Insomnia with objective short sleep duration: the most biologically severe phenotype of the disorder.
TL;DR: Evidence is presented that insomnia with objective short sleep duration is the most biologically severe phenotype of the disorder, as it is associated with cognitive-emotional and cortical arousal, activation of both limbs of the stress system, and a higher risk for hypertension, impaired heart rate variability, diabetes, neurocognitive impairment, and mortality.
About: This article is published in Sleep Medicine Reviews.The article was published on 2013-08-01 and is currently open access. It has received 537 citations till now. The article focuses on the topics: Sleep disorder & Polysomnography.
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University of Freiburg1, University of Bergen2, Northumbria University3, University of Oxford4, Stavanger University Hospital5, Karolinska Institutet6, University of Copenhagen7, Paris Descartes University8, University of Parma9, National Institutes of Health10, University of Antwerp11, University of Bucharest12, Frederiksberg Hospital13
TL;DR: In this article, a European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia.
Abstract: This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The target audience for this guideline includes all clinicians involved in the management of insomnia, and the target patient population includes adults with chronic insomnia disorder. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the evidence and guide recommendations. The diagnostic procedure for insomnia, and its co-morbidities, should include a clinical interview consisting of a sleep history (sleep habits, sleep environment, work schedules, circadian factors), the use of sleep questionnaires and sleep diaries, questions about somatic and mental health, a physical examination and additional measures if indicated (i.e. blood tests, electrocardiogram, electroencephalogram; strong recommendation, moderate- to high-quality evidence). Polysomnography can be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders), in treatment-resistant insomnia, for professional at-risk populations and when substantial sleep state misperception is suspected (strong recommendation, high-quality evidence). Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence). A pharmacological intervention can be offered if cognitive behavioural therapy for insomnia is not sufficiently effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective in the short-term treatment of insomnia (≤4 weeks; weak recommendation, moderate-quality evidence). Antihistamines, antipsychotics, melatonin and phytotherapeutics are not recommended for insomnia treatment (strong to weak recommendations, low- to very-low-quality evidence). Light therapy and exercise need to be further evaluated to judge their usefulness in the treatment of insomnia (weak recommendation, low-quality evidence). Complementary and alternative treatments (e.g. homeopathy, acupuncture) are not recommended for insomnia treatment (weak recommendation, very-low-quality evidence).
1,076 citations
TL;DR: Global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans is assessed and sleep disturbance and long sleep duration are associated with increases in markers of systemic inflammation.
1,013 citations
13 Dec 2017
TL;DR: This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia.
810 citations
Cites background from "Insomnia with objective short sleep..."
...Another recent discovery concerns differences between insomnia with, and without, an objective short sleep duration (Fernandez-Mendoza, 2017; Vgontzas et al., 2013)....
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TL;DR: The impact of sleep on adaptive and innate immunity, with consideration of the dynamics of sleep disturbance, sleep restriction, and insomnia on antiviral immune responses with consequences for vaccine responses and infectious disease risk and proinflammatoryimmune responses with implications for cardiovascular disease, cancer, and depression is highlighted.
Abstract: Sleep has a critical role in promoting health. Research over the past decade has documented that sleep disturbance has a powerful influence on the risk of infectious disease, the occurrence and progression of several major medical illnesses including cardiovascular disease and cancer, and the incidence of depression. Increasingly, the field has focused on identifying the biological mechanisms underlying these effects. This review highlights the impact of sleep on adaptive and innate immunity, with consideration of the dynamics of sleep disturbance, sleep restriction, and insomnia on (a) antiviral immune responses with consequences for vaccine responses and infectious disease risk and (b) proinflammatory immune responses with implications for cardiovascular disease, cancer, and depression. This review also discusses the neuroendocrine and autonomic neural underpinnings linking sleep disturbance and immunity and the reciprocal links between sleep and inflammatory biology. Finally, interventions are discussed as effective strategies to improve sleep, and potential opportunities are identified to promote sleep health for therapeutic control of chronic infectious, inflammatory, and neuropsychiatric diseases.
730 citations
Cites background or result from "Insomnia with objective short sleep..."
...…insomnia with short sleep duration are more likely to show increases in urinary catecholamines and levels of their metabolites than are insomniacs without objective sleep disturbance, similar to the greater activation of inflammatory biomarkers in this more severe phenotype (Vgontzas et al. 2013)....
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...…measured by blood pressure, heart rate variability, and impedance cardiography) are found in patients with insomnia (Bonnet & Arand 1997, De Zambotti et al. 2011, Lanfranchi et al. 2009, Riemann 2010, Vgontzas et al. 2013) and following sleep deprivation (Irwin et al. 1999, Irwin & Ziegler 2005)....
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...In contrast, chronic sleep disturbance leads to activation of the HPA and SNS pathways (Vgontzas et al. 2013), which together contribute to an increased proinflammatory and reduced antiviral skewing of the basal gene expression profile, termed the basal transcriptome....
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...…with compelling evidence that disturbances of sleep including insomnia complaints and extremes of sleep duration adversely influence risk of infectious and inflammatory disease and contribute to allcause mortality (Dew et al. 2003, Kripke et al. 2002, Mallon et al. 2002, Vgontzas et al. 2013)....
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...Those who report sleep complaints and/or have short sleep duration appear to be at greatest risk of cardiovascular disease (Vgontzas et al. 2013)....
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TL;DR: The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep, and sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines.
Abstract: Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body’s defense system. Stimulation of the immune s...
616 citations
References
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11 Jun 2013
113,134 citations
TL;DR: This outstanding manual is more than an outline; it includes diagnostic criteria, clinical course, predisposing factors, prevalence, differential diagnosis, and a bibliography for each of the numerous disorders.
Abstract: I congratulate the American Sleep Disorders Association for this outstanding manual, modeled after DSM-111 and consistent in style with the ICD-9-CM Classification. Like the DSM-111, it is more than an outline; it includes diagnostic criteria, clinical course, predisposing factors, prevalence, differential diagnosis, and a bibliography for each of the numerous disorders. The book obviously is essential for polysomnographers, but all neurologists seeing patients with sleep disorders or sleep-related phenomena should have i t available.
4,004 citations
Journal Article•
3,696 citations
TL;DR: Sleep debt has a harmful impact on carbohydrate metabolism and endocrine function similar to those seen in normal ageing and, therefore, sleep debt may increase the severity of age-related chronic disorders.
3,322 citations
TL;DR: The association between insomnia and major depressive episodes has been constantly reported: individuals with insomnia are more likely to have a major depressive illness and longitudinal studies have shown that the persistence of insomnia is associated with the appearance of a new depressive episode.
3,112 citations