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161. Insomnia Treatment for Women Veterans

of the patients we serve is critical. Insomnia complaints are more common among women than men, with a mean prevalence of over 23% among US women. Insomnia (defined as sleep disturbance that is sufficiently severe to cause distress or impact functioning), is a significant public health concern that contributes to lost productivity, psychological distress, medical morbidity, and mortality risk. In a recent paper on transformation of care for women Veterans, Yano et al. included "sleep issues" as part (...) Insomnia Treatment for Women Veterans Insomnia Treatment for Women Veterans - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Insomnia Treatment for Women Veterans The safety and scientific validity

2014 Clinical Trials

162. Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia

. Individuals with insomnia have a decreased quality of life compared to those who report other serious illnesses such as major depression and congestive heart failure. Chronic insomnia can be caused by medications, drug or alcohol abuse, psychiatric disorders, medical and neurologic disorders. It can impair cognitive and physical functioning. Propofol is an approved drug administered intravenously for use in the induction and maintenance of anesthesia or sedation. Some research suggests that propofol when (...) Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies

2014 Clinical Trials

163. The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease. (PubMed)

with hypoxia (p<0.005). Only in the patients with CVD was hypoxia associated with insomnia (p<0.001) which mediated an indirect effect (p<0.05) between SDB and insomnia. Hypoxia of more than 1.5% of sleep time with SaO2<90% was found to be a critical level for causing insomnia. According to this criterion 32% (n=39) and 26% (n=55) of those with and without CVD had hypoxia, respectively. These groups did not differ with respect to age, gender, body mass index, diabetes, hypertension, respiratory disease (...) The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease. This study explores if nightly hypoxia (i.e. percentage of sleep time with oxygen saturation lower than 90% (SaO2<90%)) contributed to the association between sleep-disordered breathing (SDB) and insomnia in community-dwelling elderly with and without cardiovascular disease (CVD). A second aim was to explore

2014 European Journal of Cardiovascular Nursing

164. Quetiapine for insomnia: A review of the literature. (PubMed)

Quetiapine for insomnia: A review of the literature. The safety and efficacy of quetiapine for the treatment of insomnia in adults are reviewed.Quetiapine was developed for the treatment of psychiatric disorders, but its antagonism of histamine H1- and serotonin type 2A receptors has the added effect of causing sedation. As such, quetiapine is widely used off-label as a treatment for insomnia. Due to quetiapine's potential adverse effects, guidelines for the treatment of insomnia have (...) recommended the drug's use only in patients with specific comorbid psychiatric disorders. The use of quetiapine for the treatment of insomnia in the absence of comorbid conditions has been evaluated in only two clinical trials of 31 patients in total, and very few studies have evaluated quetiapine use in patients with insomnia and other comorbidities. No trials have been conducted comparing quetiapine with an active control (e.g., zolpidem); the data that exist compare quetiapine to a placebo

2014 American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

165. Binge drinking and insomnia in middle-aged and older adults: the Health and Retirement Study. (PubMed)

Binge drinking and insomnia in middle-aged and older adults: the Health and Retirement Study. Alcohol use in later life has been linked to poor sleep. However, the association between binge drinking, which is common among middle-aged and older adults, and insomnia has not been previously assessed.We studied participants aged 50 years and older (n = 6027) from the 2004 Health and Retirement Study who reported the number of days they had ≥4 drinks on one occasion in the prior 3 months (...) . Participants also reported the frequency of four insomnia symptoms. Logistic regression analyses assessed the association between binge drinking frequency and insomnia.Overall, 32.5% of participants had >0 to ≤2 binge drinking days/week; and 3.6% had >2 binge drinking days/week. After adjusting for demographic variables, medical conditions, body mass index, and elevated depressive symptoms, participants who binged >2 days/week had a 64% greater odds of insomnia than non-binge drinkers (adjusted odds ratio

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2014 International Journal of Geriatric Psychiatry

