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Sleep disorder

About: Sleep disorder is a research topic. Over the lifetime, 19380 publications have been published within this topic receiving 884281 citations. The topic is also known as: somnipathy & non-organic sleep disorder.


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Journal ArticleDOI
01 Jun 2009-Sleep
TL;DR: High rates of PI and sleep apnea highlight the need to refer TMD patients complaining of sleep disturbance for polysomnographic evaluation and suggest that PI may be linked with central sensitivity and could play an etiologic role in idiopathic pain disorders.
Abstract: TEMPOROMANDIBULAR JOINT DISORDER (TMD) HAS BEEN DESCRIBED AS A PROTOTYPIC IDIOPATHIC PAIN SYNDROME CHARACTERIZED BY POORLY understood, episodic, masticatory muscle and/or joint pain. TMD affects an estimated 12% of the population.1 As in other idiopathic pain disorders such as fibromyalgia and irritable bowel syndrome, patients often present with overlapping signs and symptoms including psychological distress, neuroendocrine abnormalities, and chronic insomnia.2,3 Recent theoretical perspectives have proposed that these “central sensitivity syndromes” share a common central nervous system substrate characterized by heightened processing of noxious input, which contributes to overlapping daytime sequelae among these disorders.4 Several cross-sectional studies have demonstrated that compared to controls, TMD patients exhibit enhanced responsivity to a variety of painful stimuli measured both at facial and extracranial anatomic sites.5–7 Pain sensitivity at “unaffected” (i.e., non-jaw) sites suggests the involvement of central pain processing mechanisms, beyond peripheral contributions. Recent longitudinal work has reported that enhanced laboratory pain sensitivity in pain free individuals is linked to genetic polymorphisms that predict the development of new onset TMD.8 This suggests that central processes associated with pain amplification may be critical to understanding the etiopathophysiology of TMD. Clinical factors that contribute to pain amplification in TMD, however, are poorly understood. Our group has focused on the possibility that sleep disturbance is one such factor that may directly contribute to central sensitization and pain amplification.9 We recently reported, for example, that sleep onset insomnia symptoms predict the development of chronic pain following serious burn injury.10 While it is often assumed that insomnia or sleep loss occurring in the context of chronic pain occurs secondarily to the sleep interrupting effects of pain, we and others have demonstrated that insomnias associated with chronic pain are often phenotypically similar to primary insomnia.11 Shared features include high levels of pre-sleep cognitive rumination and evidence of maladaptive coping strategies that may exist prior to the development of pain and/or independently contribute to insomnia symptoms. It is unknown, however, whether primary insomnia is associated with alterations in laboratory pain sensitivity when it occurs either as a sole condition or as part of a chronic pain disorder such as TMD. Only a handful of investigations have systematically sought to evaluate the sleep quality of TMD patients. These studies have consistently found that the majority ( > 50%) of TMD patients report poor sleep quality, and that subjective ratings of poor sleep are associated with increased clinical pain severity and psychological distress.12–14 Fundamental descriptive data using polysomnography and standard research diagnostic interviews to quantify the range of sleep disorders in TMD and determine their possible associations with laboratory measures of pain sensitivity are lacking. The extant literature has largely focused on possible relationships between sleep bruxism and TMD.15,16 Sleep bruxism, however, has not been found to be associated with either poor sleep quality or polysomnographic measures of sleep continuity or architecture disturbances.17–19 The objective of this study was to address two critical gaps in the literature: (1) characterize the spectrum of sleep disorders in a well-described sample of myofascial TMD patients, using polysomnography and state-of-the art structured diagnostic interviews; and (2) evaluate possible associations between observed sleep disorder indices and laboratory measures of pain threshold. We hypothesized that rates of primary insomnia would be substantive in TMD and that primary insomnia would be associated with reductions in pain threshold at both masseter and extracranial sites.

