorphism Located in TCRA Locus Confers Susceptibility to Essential Hypersomnia with HLA-DRB1&Ast;1501-DQB1&Ast;0602
Journal of Human Genetics (2010) 55, 63–65 & 2010 The Japan Society of Human Genetics All rights reserved 1434-5161/10 $32.00 www.nature.com/jhg SHORT COMMUNICATION Polymorphism located in TCRA locus confers susceptibility to essential hypersomnia with HLA-DRB1*1501-DQB1*0602 haplotype Taku Miyagawa1, Makoto Honda2,3, Minae Kawashima1,4, Mihoko Shimada1, Susumu Tanaka2, Yutaka Honda3 and Katsushi Tokunaga1 Essential hypersomnia (EHS) exhibits excessive daytime sleepiness without cataplexy and is associated with the HLA-DRB1*1501-DQB1*0602 haplotype, similar to narcolepsy with cataplexy. Single-nucleotide polymorphism (SNP) rs1154155 located in the T-cell receptor a (TCRA) locus has been recently identified as a novel genetic marker of susceptibility for narcolepsy with cataplexy. We investigated whether the SNP was associated with EHS in the Japanese population. We found a significant association with EHS patients possessing the HLA-DRB1*1501-DQB1*0602 haplotype, compared À4 with HLA-matched healthy individuals (Pallele¼0.008; Ppositivity¼5Â10 ), whereas no significant association was observed for EHS patients without this haplotype. Thus, TCRA is a plausible candidate for susceptibility to EHS patients positive for the HLA-DRB1*1501-DQB1*0602 haplotype. Journal of Human Genetics (2010) 55, 63–65; doi:10.1038/jhg.2009.118; published online 20 November 2009 Keywords: essential hypersomnia; HLA; narcolepsy; TCRA INTRODUCTION possible association between SNP rs1154155 in the TCRA locus and Earlier studies have revealed that narcolepsy with cataplexy is asso- essential hypersomnia (EHS), CNS hypersomnia similar to narcolepsy ciated with the human leukocyte antigen (HLA) and T-cell receptor a with cataplexy, with regard to the symptom of excessive daytime (TCRA) genes. -
Sleep Disorders and Sleep Deprivation: an Unmet Public Health Problem
REPORT BRIEF • APRIL 2006 SLEEP DISORDERS AND SLEEP DEPRIVATION: AN UNMET PUBLIC HEALTH PROBLEM It is estimated that 50 to 70 million Americans chronically suffer from a disorder of sleep and wakefulness, hindering daily functioning and adversely affecting their health and longevity. The cumulative effects of sleep loss and sleep disorders represent an under-recognized public health problem and have been associated with a wide range of health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. Almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness. Hundreds of billions of dollars a year are spent on direct medical costs related to sleep disorders such as doctor visits, hospital services, prescriptions, and over-the-counter medications. Recognizing the health consequences of sleep disorders and sleep deprivation, the American Academy of Sleep Medicine, the National Center on Sleep Disorders Research at the National Institutes of Health, the National Sleep Foundation, and the Sleep Research Society The cumulative requested that the Institute of Medicine review the public health effects of sleep loss significance of sleep, sleep loss, and sleep disorders; examine gaps and sleep disorders in research, education, and training in the public health system and academia; and provide a comprehensive plan for enhancing sleep represent an under- medicine and research. recognized public Sleep Disorders and Sleep Deprivation: An Unmet Public Health health problem and Problem concluded that although scientific opportunities and clinical have been associat- activities in the field are expanding, the available human resources and ed with a wide infrastructural capacity to improve patient care and expand scientific range of health research are insufficient. -
Sleep Disturbance in MS
SLEEP DISTURBANCE AND MULTIPLE SCLEROSIS Abbey J. Hughes, PhD Department of Rehabilitation Medicine University of Washington School of Medicine Table of Contents Introduction ................................................................................................................................................................ 2 Summary of MS Sleep Research .......................................................................................................................... 3 Emerging Treatments for Sleep Disturbance in MS .................................................................................... 6 Tips for Assessing Your Sleep – Worksheet .................................................................................................. 8 Additional Tools and Resources.......................................................................................................................... 9 References ................................................................................................................................................................ 10 1 Introduction Multiple sclerosis (MS) is a chronic disease characterized by loss of myelin (demyelination) and damage to nerve fibers (neurodegeneration) in the central nervous system (CNS). MS is associated with a diverse range of physical, cognitive, emotional, and behavioral symptoms, and can significantly interfere with daily functioning and overall quality of life. MS directly impacts the CNS by causing demyelinating lesions, or plaques, in the brain, -