166. Persistent Insomnia is Associated with Mortality Risk. (PubMed)

 = .004) insomnia. Although CRP levels were themselves associated with increased mortality (adjusted HR 1.36; 95% CI, 1.01-1.82; P = .04), adjustment for CRP levels did not notably change the association between persistent insomnia and mortality.In a population-based cohort, persistent, and not intermittent, insomnia was associated with increased risk for all-cause and cardiopulmonary mortality and was associated with a steeper increase in inflammation.Copyright © 2015 Elsevier Inc. All rights (...) Persistent Insomnia is Associated with Mortality Risk. Insomnia has been associated with mortality risk, but whether this association is different in subjects with persistent vs intermittent insomnia is unclear. Additionally, the role of systemic inflammation in such an association is unknown.We used data from a community-based cohort to determine whether persistent or intermittent insomnia, defined based on persistence of symptoms over a 6-year period, was associated with death during

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2014 American Journal of Medicine

167. Primary Insomnia (Treatment)

> Primary Insomnia Updated: Aug 25, 2014 Author: Catherine McVearry Kelso, MD, MS; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK) Share Email Print Feedback Close Sections Sections Primary Insomnia Criteria for Primary Insomnia Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. Below are the diagnostic criteria for primary insomnia as set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR (...) that indicate sleep deprivation and fatigue can include features such as eye redness. Depending on the origin of the sleep dysfunction, other physical findings would be included to rule out secondary causes (ie, weight, neck circumference, thyroid). Previous Next: Assessment of Mental Status A complete neurologic examination is included in the evaluation of insomnia, to assess for comorbid conditions. Recognition of mental disorders that may be contributing to insomnia is key to effectively managing

2014 eMedicine.com

168. Insomnia (Treatment)

and conditioning to arousal in bed. If the patient has a psychiatric disorder, the disorder should be treated. Management may involve medications, psychotherapy, and possible referral to a psychiatrist, psychologist, or therapist. If the insomnia is related to medication or drug abuse, the offending medication or drug must be slowly tapered and withdrawn. Even when comorbid causes of insomnia (ie, medical, psychiatric) are treated, however, variable degrees of insomnia persist that require additional (...) 15. 3(1):63-72. . Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep . 2010 Feb 1. 33(2):177-84. . . Phillips B, Buzková P, Enright P. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep . 2009 Jan 1. 32(1):65-72. . . Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et

2014 eMedicine.com

169. Primary Insomnia (Overview)

> Primary Insomnia Updated: Aug 25, 2014 Author: Catherine McVearry Kelso, MD, MS; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK) Share Email Print Feedback Close Sections Sections Primary Insomnia Criteria for Primary Insomnia Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. Below are the diagnostic criteria for primary insomnia as set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR (...) that indicate sleep deprivation and fatigue can include features such as eye redness. Depending on the origin of the sleep dysfunction, other physical findings would be included to rule out secondary causes (ie, weight, neck circumference, thyroid). Previous Next: Assessment of Mental Status A complete neurologic examination is included in the evaluation of insomnia, to assess for comorbid conditions. Recognition of mental disorders that may be contributing to insomnia is key to effectively managing

2014 eMedicine.com

170. Insomnia (Overview)

conditions that may contribute to more common causes of insomnia (eg, psychiatric disorders) A social history should be obtained, addressing the following: Transient or short-term insomnia: Recent situational stresses Chronic insomnia: Past stresses or medical illnesses Use of tobacco, caffeinated products, alcohol, and illegal drugs The medication history should be reviewed, focusing on agents that commonly cause insomnia, such as the following: Beta blockers Clonidine Theophylline (acutely) Certain (...) antidepressants (eg, protriptyline, fluoxetine) Decongestants Stimulants Over-the-counter and herbal remedies Physical examination may offer clues to underlying medical disorders predisposing to insomnia. [ ] Specific recommendations include the following: History suggestive of : Careful head and neck examination Symptoms of or periodic limb movement disorder or any other neurologic disorder: Careful neurologic examination Daytime symptoms consistent with a medical cause of insomnia: Careful examination