219 citations

Journal ArticleDOI
TL;DR: Almost one-third of patients randomly selected had significant arterial O2 desaturation during sleep because ofSleep apnea, and it is suggested that sleep apnea may play a part in the development of essential hypertension.
Abstract: More than half of patients with essential hypertension have sleep apnea. The incidence of unrecognized sleep apnea in patients with essential hypertension was assessed. Twenty-three patients taking antihypertensive medication were selected at random from a hypertension clinic. They were evaluated by questionnaire for symptoms of sleep apnea, and during 3 hours of sleep, measurements were made of respiratory patterns using an impedance pneumograph, arterial O2 saturation with an ear oximeter and air flow at the mouth or nose with a face mask pneumotacograph. Abnormal sleep apneas (average 20 seconds) lasting for an average of 19% sleep time were found in 11 patients (48%). Significant arterial O2 desaturation, defined as a decrease of at least 4% and to

219 citations

Journal ArticleDOI
01 Dec 2003-Sleep
TL;DR: The SCOPA-SLEEP is a reliable and valid instrument for assessing nighttime sleep and daytime sleepiness in patients with Parkinson disease and may be of value for other somatic diseases.
Abstract: STUDY OBJECTIVES: To develop a short and practical scale (SCOPA-SLEEP) that evaluates nighttime sleep and daytime sleepiness. The scale is developed for research in Parkinson disease but may be of value for other somatic diseases. DESIGN: Postal survey including 4 instruments, the SCOPA-SLEEP nighttime sleep (5 items) and daytime sleepiness (6 items), the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale. SETTING: Movement Disorders Center, Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. PARTICIPANTS: 143 patients with Parkinson disease and 104 controls. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Reliability of the scale was high: internal consistency of the nighttime sleep and daytime sleepiness scales were 0.88 and 0.91, respectively (Cronbach alpha), and test-retest reliabilities were 0.94 and 0.89, respectively (intraclass correlation coefficient). Scale scores differed significantly between patients and controls (P <.001). Construct validity was assessed by correlations with scales that addressed similar constructs. Correlation between the nighttime sleep scale and the Pittsburgh Sleep Quality Index was 0.83 (P <.001), and the correlation between the daytime sleepiness scale and the Epworth Sleepiness Scale was 0.81 (P <.001). Factor analysis revealed 1 factor each for both scales, indicating that the scales measure 1 construct, which justifies the calculation of sumscores. The coefficient of variation of both the nighttime sleep and the daytime sleepiness scale was higher than that of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, indicating a better ability to detect differences between individuals. CONCLUSIONS: The SCOPA-SLEEP is a reliable and valid instrument for assessing nighttime sleep and daytime sleepiness in patients with Parkinson disease

218 citations

Journal ArticleDOI
TL;DR: Mediation analyses indicate that pain influences fatigue directly as well as indirectly by its effect on sleep, and strategies to improve sleep by better pain management may contribute to decreased fatigue.
Abstract: Purpose/Objectives: To test whether sleep disturbance mediates the effect of pain on fatigue. Design: Cross-sectional Setting: Radiation therapy clinic, oncology ambulatory clinic, and inpatient oncology unit in an urban teaching hospital. Sample: 84 patients with cancer with multiple primary diagnoses who were experiencing pain. Fifty-three percent were female and 92% were Caucasian, with a mean age of 54 years. Methods: All participants completed a symptom questionnaire that included the brief pain inventory – short form, the Pittsburgh Sleep Quality Index, and the fatigue subscale of the Profile of Mood States questionnaire. Multistage linear regression was used to test a mediation model. Main Research Variables: Fatigue, pain, and sleep disturbance. Findings: Mediation analyses indicate that pain influences fatigue directly as well as indirectly by its effect on sleep. About 20% (adjusted R2 = 0.20) of the variation in fatigue is explained by pain. Thirty-five percent of the variance in fatigue explained by pain was accounted for by the mediation pathway. Conclusions: Some of the effect of pain on fatigue is mediated by sleep disturbance, but pain has a direct effect on fatigue as well. Implications for Nursing: Although the relationship can be explained only partially by the commonsense point of view that people who are in pain lose sleep and naturally report more fatigue, this finding is important and leads to a potential intervention opportunity. Strategies to improve sleep by better pain management may contribute to decreased fatigue.

218 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023344
2022644
20211,073
2020954
2019742
2018751