Comorbidity of Chronic Insomnia With Medical Problems

Taylor, Daniel J.; Mallory, Laurel J.; Lichstein, Kenneth L.; Durrence, H. Heith; Riedel, Brant W.; Bush, Andrew

doi:10.1093/sleep/30.2.213

Cited by 743 publications

(514 citation statements)

References 25 publications

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“…A bidirectional link exists between insomnia and hypertension; 43% of insomnia patients have hypertension, compared to 19% among good sleepers; 44% of hypertensive patients have insomnia, compared to 19% among normotensive patients (Thase, 2005; Taylor et al, 2007; Roth, 2009; Hoevenaar‐Blom et al, 2011). Nocturnal hypertension is significantly higher in older than younger patients (63.1 vs. 41.1%).…”

Section: Melatonin In the Treatment Of Circadian Rhythm And Sleep Dismentioning

confidence: 99%

New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation

Zisapel

2018

British J Pharmacology

550

350

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In mammals, a central circadian clock, located in the suprachiasmatic nuclei (SCN) of the hypothalamus, tunes the innate circadian physiological rhythms to the ambient 24 h light–dark cycle to invigorate and optimize the internal temporal order. The SCN‐activated, light‐inhibited production of melatonin conveys the message of darkness to the clock and induces night‐state physiological functions, for example, sleep/wake blood pressure and metabolism. Clinically meaningful effects of melatonin treatment have been demonstrated in placebo‐controlled trials in humans, particularly in disorders associated with diminished or misaligned melatonin rhythms, for example, circadian rhythm‐related sleep disorders, jet lag and shift work, insomnia in children with neurodevelopmental disorders, poor (non‐restorative) sleep quality, non‐dipping nocturnal blood pressure (nocturnal hypertension) and Alzheimer's disease (AD). The diminished production of melatonin at the very early stages of AD, the role of melatonin in the restorative value of sleep (perceived sleep quality) and its sleep‐anticipating effects resulting in attenuated activation of certain brain networks are gaining a new perspective as the role of poor sleep quality in the build‐up of β amyloid, particularly in the precuneus, is unravelled. As a result of the recently discovered relationship between circadian clock, sleep and neurodegeneration, new prospects of using melatonin for early intervention, to promote healthy physical and mental ageing, are of prime interest in view of the emerging link to the aetiology of Alzheimer's disease.Linked ArticlesThis article is part of a themed section on Recent Developments in Research of Melatonin and its Potential Therapeutic Applications. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.16/issuetoc

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Section: Melatonin In the Treatment Of Circadian Rhythm And Sleep Dismentioning

confidence: 99%

New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation

Zisapel

2018

British J Pharmacology

550

350

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“…The brain requires sleep in order for energy stores to be restored (Porkka-Heiskanen, Kalinchuk, Alanko, Urrila, & Stenberg, 2003) and research has shown an association between chronic poor sleep and a multitude of different health impairments, such as self-reported coronary heart disease (Schwartz, Anderson, Cole, Cornin-Huntley, Hays, & Blazer, 1999), gastrointestinal problems, high blood pressure, neurological disorders (Taylor, Mallory, Lichstein, Durrence, Riedel, & Bush, 2007), cardiovascular disease (CVD), diabetes, obesity and depression (Akerstedt, 2006). Performance is also negatively impacted by sleep loss and sleep disturbance and sleep loss can result in increased fatigue, mood changes, and impairment of the immune system (Harrison & Horne, 1999;Rogers, Szuba, Staab, Evans, & Dinges, 2001).…”

Section: Work-related Rumination and Recovery From Workmentioning

confidence: 99%

Internet-based instructor-led mindfulness for work-related rumination, fatigue, and sleep: Assessing facets of mindfulness as mechanisms of change. A randomized waitlist control trial.

Querstret

Cropley

Fife‐Schaw

2017

Journal of Occupational Health Psychology

119

138

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Title. Internet-based instructor-led mindfulness for work-related rumination, fatigue and sleep: assessing facets of mindfulness as mechanisms of change. A randomised waitlist control trial.Abstract. This study aimed to extend our theoretical understanding of how mindfulnessbased interventions exert their positive influence on measures of occupational health.Employing a randomised waitlist control study design, we sought to: (1) assess an Internetbased instructor-led mindfulness intervention for its effect on key factors associated with 'recovery from work', specifically, work-related rumination, fatigue and sleep quality; (2) assess different facets of mindfulness (acting with awareness, describing, non-judging, and non-reacting) as mechanisms of change; and (3) assess whether the effect of the intervention was maintained over time by following up our participants after three and six months.Participants who completed the mindfulness intervention (N=60) reported significantly lower levels of work-related rumination and fatigue, and significantly higher levels of sleep quality, when compared with waitlist control participants (N=58). Effects of the intervention were maintained at three and six month follow-up with medium to large effect sizes. The effect of the intervention was primarily explained by increased levels of only one facet of mindfulness (acting with awareness). This study provides support for online mindfulness interventions to aid recovery from work and furthers our understanding with regards to how mindfulness interventions exert their positive effects.