2014 eMedicine.com

171. Insomnia (Overview)

conditions that may contribute to more common causes of insomnia (eg, psychiatric disorders) A social history should be obtained, addressing the following: Transient or short-term insomnia: Recent situational stresses Chronic insomnia: Past stresses or medical illnesses Use of tobacco, caffeinated products, alcohol, and illegal drugs The medication history should be reviewed, focusing on agents that commonly cause insomnia, such as the following: Beta blockers Clonidine Theophylline (acutely) Certain (...) antidepressants (eg, protriptyline, fluoxetine) Decongestants Stimulants Over-the-counter and herbal remedies Physical examination may offer clues to underlying medical disorders predisposing to insomnia. [ ] Specific recommendations include the following: History suggestive of : Careful head and neck examination Symptoms of or periodic limb movement disorder or any other neurologic disorder: Careful neurologic examination Daytime symptoms consistent with a medical cause of insomnia: Careful examination

2014 eMedicine.com

172. Insomnia (Treatment)

and conditioning to arousal in bed. If the patient has a psychiatric disorder, the disorder should be treated. Management may involve medications, psychotherapy, and possible referral to a psychiatrist, psychologist, or therapist. If the insomnia is related to medication or drug abuse, the offending medication or drug must be slowly tapered and withdrawn. Even when comorbid causes of insomnia (ie, medical, psychiatric) are treated, however, variable degrees of insomnia persist that require additional (...) 15. 3(1):63-72. . Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep . 2010 Feb 1. 33(2):177-84. . . Phillips B, Buzková P, Enright P. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep . 2009 Jan 1. 32(1):65-72. . . Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et

2014 eMedicine.com

173. Primary Insomnia (Follow-up)

> Primary Insomnia Updated: Aug 25, 2014 Author: Catherine McVearry Kelso, MD, MS; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK) Share Email Print Feedback Close Sections Sections Primary Insomnia Criteria for Primary Insomnia Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. Below are the diagnostic criteria for primary insomnia as set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR (...) that indicate sleep deprivation and fatigue can include features such as eye redness. Depending on the origin of the sleep dysfunction, other physical findings would be included to rule out secondary causes (ie, weight, neck circumference, thyroid). Previous Next: Assessment of Mental Status A complete neurologic examination is included in the evaluation of insomnia, to assess for comorbid conditions. Recognition of mental disorders that may be contributing to insomnia is key to effectively managing

2014 eMedicine.com

174. Insomnia (Follow-up)

and conditioning to arousal in bed. If the patient has a psychiatric disorder, the disorder should be treated. Management may involve medications, psychotherapy, and possible referral to a psychiatrist, psychologist, or therapist. If the insomnia is related to medication or drug abuse, the offending medication or drug must be slowly tapered and withdrawn. Even when comorbid causes of insomnia (ie, medical, psychiatric) are treated, however, variable degrees of insomnia persist that require additional (...) 15. 3(1):63-72. . Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep . 2010 Feb 1. 33(2):177-84. . . Phillips B, Buzková P, Enright P. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep . 2009 Jan 1. 32(1):65-72. . . Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et

2014 eMedicine.com

175. Insomnia (Follow-up)

and conditioning to arousal in bed. If the patient has a psychiatric disorder, the disorder should be treated. Management may involve medications, psychotherapy, and possible referral to a psychiatrist, psychologist, or therapist. If the insomnia is related to medication or drug abuse, the offending medication or drug must be slowly tapered and withdrawn. Even when comorbid causes of insomnia (ie, medical, psychiatric) are treated, however, variable degrees of insomnia persist that require additional (...) 15. 3(1):63-72. . Chien KL, Chen PC, Hsu HC, Su TC, Sung FC, Chen MF, et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep . 2010 Feb 1. 33(2):177-84. . . Phillips B, Buzková P, Enright P. Insomnia did not predict incident hypertension in older adults in the cardiovascular health study. Sleep . 2009 Jan 1. 32(1):65-72. . . Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et

