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Insomnia Causes

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1. Insomnia

cause sleep disturbances via: o Stimulating or activating properties o Changes in sleep architecture (e.g., slow wave sleep and REM suppression) o Physiological changes (e.g., increased urination) • Medication effects on sleep vary greatly by individual. For example, some patients who take fluoxetine report insomnia as an adverse effect, whereas other patients experience daytime somnolence. • For patients who are having difficulty falling or staying asleep, consider: o The time of day the patient (...) and sleep efficiency • Decreased delta wave or slow wave sleep • Increased sleep fragmentation • Increased time spent in bed awake after retiring • Changes in circadian rhythm that cause sleepiness in the early evening and earlier waking • Increased frequency of daytime naps, which makes it harder to sleep at night Step-wise approach to insomnia treatment The following step-wise approach is recommended for treatment of insomnia. Note that prescribing medication is the last step and is only appropriate

2019 Kaiser Permanente Clinical Guidelines

2. Insomnia

Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013. insomnia is defined as difficulty initiating or maintaining sleep, or early-morning awakening that leads to dissatisfaction with sleep quantity or quality. The resulting sleep disturbance leads to impairment in social, occupational, educational, academic, behavioural, or other important areas of functioning, as well as causing significant distress (...) Insomnia Insomnia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Insomnia Last reviewed: February 2019 Last updated: April 2018 Summary One of the most common complaints reported in primary care. Unmanaged insomnia can cost over US $100 billion each year due to accidents and poor work productivity. Associated with anxiety, depression, and physical complaints. Diagnosis is made primarily by patient interview. Sleep

2018 BMJ Best Practice

3. The association of insomnia and depressive symptoms with all-cause mortality among middle-aged and old adults. (PubMed)

The association of insomnia and depressive symptoms with all-cause mortality among middle-aged and old adults. Insomnia and depressive symptoms are commonly reported by adults and have independently been found to be associated with mortality, though contrasting findings are reported. Given the high comorbidity and interrelatedness between these symptoms, we tested whether insomnia symptoms explain risk of death independent of depressive symptoms. We examined insomnia symptoms and depressive (...) symptoms, in addition to other health and demographic covariates, as predictors of all-cause mortality.The sample included 15 418 adults aged 51 and older drawn from a nationally representative, population-based study of adults in the United States, the Health and Retirement Study. Cox survival models were used to analyze time to death between the 2002 and 2014 study waves (5 waves). Controlling for health and demographic covariates, in 3 separate models, depressive symptoms and insomnia symptoms were

2018 International Journal of Geriatric Psychiatry

4. Brief behavioural therapy for insomnia in adults

waking behaviours, the physiological systems that regulate sleep (homeostatic and circadian drives) can be modified. Indication Chronic primary insomnia in adults Primary insomnia is defined as repeated difficulty with sleep initiation, duration, consolidation or quality despite adequate time and opportunity for sleep, lasting for at least a month. Precautions Ensure the diagnosis is most likely to be primary insomnia (there are no other conditions or causes such as anxiety, depression, excessive (...) Brief behavioural therapy for insomnia in adults RACGP - Brief behavioural therapy: insomnia in adults Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship

2017 Handbook of Non-Drug interventions (HANDI)

5. Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education. (PubMed)

Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education. Insomnia is a leading cause of disability in postmenopausal women. Multicomponent cognitive-behavioral therapy for insomnia (CBTI) is a first-line treatment for chronic insomnia, but support for its efficacy in treating menopause-related insomnia is scarce. The present study evaluated whether CBTI (...) is an efficacious treatment for menopause-related chronic insomnia, and whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious compared with CBTI.In a single-site, randomized controlled trial, 150 postmenopausal women (56.44 ± 5.64 years) with chronic DSM-5 insomnia disorder related to menopause were randomized to three treatment conditions: sleep hygiene education (SHE), SRT, or CBTI. Blinded assessments were performed at baseline, posttreatment, and 6 months after treatment

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2019 Sleep

6. Insomnia: Getting to the cause, facilitating relief. (PubMed)

Insomnia: Getting to the cause, facilitating relief. Chronic insomnia is often the result of multiple underlying physiologic, psychological, and social factors. A sleep log, sleep hygiene, CBT, and medication can help.

2017 Journal of Family Practice

7. Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study. (PubMed)

Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study. Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence.A prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. 996 (...) respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA1c ≥ 6.5% or 48 mmol/mol). Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress

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2017 BMC Psychiatry

8. Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes (PubMed)

Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, botanicals can represent an alternative treatment for those kinds (...) of symptoms. The scope of the present study is to evaluate safety and effectiveness of a herbal compound composed of valerian, hop, and jujube (Vagonotte®) on primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes.One hundred and twenty subjects with sleep disturbances symptoms were randomized in two branches of 60 persons each, receiving the herbal compound or placebo at dosage of two pills per day 30 minutes before their scheduled bedtime. All subjects were

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2017 Nature and science of sleep

