3,738 results match your criteria Insomnia Primary

The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials.

Sleep Med Rev 2021 Apr 21;58:101493. Epub 2021 Apr 21.

Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, UK. Electronic address:

Sleep restriction therapy (SRT) is an established treatment for insomnia that has been used in clinical practise for over 30 y. It is commonly delivered as part of multicomponent cognitive-behavioural therapy (CBT-I) but has also been linked to beneficial effects as a standalone intervention. In order to quantify the efficacy of SRT we performed a comprehensive meta-analysis of randomised controlled trials (RCTs) comparing SRT to minimally active or non-active control groups. Read More

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Knowledge to action: a scoping review of approaches to educate primary care providers in the identification and management of routine sleep disorders.

J Clin Sleep Med 2021 May 13. Epub 2021 May 13.

Flinders Health and Medical Research Institute Sleep Health / Adelaide Institute of Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Study Objectives: The referral burden on healthcare systems for routine sleep disorders could be alleviated by educating primary care providers (PCPs) to diagnose and manage patients with sleep health issues. This requires effective professional education strategies and resources. This scoping review examined the literature on existing approaches to educate PCPs in sleep health management. Read More

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Acute psychological impact of coronavirus disease 2019 outbreak among psychiatric professionals in China: a multicentre, cross-sectional, web-based study.

BMJ Open 2021 May 11;11(5):e047828. Epub 2021 May 11.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China

Objectives: To assess the magnitude of mental health outcomes and associated factors among psychiatric professionals in mental health services during COVID-19 in China.

Design, Setting And Participants: This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from psychiatric professionals in 34 hospitals between 29 January and 7 February 2020, in China. Hospitals equipped with fever clinics or deployed on wards for patients with COVID-19 were eligible. Read More

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Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes.

Acta Med Port 2021 Mar 1;34(3):209-216. Epub 2021 Mar 1.

Drug Addiction Treatment Centre. Agualva-Cacém. Cacém. Portugal.

Introduction: The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.

Material And Methods: We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). Read More

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Developing a real-world evidence base for prescribed cannabis in the United Kingdom: preliminary findings from Project Twenty21.

Psychopharmacology (Berl) 2021 May 10. Epub 2021 May 10.

Imperial College London, Burlington Danes Building, Hammersmith Hospital, Du Cane Rd, White City, London, W12 0NN, UK.

The therapeutic potential of medical cannabis to treat a variety of conditions is becoming increasingly recognised. Globally, a large number of countries have now legalised cannabis for medical uses and a substantial number of patients are able to access their medications. Yet in the UK, where medical cannabis was legalised in November 2018, only a handful of NHS prescriptions have been written, meaning that most patients are unable to access the medicine. Read More

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The Adjunctive Effect of Acupuncture for Advanced Cancer Patients in a Collaborative Model of Palliative Care: Study Protocol for a 3-Arm Randomized Trial.

Integr Cancer Ther 2021 Jan-Dec;20:15347354211012749

The University of Hong Kong, Hong Kong, China.

Background: Cancer is the second leading cause of death before the age of 70. Improved cancer survival has put increasing demands on cancer care. Palliative care is the specialized multi-disciplinary care providing relief from the pain, symptoms, and stress of serious illness. Read More

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Acupuncture treatment for post-stroke insomnia: A systematic review and meta-analysis of randomized controlled trials.

Jialei Yang

Complement Ther Clin Pract 2021 Apr 23;44:101396. Epub 2021 Apr 23.

Department of Traditional Chinese Medicine, Beijing Tian Tan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China. Electronic address:

Objectives: The meta-analysis aimed to assess the effectiveness and safety of acupuncture for the treatment of post-stroke insomnia.

Methods: Randomized controlled trials were identified from five databases before April 2020. The primary outcomes were the rate of improvement and the Pittsburgh sleep quality index (PSQI) scores; the secondary outcomes included the follow-up PSQI scores and safety. Read More

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Clinical Effect of Different Drugs and Infusion Techniques for Patient-Controlled Analgesia After Spinal Tumor Surgery: A Prospective, Randomized, Controlled Clinical Trial.

Clin Ther 2021 May 2. Epub 2021 May 2.

Department of Anaesthesiology, First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, China. Electronic address:

Purpose: To evaluate the outcomes of the different drug combination and infusion techniques for patient-controlled analgesia (PCA).

Methods: Ninety-seven patients who had undergone spinal tumor surgery were randomized to 4 groups with different PCA drugs and infusion techniques: subcutaneous sufentanil (SS) group; (n=25), subcutaneous sufentanil and dexmedetomidine (SDS) group (n=24), intravenous sufentanil (SI) group (n=23), and intravenous sufentanil and dexmedetomidine (SDI) group (n=25). The primary outcome measured the cumulative amount of sufentanil delivered to the patients through PCA 24 and 48 hours after the surgery. Read More

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Quetiapine for primary insomnia: Consider the risks.

