Thesis (M.Tech.: Homoeopathy)-Dept. of Homoeopathy, Durban Institute of Technology, 2005 xli, 193 p. : ill. ; 30 cm / The purpose of this double-blind placebo controlled study was to evaluate the efficacy of homoeopathic simillimum in the treatment of chronic primary insomnia.

Thesis (D. Psych.)--Victoria University (Melbourne, Vic.), 2008. / Includes bibliographical references.

Thesis (Ph. D.)--Virginia Commonwealth University, 2009. / Prepared for: Dept. of Psychology. Bibliography: leaves 39 - 43. Also available online via the Internet.

The available evidence suggests insomnia is common in individuals who experience psychosis. Poor sleep within this population has been associated with numerous detriments to mental health and well-being. Nevertheless, the majority of work to date has focused on chronic presentations, with few studies investigating the role of insomnia in recently onset psychosis. Understanding and treating psychosis following the first presentation is important to promote recovery and prevent the development of long-term illness. This work therefore aimed to utilise mixed methods to comprehensively investigate insomnia in early psychosis. It is presented in a series of five research papers, supplemented by additional chapters to provide an introduction, additional methodological details and general discussion. Paper one presents a systematic review, which aimed to synthesise the relevant literature with regards to the nature and correlates of insomnia in early psychosis. Paper two utilised qualitative methods aiming to understand the experience of insomnia, its impacts and experiences of help-seeking in early psychosis. Paper three aimed to investigate the nature of insomnia symptoms in first episode psychosis, compared to a healthy control group, using actigraphy and sleep diary measurement over a 14-day period. Paper four aimed to investigate how poor sleep was associated with next-day mental health and functioning, presenting data from an electronic diary study conducted alongside the sleep profiling presented in paper three. Paper five aimed to assess the acceptability of a Brief Behavioural Treatment for Insomnia (BBTI) delivered to a first episode psychosis group. Findings across studies indicated insomnia to have a wide range of detrimental outcomes, indicating the treatment of insomnia may be an important target for relevant mental health services.

Background: Migraine trigger factors are precipitating factors that can contribute to an attack by increasing the probability of a migraine occurring. For some migraineurs, the headache phase is preceded by a transient disturbance in neurological function (an aura). An aura could be visual or sensory in nature. There are medications that can be used to treat a migraine attack when it occurs (acute medication) and medication that can be used to reduce frequency and severity of migraine attacks (prophylactic medication). Objectives: The primary aim of the study was to identify if there was a relationship between migraine trigger factors, auras and treatment. Methods: The study was conducted in 2014 in Port Elizabeth and consisted of two self-administered questionnaire-based surveys, one for pharmacists and one for migraine patients. Migraine patient questionnaires were distributed to migraine patients who frequented pharmacies, physiotherapy practices and health shops. A total of 18 pharmacist questionnaires and 173 migraine patient questionnaires were analysed. Results: Experiencing an aura before a migraine attack was reported by 43.9% of respondents and only “sometimes” by 22.5% of respondents. Visual auras were experienced by 92.0% of respondents who indicated that they suffered from migraine with aura and sensory auras were experienced by 71.5% of respondents, with 62.8% of respondents experiencing both visual and sensory auras. Trigger factors were experienced by 89.0% of respondents. There was no statistical relationship between aura and trigger factors, but there was a statistical relationship between trigger factors and visual aura at the 5% level (Chi-square = 7.966, d.f. = 1, p-value = 0.005). Cramér’s V showed a small practical significance at 0.218. About 80.0% of respondents used over-the-counter (OTC) medication and only 12.6% used migraine specific medication to abort a migraine attack. There was no statistical relationship between aura (visual or sensory) and abortive medication. There was a statistical relationship between abortive medication and the presence of trigger factors (Chi-square = 8.775, d.f. = 3, p-value = 0.032). Cramér’s V showed a small practical significance at 0.244. There was no statistical relationship in the presence of trigger factors between aura and abortive medication. Conclusion: Migraine is a complex disease which affects people of all ages. There appears to be a statistical relationship between visual auras and trigger factors and between abortive medication and trigger factors. There was, however, no statistical relationship between aura and abortive medication in the presence of trigger factors. Further studies need to be conducted to substantiate these findings.