9. New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate (PubMed)

New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia (...) % as the cause of insomnia, followed by illness associated causes (64%) and sleep disruption due to noise and or brightness (23%). Patients with insomnia had more awakenings due to noise, brightness, and staff interruptions than those without insomnia (1.35 times vs. 0.9 times, p = 0.027). Patients with respiratory symptoms, cardiac monitoring, oxygen use, private rooms, and no sedative use did not have a higher insomnia risk. Patients with insomnia had significant lower satisfaction scores than patients

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2017 Journal of community hospital internal medicine perspectives

10. Treatments for Insomnia: A Review of Patient and Experiences and Perspectives

-term dependence or addiction. Some people living with insomnia also report trying alternatives to pharmacotherapy including cognitive behavioural therapy, mindfulness, exercise, relaxation, herbal remedies, or other complementary therapies. For many of these people, non-pharmacological treatment is viewed as a long-term solution that can address the underlying cause of insomnia and ultimately overcome the disorder. They appreciate that the personalized nature of these treatments helps them (...) Treatments for Insomnia: A Review of Patient and Experiences and Perspectives Treatments for Insomnia: A Review of Patients’ and Caregivers’ Experiences and Perspectives | CADTH.ca Find the information you need Treatments for Insomnia: A Review of Patients’ and Caregivers’ Experiences and Perspectives Treatments for Insomnia: A Review of Patients’ and Caregivers’ Experiences and Perspectives Published on: September 27, 2017 Project Number: RD0039-000 Product Line: Research Type: Drug Report

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

11. Current Practice Analysis: Interventions for Insomnia Disorder

%) or less than 10 years (86%). We found several influencers for drug-prescribing practices in the literature. Examples included severity of insomnia; 11 how long a patient has experienced insomnia symptoms; 11 the perceived cause of insomnia (e.g., anxiety or depression); 10,13 lack of awareness of non-drug options for treatment; 10,12 the perception that the patient wants pharmacotherapy; 13 and the desire to avoid confrontation with patients or due to patient pressure for prescriptions. 10,12 One (...) have. Responses included: “If the patient presents with long-standing insomnia and tried a good 3 months of behavioural therapy, then I would add drug therapy.” “Will depend on the cause of insomnia. I like to start with behavioural therapy first and, if really needed, add drug therapy.” “I always begin with sleep hygiene discussions to correct negative influences on sleep patterns.” “Limited options for behaviour therapy — therefore, little choice but medication.” “Initiate melatonin or tryptophan

2017 CADTH - Optimal Use

12. Management of Insomnia Disorder in Adults: Current State of the Evidence

, or a combination thereof. Diagnostic criteria for insomnia disorder require that sleep symptoms cause clinically significant distress or impairment in functioning, occur despite adequate opportunity for sleep, and are experienced on a chronic basis (at least 3 nights per week for at least 3 months).1 Many treatments are available for insomnia symptoms, including sleep hygiene education, behavioral and psychological interventions, prescription medications, over-the-counter medications and supplements (...) Management of Insomnia Disorder in Adults: Current State of the Evidence Management of Insomnia Disorder in Adults: Current State of the Evidence Focus of This Summary This is a summary of a systematic review that evaluated current evidence regarding the effectiveness, comparative effectiveness, and adverse effects of management strategies for insomnia disorder in adults. The systematic review synthesized evidence from 169 randomized controlled trials and 12 observational studies published

2017 Effective Health Care Program (AHRQ)

13. Current Practice Analysis: Interventions for Insomnia Disorder

%) or less than 10 years (86%). We found several influencers for drug-prescribing practices in the literature. Examples included severity of insomnia; 11 how long a patient has experienced insomnia symptoms; 11 the perceived cause of insomnia (e.g., anxiety or depression); 10,13 lack of awareness of non-drug options for treatment; 10,12 the perception that the patient wants pharmacotherapy; 13 and the desire to avoid confrontation with patients or due to patient pressure for prescriptions. 10,12 One (...) have. Responses included: “If the patient presents with long-standing insomnia and tried a good 3 months of behavioural therapy, then I would add drug therapy.” “Will depend on the cause of insomnia. I like to start with behavioural therapy first and, if really needed, add drug therapy.” “I always begin with sleep hygiene discussions to correct negative influences on sleep patterns.” “Limited options for behaviour therapy — therefore, little choice but medication.” “Initiate melatonin or tryptophan

2017 CADTH - Optimal Use

14. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline

Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline JCSM - Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline Search article archive here ADVERTISEMENT Current Issue: Volume: 15 Number: 03 Issue Navigator Volume 13 No. 02 .155-157 Michael J. Sateia, MD 1 ; William C. Sherrill, MD 2 (...) without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website. E-mail Share Slides Please login to download PDF Subscribers can download and print full articles from current and past issues of the JCSM Not a subscriber? and receive a subscription to JCSM with your membership Special Articles http://dx.doi.org/10.5664/jcsm.6470 Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American

2017 American Academy of Sleep Medicine

15. Depression as the Primary Cause of Insomnia and Excessive Daytime Sleepiness in a Family with Multiple Cases of Spinocerebellar Ataxia (PubMed)