Cognitive Behavioral Therapy for Insomnia Enhances Depression Outcome in Patients with Comorbid Major Depressive Disorder and Insomnia
INSOMNIA AND DEPRESSION Cognitive Behavioral Therapy for Insomnia Enhances Depression Outcome in Patients with Comorbid Major Depressive Disorder and Insomnia Rachel Manber, PhD1; Jack D. Edinger, PhD2; Jenna L. Gress, BA1; Melanie G. San Pedro-Salcedo, MA1; Tracy F. Kuo, PhD1; Tasha Kalista, MA1 1Stanford University, Stanford, CA; 2VA Medical Center and Duke University Medical Center, Durham, NC Study Objective: Insomnia impacts the course of major depressive severity index (ISI), daily sleep diaries, and actigraphy. disorder (MDD), hinders response to treatment, and increases risk for EsCIT + CBTI resulted in a higher rate of remission of depression depressive relapse. This study is an initial evaluation of adding cogni- (61.5%) than EsCIT + CTRL (33.3%). EsCIT + CBTI was also associat- tive behavioral therapy for insomnia (CBTI) to the antidepressant medi- ed with a greater remission from insomnia (50.0%) than EsCIT + CTRL cation escitalopram (EsCIT) in individuals with both disorders. (7.7%) and larger improvement in all diary and actigraphy measures of Design and setting: A randomized, controlled, pilot study in a single sleep, except for total sleep time. academic medical center. Conclusion: This pilot study provides evidence that augmenting an Participants: 30 individuals (61% female, mean age 35±18) with MDD antidepressant medication with a brief, symptom focused, cognitive- and insomnia. behavioral therapy for insomnia is promising for individuals with MDD Interventions: EsCIT and 7 individual therapy sessions of CBTI or and comorbid insomnia in terms of alleviating both depression and in- CTRL (quasi-desensitization). somnia. Measurements and results: Depression was assessed with the Keywords: Major depressive disorder, Insomnia, Cognitive behavioral HRSD17 and the depression portion of the SCID, administered by raters therapy, Remission masked to treatment assignment, at baseline and after 2, 4, 6, 8, and Citation: Manber R; Edinger JD; Gress JL; San Pedro-Salcedo MG; 12 weeks of treatment. -
Sleep and Mental Wellbeing Exploring the Links
Sleep and mental wellbeing Exploring the links Technical report prepared by Kate Bartel, Cele Richardson and Michael Gradisar vichealth.vic.gov.au © VicHealth 2018 April 2018 P-MW-604 Suggested citation Bartel, K, Richardson, C & Gradisar M 2018, Sleep and mental wellbeing: exploring the links, Victorian Health Promotion Foundation, Melbourne. Acknowledgements The authors are grateful for the helpful comments of Emeritus Professor Dorothy Bruck, Chair of the Sleep Health Foundation, on an earlier draft of this report. Contents Acknowledgements ................................................................................................................................... i Key definitions .......................................................................................................................................... v Abbreviations ......................................................................................................................................... vii Executive summary ............................................................................................................................... viii Australian sleep patterns .................................................................................................................. viii Sleep and mental health.................................................................................................................... viii Lifestyle factors associated with sleep ............................................................................................. -
Normal and Delayed Sleep Phases