Introduction: In 2021, 2.5 million people aged 12 and older abused the addictive psychostimulant methamphetamine (MA) in the US. MA produces short-lasting euphoria, but also anxiety, erratic behavior, mood disturbance, and abnormal wakefulness. Chronic use of MA can lead to disordered sleep, particularly during withdrawal, and clinical studies have shown that sleep dysfunction is a strong predictor for drug-taking relapse. The neuropeptide hypocretin (HCRT) plays a critical role in the transition to a waking state and also modulates drug reward. Enhanced HCRT signaling in the brain underlies the sleep disorder insomnia and the HCRT-receptor antagonist lemborexant has recently been FDA-approved for treatment of insomnia in humans. Thus, in the current study we characterize sleep dysfunction associated with MA vapor withdrawal and hypothesize that HCRT signaling contributes to negative sleep outcomes. Methods: Adult male Wistar rats (N =8) were implanted with a telemetry device and electroencephalographic/electromyographic signals were recorded for 24 hours (12:12 hours, light:dark cycle). Data were analyzed prior to MA vapor exposure (baseline), and during withdrawal (after one week of MA vapor abstinence). Rats were administered lemborexant (0, and 30 mg/kg, in a counter-balanced order) during withdrawal at the beginning of the light cycle. Results: Rats showed a decrease in time spent in rapid eye movement (REM) sleep in the light cycle during withdrawal, and there was a trend for an increase in time spent in REM sleep during the dark cycle, indicating possible REM sleep rebound. There were no changes to non-REM (NREM) sleep or waking in either the light or dark cycle. The number of bouts of REM sleep decreased during the light cycle, and there was no change in average bout duration in REM sleep during withdrawal compared to baseline. The number of bouts of NREM sleep and waking increased during the dark cycle, while the average bout duration decreased during withdrawal compared to baseline, indicating periods of sleep/wake were more fragmented during the dark cycle. In addition, administration of lemborexant restored the amount of time spent in REM sleep and the number of REM sleep bouts during the light cycle. Conclusions: Overall, these findings show there is a role for HCRT neurotransmission in the observed dysregulated and fragmented sleep of male rats during MA withdrawal. Future research should look at gender differences for sleep dysfunction and MA withdrawal, as well as long-term consequences of MA use.

<p>    </p> <p>Machine learning (ML) models can help improve health care services. However, they need to be practical to gain wide adoption. A methodology is proposed in this study to evaluate the utility of different data modalities and cohort segmentation strategies when designing these models. The methodology is used to compare models that predict emergency department (ED) and inpatient hospital (IH) visits. The data modalities include socio-demographics, diagnosis and medications and cohort segmentation is based on age group and disease severity. The proposed methodology is applied to models developed using a cohort of insomnia patients and a cohort of general non- insomnia patients under different data modalities and segmentation strategies. All models are evaluated using the traditional intra-cohort testing. In addition, to establish the need for disease- specific segmentation, transfer testing is recommended where the same insomnia test patients used for intra-cohort testing are submitted to the general-patient model. The results indicate that using both diagnosis and medications as a source of data does not generally improve model performance and may increase its overhead. For insomnia patients, the best ED and IH models using both data modalities or either one of the modalities achieved an area under the receiver operating curve (AUC) of 0.71 and 78, respectively. Our results also show that an insomnia-specific model is not necessary when predicting future ED visits but may have merit when predicting IH visits. As such, we recommend the evaluation of disease-specific models using transfer testing. Based on these initial findings, a language model was pretrained using diagnosis codes. This model can be used for the prediction of future ED and IH visits for insomnia and non-insomnia patients. </p>