2014 eMedicine.com

176. Insomnia (Diagnosis)

conditions that may contribute to more common causes of insomnia (eg, psychiatric disorders) A social history should be obtained, addressing the following: Transient or short-term insomnia: Recent situational stresses Chronic insomnia: Past stresses or medical illnesses Use of tobacco, caffeinated products, alcohol, and illegal drugs The medication history should be reviewed, focusing on agents that commonly cause insomnia, such as the following: Beta blockers Clonidine Theophylline (acutely) Certain (...) antidepressants (eg, protriptyline, fluoxetine) Decongestants Stimulants Over-the-counter and herbal remedies Physical examination may offer clues to underlying medical disorders predisposing to insomnia. [ ] Specific recommendations include the following: History suggestive of : Careful head and neck examination Symptoms of or periodic limb movement disorder or any other neurologic disorder: Careful neurologic examination Daytime symptoms consistent with a medical cause of insomnia: Careful examination

2014 eMedicine.com

177. Insomnia (Diagnosis)

conditions that may contribute to more common causes of insomnia (eg, psychiatric disorders) A social history should be obtained, addressing the following: Transient or short-term insomnia: Recent situational stresses Chronic insomnia: Past stresses or medical illnesses Use of tobacco, caffeinated products, alcohol, and illegal drugs The medication history should be reviewed, focusing on agents that commonly cause insomnia, such as the following: Beta blockers Clonidine Theophylline (acutely) Certain (...) antidepressants (eg, protriptyline, fluoxetine) Decongestants Stimulants Over-the-counter and herbal remedies Physical examination may offer clues to underlying medical disorders predisposing to insomnia. [ ] Specific recommendations include the following: History suggestive of : Careful head and neck examination Symptoms of or periodic limb movement disorder or any other neurologic disorder: Careful neurologic examination Daytime symptoms consistent with a medical cause of insomnia: Careful examination

2014 eMedicine.com

178. Primary Insomnia (Diagnosis)

> Primary Insomnia Updated: Aug 25, 2014 Author: Catherine McVearry Kelso, MD, MS; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK) Share Email Print Feedback Close Sections Sections Primary Insomnia Criteria for Primary Insomnia Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. Below are the diagnostic criteria for primary insomnia as set forth by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR (...) that indicate sleep deprivation and fatigue can include features such as eye redness. Depending on the origin of the sleep dysfunction, other physical findings would be included to rule out secondary causes (ie, weight, neck circumference, thyroid). Previous Next: Assessment of Mental Status A complete neurologic examination is included in the evaluation of insomnia, to assess for comorbid conditions. Recognition of mental disorders that may be contributing to insomnia is key to effectively managing

2014 eMedicine.com

179. Hospital-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus: telavancin

Hospital-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus: telavancin Hospital-acquired pneumonia caused b Hospital-acquired pneumonia caused by y methicillin-resistant Staph methicillin-resistant Staphylococcus aureus: ylococcus aureus: tela telavancin vancin Evidence summary Published: 15 July 2014 nice.org.uk/guidance/esnm44 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in July 2014. See (...) summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA or NICE websites for up- to-date information. Summary T elavancin (Vibativ; Clinigen Healthcare Limited) is a lipoglycopeptide antibacterial agent, the first of a new class of antibiotics. It has been granted a marketing authorisation for the 'treatment of adults with nosocomial pneumonia including ventilator-associated pneumonia, known or suspected to be caused by methicillin-resistant Staphylococcus aureus (MRSA

2014 National Institute for Health and Clinical Excellence - Advice

180. Comfrey herbal remedy causing second-degree heart block: do not be outfoxed by digitalis (PubMed)

Comfrey herbal remedy causing second-degree heart block: do not be outfoxed by digitalis A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular

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2016 BMJ case reports

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