Depression as the Primary Cause of Insomnia and Excessive Daytime Sleepiness in a Family with Multiple Cases of Spinocerebellar Ataxia Spinocerebellar ataxia (SCA) is a hereditary disease characterized by central nervous system-related motor dysfunctions. Sleep disorders and frequent non-motor manifestations are commonly comorbid with SCA. To elucidate this relationship, we present three cases in a family that included multiple SCA type 2 patients with various sleep disorders. Complete physical (...) examination, and genetic and imaging studies were performed. Anti-parkinsonism medications were prescribed after neurological examination. Clonazepam and/or quetiapine were administered for sleep disorders but failed to resolve insomnia and excessive daytime sleepiness (EDS). Based on DSM-5 criteria, all cases were diagnosed with depression. After treatment with serotonin-norepinephrine reuptake inhibitors and noradrenergic and specific serotonergic antidepressants, symptoms of insomnia and EDS, which

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2016 Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

16. Insomnia predicts long-term all-cause mortality after acute myocardial infarction: A prospective cohort study. (PubMed)

Insomnia predicts long-term all-cause mortality after acute myocardial infarction: A prospective cohort study. Sleep impairment such as insomnia is an established risk factor for the development of cardiovascular disease and acute myocardial infarction (AMI). The aim of the current study was to examine the association between insomnia and all-cause mortality among AMI patients.This prospective cohort study used data on n=732 patients recruited from September 2006 to May 2011 as part (...) of the Västmanland Myocardial Infarction Study (VaMIS), a prospective cohort study of AMI patients living in Västmanland County, Sweden. Participants were followed up for all-cause mortality until December 9, 2015. The outcome of interest was time-to-death (TTD), with the presence of insomnia being the risk factor of main interest. Data were analyzed using a piecewise Cox regression model with change point for insomnia at two years of follow-up, adjusted for socioeconomic, lifestyle and clinical risk factors.In

2016 International journal of cardiology

17. Insomnia Causes

Insomnia Causes Insomnia Causes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Insomnia Causes Insomnia Causes Aka: Insomnia Causes (...) , Insomnia Associated Conditions , Organic Insomnia From Related Chapters II. Causes: Medications See III. Causes: Chronic medical conditions Endocrine conditions (and ) (and ) Musculoskeletal conditions Joint or muscle pain (e.g. , ) Genitourinary (and ) Cardiopulmonary (and ) Miscellaneous conditions due to dermatologic or systemic conditions IV. Causes: Psychiatric disorders (including ) V. Causes: Sleep disorders disorder Extrinsic (e.g. , , ) Intrinsic (e.g. ) VI. References Images: Related links

2018 FP Notebook

18. Medication Causes of Insomnia

Medication Causes of Insomnia Medication Causes of Insomnia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Medication Causes (...) of Insomnia Medication Causes of Insomnia Aka: Medication Causes of Insomnia , Insomnia due to Medications From Related Chapters II. Causes: Recreational Drugs Nicotine s or s III. Causes: Cardiovascular agents s s ( ) IV. Causes: Antineoplastics Interferon alpha V. Causes: Neurologic and psychiatric agents ( ) ( ) s ( ) Activating agents such as ( ) Stimulants ( ) ( ) VI. Causes: Endocrine agents s hormone VII. Causes: Miscellaneous agents s Protriptyline (Vivactil) ( ) Pseudophedrine ( ) s VIII

2018 FP Notebook

19. Cohort study: Insomnia is associated with risk of future cardiovascular events irrespective of comorbidities

limitations in prior literature. An important methodological shortcoming was the inadequate consideration of comorbidities in several previous studies. Insomnia symptoms clearly overlap with those of depression, and could be caused by other sleep disorders, most importantly by obstructive sleep apnoea and by several somatic diseases which could increase the risk for cardiovascular diseases. Hsu and colleagues took advantage of a large nationwide health database and investigated the long-term association (...) Cohort study: Insomnia is associated with risk of future cardiovascular events irrespective of comorbidities Insomnia is associated with risk of future cardiovascular events irrespective of comorbidities | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal

2016 Evidence-Based Medicine (Requires free registration)

20. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians

) Insomnia is a major health care problem in the United States. It is defined as dissatisfaction with sleep quantity or quality and is associated with difficulty initiating or maintaining sleep and early-morning waking with inability to return to sleep ( ). Approximately 6% to 10% of adults have insomnia that meets diagnostic criteria ( ). Insomnia is more common in women and older adults ( , ) and can occur independently or be caused by another disease. People with the disorder often experience fatigue (...) Disorders, Fifth Edition (DSM-5), is diagnosed according to the DSM-5 ( ) and the International Classification of Sleep Disorders ( ), which have similar criteria for making the diagnosis. These criteria specify that symptoms must cause clinically significant functional distress or impairment; be present for at least 3 nights per week for at least 3 months; and not be linked to other sleep, medical, or mental disorders ( ). Symptoms of insomnia differ between older adults and the younger population

2016 American College of Physicians

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