<p>Sömnen är ett grundläggande behov hos människan som bland annat ses ha en livsuppehållande och återhämtande funktion på kroppen och psyket. Sömnkvaliteten ändras med stigande ålder och sömnbesvär är vanligt förekommande bland äldre. Syftet med studien var att beskriva ickefarmakologiska behandlingsalternativ, och därmed relaterade effekter, som sjuksköterskan kan tillämpa mot insomnia för äldre. Metoden var en litteraturstudie. Resultatet bygger på en analys av femton artiklar mellan 1990-2006 som sökts via databaserna CINAHL och Medline. Vid analysen växte tre huvudkategorier fram: information, insatsinriktade alternativ samt rutininriktade alternativ med tillhörande underkategorier. Genom att informera patienter om effekter av exempelvis kaffe, tillämpa avslappningsövningar, ändra rutiner samt skapa stimulans under dagtid till patienter med insomnia kan sömnen förbättras på flera sätt. Effekter av den ickefarmakologiska behandlingen mot insomnia är till exempel minskad insomningstid, ökad sovtid, reducerad användning av sömnläkemedel, en större upplevd livstillfredsställelse samt ökad vakenhet dagtid.</p>

Psychiatric patients are particularly affected by symptoms of insomnia. Because insomnia is often secondary to other conditions and was once thought to be less treatable, this condition has received little attention in terms of treatment and research. Additionally, psychiatric patients have typically fewer resources to seek treatment. Generally, insomnia is treated with medications that may have biological side effects and offer little restorative sleep. Behavioral or cognitive interventions have often been overlooked. This experiment uses profile analysis to test the hypothesis that psychiatric outpatients randomized to a treatment group would have decreased levels of sleep difficulties (measured by PSQI) when levels of depression (measured by PHQ-9) were held constant compared to participants in a control/wait group. Also, it was hypothesized that levels of depression would decrease in the treatment group when initial levels of sleep difficulties were held constant compared to participants in a wait group. Levels of sleep difficulty were found to be significantly lower in the treatment group than the wait group at post and follow up. Levels of depression were found to be significantly lower in the treatment group than in the wait group at post and follow up. The treatment group received one, 50-minute, individual therapy session that addressed sleep hygiene, stimulus control and sleep restriction activities and also received an additional telephone session two weeks later. These findings suggest that providing behavioral and cognitive interventions may be a feasible alternative to using pharmacological interventions as a first-line treatment for insomnia.

Background: College students are at increased risk for general sleep issues as well as specific disorders, including Behaviorally Induced Insufficient Sleep Syndrome (BISS) and insomnia. These disorders can have deleterious daytime consequences, which can be compounded by exacerbating depression. The present study aims to establish college prevalence of BISS/insomnia, to characterize sleep characteristics in this sample, and to compare depression across BISS/insomnia. Methods: Data from a college risk behaviors and health study (n=989) was used. Insomnia and BISS were defined as mutually exclusive disorders, using ICD-10/DSM-5 criteria, and Pittsburg Sleep Quality Index items. Results: Overall, the results of this study characterize sleep in college students as commonly insufficient, with moderate sleep quality, normal sleep latency, and high levels of daytime sleepiness. A majority (~68%) of students were categorized as normal sleepers, followed by insomnia (~22%), and BISS (~10%). Insomnia was associated with the most depression, followed by BISS, and normal sleep, after controlling for gender and ethnicity. BISS and insomnia predicted depressive symptoms over and above potent risk and demographic factors, including ethnicity, gender, binge drinking, anxiety, and interpersonal trauma exposure. Conclusion: These findings reinforce the importance of incorporating sleep screening into depression treatment (and vice-versa) in college students. Future research can extend the present study’s findings by utilizing a longitudinal design, including additional measures, and evaluating screening/clinical interventions for this population.