Cleve Clin J Med 2021 05 3;88(5):286-294. Epub 2021 May 3.

University of Connecticut School of Medicine, Farmington, CT.

The second-generation antipsychotic drug quetiapine (Seroquel) is increasingly being used off-label for treating insomnia in the general population, possibly to avoid standard medications with known addictive qualities and adverse side effects. However, evidence to support using it in this way is scant, and quetiapine is associated with weight gain and other metabolic effects. It must be used cautiously and with appropriate monitoring for adverse effects and abuse. Read More

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Evaluation of the Etiology, Clinical Presentation, Findings and Prophylaxis of Children with Headache.

Betul Kilic

Sisli Etfal Hastan Tip Bul 2021 17;55(1):128-133. Epub 2021 Mar 17.

Department of Pediatric Neurology, University of Health Sciences Turkey Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Objectives: A headache is prevalent in childhood and constitutes a significant part of outpatient applications. This study aimed to evaluate the results of etiology, clinical features, examination results, prophylactic treatment and follow-up in patients with a headache.

Methods: Between January 2017 and December 2018, the files of the patients with the complaint of headache were reviewed retrospectively in this study. Read More

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Treatment of chronic primary sleep onset insomnia with Kundalini Yoga: a randomized controlled trial with active sleep hygiene comparison.

J Clin Sleep Med 2021 Apr 30. Epub 2021 Apr 30.

Division of Sleep Medicine, Harvard Medical School.

Study Objectives: Prior studies have suggested a benefit of yoga for alleviating sleep disturbance; however, many studies have had methodological limitations. This trial study aimed to extend that literature by including an active sleep hygiene (SH) comparison.

Methods: Participants aged 25-59 with a primary complaint of sleep onset insomnia lasting at least six months were block randomized to 8-week Kundalini Yoga or SH intervention, both consisting of initial 60-minute instruction and weekly check-ins. Read More

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The Herbal Formula CWBSD Improves Sleep Quality Dependent on Oral Microbial Type and Tongue Diagnostic Features in Insomnia.

J Pers Med 2021 Apr 21;11(5). Epub 2021 Apr 21.

Department of Rehabilitation Medicine of Korean Medicine, Dongguk University, Goyang 10326, Korea.

Cheonwangbosim-dan (CWBSD) is a traditional Korean herb formula that has been widely prescribed for insomnia patients with a heart-yin deficiency (HYD) pattern. Several studies have reported that heart function and insomnia are interrelated, and few have explored associations between insomnia, oral microbiota, and tongue diagnosis. This study aimed to evaluate the effects of CWBSD on primary insomnia, tongue diagnosis, and oral microbiota. Read More

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The effect of melatonin on sleep quality and insomnia in patients with cancer: a systematic review study.

Sleep Med 2021 Apr 25;82:96-103. Epub 2021 Apr 25.

Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran; World Federation of Acupuncture-Moxibustion Societies (WFAS), Beijing, China. Electronic address:

Background: Considering the importance of sleep in the treatment success and quality of life in patients with cancer, it is necessary to seek effective solutions to improve their sleep quality. In this regard, a comprehensive review of the effect of melatonin on sleep can be very useful to provide an evidence-based clinical guide. Therefore, the aim of the present systematic review was to investigate effect of melatonin on sleep quality and insomnia in patients with cancer. Read More

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ISI-3: evaluation of a brief screening tool for insomnia.

Sleep Med 2020 Aug 27;82:104-109. Epub 2020 Aug 27.

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.

Study Objectives: We evaluated the performance of the Insomnia Severity Index-3 (ISI-3) as a short screening tool to identify clinically significant insomnia derived from the 7-item ISI in an older primary care population.

Methods: We used results from two surveys including the 7-item ISI: Sample 1 (n = 3197) and Sample 2 (n = 247) individuals aged ≥60 years with a diagnosis of osteoarthritis from electronic health records. The 7 items were: difficulty falling asleep, difficulty staying asleep, waking too early, sleep satisfaction, sleep interference with daytime functioning, noticeability of sleep problems by others, and worry about sleep. Read More

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A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Healthcare Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial.

JMIR Mhealth Uhealth 2021 Mar 31. Epub 2021 Mar 31.

Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, ES.

Background: The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to healthcare workers (HCWs), who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features (low cost, high scalability), despite the lack of evidence about their efficacy in this specific population and context.

Objective: This trial aims to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in HCWs during the COVID-19 pandemic. Read More

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Lavender essential oil on postmenopausal women with insomnia: Double-blind randomized trial.

Complement Ther Med 2021 Apr 24;59:102726. Epub 2021 Apr 24.