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“…7,8 The common co-occurrence of insomnia with other conditions is an important consideration when examining HCU and associated costs as the rates of insomnia occurring in the context of other common medical and psychiatric conditions are much higher than that in the general population. 9,10 For example, an epidemiological study revealed that approximately 38% of individuals with a comorbid condition exhibited insomnia compared to only 8% of individuals without a comorbid condition. 9 Individuals with comorbid insomnia and major depressive disorder have demonstrated significantly greater direct health care costs (i.e., greater number of overall outpatient physician visits, depressionrelated visits, and a greater number of antidepressant prescriptions) than individuals with major depressive disorder alone.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

“…9,10 For example, an epidemiological study revealed that approximately 38% of individuals with a comorbid condition exhibited insomnia compared to only 8% of individuals without a comorbid condition. 9 Individuals with comorbid insomnia and major depressive disorder have demonstrated significantly greater direct health care costs (i.e., greater number of overall outpatient physician visits, depressionrelated visits, and a greater number of antidepressant prescriptions) than individuals with major depressive disorder alone. 10 A recent study by Bramoweth and colleagues provides support for increased costs related to comorbid insomnia.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

McCrae

Bramoweth

Williams

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: To examine health care utilization (HCU) and costs following brief cognitive behavioral treatment for insomnia (bCBTi). Methods: Reviewed medical records of 84 outpatients [mean age = 54.25 years (19.08); 58% women] treated in a behavioral sleep medicine clinic (2005)(2006)(2007)(2008)(2009)(2010) based in an accredited sleep disorders center. Six indicators of HCU and costs were obtained: estimated total and outpatient costs, estimated primary care visits, CPT costs, number of office visits, and number of medications. All patients completed ≥ 1 session of bCBTi. Those who attended ≥ 3 sessions were considered completers (n = 37), and completers with significant sleep improvements were considered responders (n = 32). Results: For completers and responders, all HCU and cost variables, except number of medications, signifi cantly decreased (ps < 0.05) or trended towards decrease at posttreatment. Completers had average decreases in CPT costs of $200 and estimated total costs of $75. Responders had average decreases in CPT costs of $210. No signifi cant decreases occurred for non-completers. Conclusions: bCBTi can reduce HCU and costs. Response to bCBTi resulted in greater reduction of HCU and costs. While limited by small sample size and non-normal data distribution, the fi ndings highlight the need for greater dissemination of bCBTi for several reasons: a high percentage of completers responded to treatment, as few as 3 sessions can result in signifi cant improvements in insomnia severity, bCBTi can be delivered by novice clinicians, and health care costs can reduce following treatment. Insomnia remains an undertreated disorder, and brief behavioral treatments can help to increase access to care and reduce the burden of insomnia. Keywords: Insomnia, health care utilization, costs, brief cognitive behavioral treatment, physician visits, medication Citation: McCrae CS; Bramoweth AD; Williams J; Roth A; Mosti C. Impact of brief cognitive behavioral treatment for insomnia on health care utilization and costs. J Clin Sleep Med 2014;10(2):127-135.http://dx.doi.org/10.5664/jcsm.3436 S C I E N T I F I C I N V E S T I G A T I O N SC hronic insomnia impacts approximately 8% to 10% of adults in the United States population 1 and carries substantial economic burden. Direct costs (i.e., costs directly related to treatment) have been estimated at $13.9 billion annually in the United States, with total treatment costs estimated at $77 to $92 billion. 2 When indirect costs (i.e., lost productivity, insomniarelated accidents, increased medical problems) are included, annual costs exceed $100 billion. 3 Evidence from outside the U.S. reveals a similar pattern. Specifi cally, a study in Quebec, Canada, found that the combined direct and indirect per-person costs of insomnia syndrome (insomnia complaint ≥ 3 nights/ week with > 1 month duration, dissatisfaction with sleep, and daytime impairment; prescription sleep medication ≥ 3 nights/ week) was approximately $5,010; with $293 attributed to direct costs and $4,717...

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Comorbidity of Chronic Insomnia With Medical Problems

Cited by 743 publications

References 25 publications

New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation

New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation

Internet-based instructor-led mindfulness for work-related rumination, fatigue, and sleep: Assessing facets of mindfulness as mechanisms of change. A randomized waitlist control trial.

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

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