1 Overview • Introduction • Circadian Rhythm Sleep Disorders – DSPS – Non-24 • Diagnosis • Treatment • Research Issues • Circadian Sleep Disorders Network © 2014 Circadian Sleep Disorders Network 2 Circadian Rhythms • 24 hours 10 minutes on average • Entrained to 24 hours (zeitgebers) • Suprachiasmatic nucleus (SCN) – the master clock • ipRGC cells (intrinsically photosensitive Retinal Ganglion Cells) © 2014 Circadian Sleep Disorders Network 3 Circadian Rhythm Sleep Disorders • Definition – A circadian rhythm sleep disorder is an abnormality of the body’s internal clock, in which a person is unable to fall asleep at a normal evening bedtime, although he is able to sleep reasonably well at other times dictated by his internal rhythm. • Complaints – Insomnia – Excessive daytime sleepiness • Inflexibility • Coordination with other circadian rhythms © 2014 Circadian Sleep Disorders Network 4 Circadian Sleep Disorder Subtypes* • Delayed Sleep-Phase Syndrome (G47.21**) • Non-24-Hour Sleep-Wake Disorder (G47.24) • Advanced Sleep-Phase Syndrome (G47.22) • Irregular Sleep-Wake Pattern (G47.23) • Shift Work Sleep Disorder (G47.26) • Jet Lag Syndrome * From The International Classification of Sleep Disorders, Revised (ICSD-R) ** ICD-10-CM diagnostic codes in parentheses © 2014 Circadian Sleep Disorders Network 5 Definition of DSPS from The International Classification of Sleep Disorders, Revised (ICSD-R): • Sleep-onset and wake times that are intractably later than desired • Actual sleep-onset times at nearly the same daily clock hour • Little or no reported difficulty in maintaining sleep once sleep has begun • Extreme difficulty awakening at the desired time in the morning, and • A relatively severe to absolute inability to advance the sleep phase to earlier hours by enforcing conventional sleep and wake times. -
Somnology-Jr-Book.Pdf
1 To Grace Zamudio and Zoe Lee-Chiong. 2 Preface Carpe noctem. Teofilo Lee-Chiong MD Professor of Medicine Division of Sleep Medicine National Jewish Health Denver, Colorado University of Colorado Denver School of Medicine Denver, Colorado Chief Medical Liaison Philips Respironics Murrysville, Pennsylvania 3 Abbreviations AHI Apnea-hypopnea index BPAP Bi-level positive airway pressure CPAP Continuous positive airway pressure CSA Central sleep apnea ECG Electrocardiography EEG Electroencephalography EMG Electromyography EOG Electro-oculography FEV1 Forced expiratory volume in 1 second GABA Gamma-aminobutyric acid N1 NREM stage 1 sleep N2 NREM stage 2 sleep N3 NREM stages 3 (and 4) sleep NREM Non-rapid eye movement O2 Oxygen OSA Obstructive sleep apnea PaCO2 Partial pressure of arterial carbon dioxide PaO2 Partial pressure of arterial oxygen REM Rapid eye movement sleep SaO2 Oxygen saturation SOREMP Sleep onset REM period 4 Table of contents Introduction 15 Neurobiology of sleep 16 Neural systems generating wakefulness 16 Neural systems generating NREM sleep 16 Neural systems generating REM sleep 16 Main neurotransmitters 17 Acetylcholine 17 Adenosine 17 Dopamine 17 Gamma-aminobutyric acid 17 Glutamate 17 Glycine 17 Histamine 18 Hypocretin 18 Melatonin 18 Norepinephrine 18 Serotonin 18 Physiology during sleep 19 Autonomic nervous system 19 Respiratory system 19 Respiratory patterns 19 Cardiovascular system 19 Gastrointestinal system 20 Renal and genito-urinary systems 20 Endocrine system 20 Growth hormone 20 Thyroid stimulating hormone -
Sleep Hygiene Instructions
SLEEP HYGIENE INSTRUCTIONS Sleep only as much as you need to feel refreshed during the following day. Restricting your time in bed helps to consolidate and deepen your sleep. Excessively long times in bed lead to fragmented and shallow sleep. Get up at your regular time the next day, no matter how little you slept. Get up at the same time each day, 7 days a week. A regular wake time in the morning leads to regular times of sleep onset, and helps to set your biological clock. Exercise regularly. Schedule exercise times so that they do not occur within 3 hours of when you intend to go to bed. Exercise makes it easier to initiate sleep and deepen sleep. Don’t take your problems to bed. Plan some time earlier in the evening for working on your problems or planning the next day’s activities. Worrying may interfere with initiating sleep and produce shallow sleep. Train yourself to use the bedroom only for sleep and sexual activity. This will help condition your brain to see bed as the place for sleeping. Do not read, watch TV or eat in bed. Do not try and fall asleep. This only makes the problem worse. Instead, turn on the light, leave the bedroom, and do something different like reading a book. Don’t engage in stimulating activity. Return to bed only when you feel sleepy. Avoid long naps. Staying awake during the day helps to fall asleep at night. Naps totalling more than 30 minutes increase your chances of having trouble sleeping at night. -
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.