Department of Psychobiology, Universidade Federal de Sao Paulo, Brazil; Department of Gynecology, Universidade Federal de Sao Paulo, Brazil. Electronic address:

Background: To evaluate the effect of Lavandula angustifolia essential oil inhalation on sleep and menopausal symptoms in postmenopausal women with insomnia.

Participants: 35 postmenopausal women with a clinical diagnosis of insomnia were included, 17 in Aroma Group (AG) and 18 in Placebo Group (PG).

Methods: In this double-blind, randomized controlled trial, PG participants inhaled sunflower oil and AG participants inhaledLavandula angustifolia essential oil, for 29 days. Read More

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Efficacy of Flower Therapy for Anxiety in Overweight or Obese Adults: A Randomized Placebo-Controlled Clinical Trial.

J Altern Complement Med 2021 Apr 27. Epub 2021 Apr 27.

Nursing Department, Medical School, São Paulo State University (Unesp), Botucatu, Brazil.

The aim of this study was to compare the efficacy of flower therapy for the treatment of anxiety in overweight or obese adults with that of a placebo. The authors examined improvement in sleep patterns, reduction in binge eating, and change in resting heart rate (RHR). This was a randomized, double-blind, placebo-controlled clinical trial with a parallel-group design and two arms. Read More

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The Efficacy of computerized Cognitive Behavior Therapy (cCBT) for Depressive and Anxiety Symptoms in Patients with COVID-19: Randomized Controlled Trial.

J Med Internet Res 2021 Apr 24. Epub 2021 Apr 24.

Department of Psychiatry, the First Hospital of Shanxi Medical University, 85 of Jiefang South Street, Yinze District, Taiyuan, CN.

Background: The prevalence of depressive and anxiety symptoms in patients with coronavirus disease 2019 (COVID-19) is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was urgently needed. Read More

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The Risk of Overdose With Concomitant Use of Z-Drugs and Prescription Opioids: A Population-Based Cohort Study.

Am J Psychiatry 2021 Apr 26:appiajp202020071038. Epub 2021 Apr 26.

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Szmulewicz, Huybrechts); Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine (Bateman, Levin, Huybrechts), and Department of Anesthesiology, Perioperative and Pain Medicine (Bateman), Brigham and Women's Hospital and Harvard Medical School, Boston.

Objective: The Z-drugs (zolpidem, zopiclone, zaleplon) are widely used to treat insomnia in patients receiving prescription opioids, and the risk of overdose resulting from this coprescription has not been explored. The authors compared the rates of overdose among patients using opioids plus Z-drugs and patients using opioids alone.

Methods: All individuals 15 to 85 years of age receiving prescription opioids, regardless of underlying indication and without evidence of cancer, were identified in the IBM MarketScan database (2004-2017). Read More

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The reliability of objective total sleep time in predicting the effectiveness of cognitive-behavioral therapy for insomnia.

Sleep Med 2021 Mar 25;82:43-46. Epub 2021 Mar 25.

IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy.

Background: Despite insomnia diagnosis is based only on subjective sleep assessment, recent literature suggested the usefulness of objective sleep duration for the identification of two insomnia phenotypes based on objective total sleep time (oTST). In particular, insomnia with short sleep duration (SS) (oTST<6 h) seems to receive less benefit from Cognitive-Behavioral Therapy for Insomnia (CBT-I) compared to patients with normal sleep duration (NS) (oTST≥6 h). The aim of this study is to evaluate CBT-I response of patients previously divided into SS and NS and to assess the agreement between oTST measured by polysomnography (PSG) and by actigraphy in identifying the two subgroups. Read More

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Effects of the COVID-19 lockdown on sleep duration in children and adolescents: A survey across different continents.

Pediatr Pulmonol 2021 Apr 22. Epub 2021 Apr 22.

Department of Child Health and Child Health Research Institute, Women's and Children's Hospital, University of Missouri School of Medicine, Columbia, Missouri, USA.

Background: A parent survey was conducted to assess the sleep habits of children residing in various countries before and during the SARS-CoV-2 pandemic. It was hypothesized that lockdown would be associated with increased sleep duration.

Methods: Outcomes were changes in bedtime, wake time, and sleep duration in the pandemic compared to before. Read More

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Palliative care needs and preferences of female patients and their caregivers in Ethiopia: A rapid program evaluation in Addis Ababa and Sidama zone.

PLoS One 2021 22;16(4):e0248738. Epub 2021 Apr 22.

Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.

Introduction: In Ethiopia there is an extensive unmet need for palliative care, while the burden of non-communicable diseases and cancer is increasing. This study aimed to explore palliative care needs and preferences of patients, their caregivers, and the perspective of stakeholders on service provision in palliative programs for women, mostly affected by cervical cancer and breast cancer.

Methods: A rapid program evaluation using a qualitative study approach was conducted in three home-based palliative care programs in Addis Ababa and Yirgalem town, Ethiopia. Read More

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Mindfulness-based interventions: an overall review.

Br Med Bull 2021 Apr 21. Epub 2021 Apr 21.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.

Introduction: This is an overall review on mindfulness-based interventions (MBIs).

Sources Of Data: We identified studies in PubMed, EMBASE, CINAHL, PsycINFO, AMED, Web of Science and Google Scholar using keywords including 'mindfulness', 'meditation', and 'review', 'meta-analysis' or their variations.

Areas Of Agreement: MBIs are effective for improving many biopsychosocial conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms and prosocial behaviours. Read More

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Pain Profiles among Young Adult Cannabis Users: An Analysis of Antecedent Factors and Distal Outcomes.

Subst Use Misuse 2021 Apr 21:1-11. Epub 2021 Apr 21.

Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA.

Background: Pain is a primary reason for medical cannabis use among young adults, however little is known about the patterns of pain in this group. This study identified pain profiles among young adult cannabis users and examined related antecedents and distal outcomes.

Methods: Past 30-day cannabis users aged 18-26, both medical cannabis patients and non-patients, were enrolled in Los Angeles in 2014-2015. Read More

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Self-help cognitive behavioral therapy application for COVID-19-related mental health problems: A longitudinal trial.

Asian J Psychiatr 2021 Apr 15;60:102656. Epub 2021 Apr 15.

Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, 100096, China. Electronic address:

Background And Aim: Recently, the availability and usefulness of mobile self-help mental health applications have increased, but few applications deal with COVID-19-related psychological problems. This study explored the intervention efficacy of a mobile application on addressing psychological problems related to COVID-19.

Methods: A longitudinal control trial involving 129 Chinese participants with depression symptoms was conducted through the mobile application "Care for Your Mental Health and Sleep during COVID-19" (CMSC) based on WeChat. Read More

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Assessing the feasibility and acceptability of a cluster-randomized study of cognitive behavioral therapy for chronic insomnia in a primary care setting.

BMC Fam Pract 2021 Apr 16;22(1):77. Epub 2021 Apr 16.

Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service [IbSalut], Escola Graduada 3, 07001, Palma, Spain.

Background: Cognitive behavioral therapy for chronic insomnia (CBT-i) is the treatment of choice for this condition but is underutilized in patients who attend primary care. The purpose of the present feasibility-pilot study was to assess the feasibility and acceptability of a cluster-randomized study of CBT-i in a primary care setting.

Methods: This study, performed at two primary health care centers in Majorca, Spain, was a mixed methods feasibility-pilot study of a parallel cluster-randomized design comparing CBT-i and usual care (UC). Read More

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Researchers Seek Answers for Millions With Long COVID-19.

Leslie Mertz

IEEE Pulse 2021 Mar-Apr;12(2):17-21

"I am now eight-and-a-half months into my journey with long COVID … My symptoms include diagnosed post-COVID tachycardia and acute fatigue. I also have chest tightness and breathlessness from time to time; anxiety; muscle aches and pains, especially in the evening; memory loss; and insomnia."-38-year-old female from the U. Read More

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Antidepressants for people with epilepsy and depression.

Cochrane Database Syst Rev 2021 04 16;4:CD010682. Epub 2021 Apr 16.

Department of Health Data Science, University of Liverpool, Liverpool, UK.

Background: Depressive disorders are the most common psychiatric comorbidity in people with epilepsy, affecting around one-third, with a significant negative impact on quality of life. There is concern that people may not be receiving appropriate treatment for their depression because of uncertainty regarding which antidepressant or class works best, and the perceived risk of exacerbating seizures. This review aimed to address these issues, and inform clinical practice and future research. Read More

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[Small-world network of patients with primary insomnia: a resting-state functional magnetic resonance imaging study].

Nan Fang Yi Ke Da Xue Xue Bao 2021 Mar;41(3):424-429

Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China.

Objective: To explore the changes of small-world network properties in patients with primary insomnia based on resting-state functional magnetic resonance imaging (rs-fMRI).

Objective: The rs-MRI data and neurological scale data of 65 patients and 60 matched healthy controls were collected. The brain network was constructed using GRENTA software. Read More

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An evaluation of the mental health impact of SARS-CoV-2 on patients, general public and healthcare professionals: A systematic review and meta-analysis.

EClinicalMedicine 2021 Apr 6;34:100806. Epub 2021 Apr 6.

Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK.

Background: The global impact of COVID-19 pandemic continues to affect the lives of billions of people with recurrent waves. Healthcare systems are struggling to manage pre-existing patient care and recurring covid-19 demands. As a result, we evaluated the mental health impact using systematic review and meta-analysis. Read More

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