Sleep and insomnia النوم

وَهُوَ ٱلَّذِي جَعَلَ لَكُمُ ٱلَّيۡلَ لِبَاسࣰ ا وَٱلنَّوۡمَ سُبَاتࣰ ا وَجَعَلَ ٱلنَّهَارَ نُشُورࣰ ا

It is He who made the night a garment for you, and sleep a rest, and made the day like a resurrection

ٱللَّهُ لَآ إِلَٰهَ إِلَّا هُوَ ٱلۡحَيُّ ٱلۡقَيُّومُۚ لَا تَأۡخُذُهُۥ سِنَةࣱ وَلَا نَوۡمࣱۚ لَّهُۥ مَا فِي ٱلسَّمَٰوَٰتِ وَمَا فِي ٱلۡأَرۡضِۗ مَن ذَا ٱلَّذِي يَشۡفَعُ عِندَهُۥٓ إِلَّا بِإِذۡنِهِۦۚ يَعۡلَمُ مَا بَيۡنَ أَيۡدِيهِمۡ وَمَا خَلۡفَهُمۡۖ وَلَا يُحِيطُونَ بِشَيۡءࣲ مِّنۡ عِلۡمِهِۦٓ إِلَّا بِمَا شَآءَۚ وَسِعَ كُرۡسِيُّهُ ٱلسَّمَٰوَٰتِ وَٱلۡأَرۡضَۖ وَلَا يَـُٔودُهُۥ حِفۡظُهُمَاۚ وَهُوَ ٱلۡعَلِيُّ ٱلۡعَظِيمُ

God: there is no god but Him, the Ever Living, the Ever Watchful.Neither slumber nor sleep overtakes Him. All that is in the heavens and in the earth belongs to Him. Who is there that can intercede with Him except by His leave? He knows what is before them and what is behind them, but they do not comprehend any of His knowledge except what He wills. His throne extends over the heavens and the earth; it does not weary Him to preserve them both. He is the Most High, the Tremendous

وَجَعَلۡنَا نَوۡمَكُمۡ سُبَاتࣰ ا

give you sleep for rest

ثُمَّ أَنزَلَ عَلَيۡكُم مِّنۢ بَعۡدِ ٱلۡغَمِّ أَمَنَةࣰ نُّعَاسࣰ ا يَغۡشَىٰ طَآئِفَةࣰ مِّنكُمۡۖ وَطَآئِفَةࣱ قَدۡ أَهَمَّتۡهُمۡ أَنفُسُهُمۡ يَظُنُّونَ بِٱللَّهِ غَيۡرَ ٱلۡحَقِّ ظَنَّ ٱلۡجَٰهِلِيَّةِۖ يَقُولُونَ هَل لَّنَا مِنَ ٱلۡأَمۡرِ مِن شَيۡءࣲۗ قُلۡ إِنَّ ٱلۡأَمۡرَ كُلَّهُۥ لِلَّهِۗ يُخۡفُونَ فِيٓ أَنفُسِهِم مَّا لَا يُبۡدُونَ لَكَۖ يَقُولُونَ لَوۡ كَانَ لَنَا مِنَ ٱلۡأَمۡرِ شَيۡءࣱ مَّا قُتِلۡنَا هَٰهُنَاۗ قُل لَّوۡ كُنتُمۡ فِي بُيُوتِكُمۡ لَبَرَزَ ٱلَّذِينَ كُتِبَ عَلَيۡهِمُ ٱلۡقَتۡلُ إِلَىٰ مَضَاجِعِهِمۡۖ وَلِيَبۡتَلِيَ ٱللَّهُ مَا فِي صُدُورِكُمۡ وَلِيُمَحِّصَ مَا فِي قُلُوبِكُمۡۚ وَٱللَّهُ عَلِيمُۢ بِذَاتِ ٱلصُّدُورِ

After sorrow, He caused calm to descend upon you, a sleep that overtook some of you. Another group, caring only for themselves, entertained false thoughts about God, thoughts more appropriate to pagan ignorance, and said, ‘Do we get a say in any of this?’ [Prophet], tell them, ‘Everything to do with this affair is in God’s hands.’ They conceal in their hearts things they will not reveal to you. They say, ‘If we had had our say in this, none of us would have been killed here.’ Tell them, ‘Even if you had resolved to stay at home, those who were destined to be killed would still have gone out to meet their deaths.’ God did this in order to test everything within you and in order to prove what is in your hearts. God knows your innermost thoughts very well

فَالِقُ ٱلۡإِصۡبَاحِ وَجَعَلَ ٱلَّيۡلَ سَكَنࣰ ا وَٱلشَّمۡسَ وَٱلۡقَمَرَ حُسۡبَانࣰ اۚ ذَٰلِكَ تَقۡدِيرُ ٱلۡعَزِيزِ ٱلۡعَلِيمِ

He makes the dawn break; He makes the night for rest; and He made the sun and the moon to a precise measure. That is the design of the Almighty, the All Knowing

إِذۡ يُغَشِّيكُمُ ٱلنُّعَاسَ أَمَنَةࣰ مِّنۡهُ وَيُنَزِّلُ عَلَيۡكُم مِّنَ ٱلسَّمَآءِ مَآءࣰ لِّيُطَهِّرَكُم بِهِۦ وَيُذۡهِبَ عَنكُمۡ رِجۡزَ ٱلشَّيۡطَٰنِ وَلِيَرۡبِطَ عَلَىٰ قُلُوبِكُمۡ وَيُثَبِّتَ بِهِ ٱلۡأَقۡدَامَ

Remember when He gave you sleep as a reassurance from Him, and sent down water from the sky to cleanse you, to remove Satan’s pollution from you, to make your hearts strong and your feet firm

And He it is Who made for you the night as a garment veiling you like a garment and sleep for repose rest for bodies through the temporary cessation of labour and He made the day for rising a time in which all rise to seek their livelihood and so on.

Have you not seen how your Lord spread the shadow. If He willed, He could have made it still – but We have made the sun its guide (45)Then We withdraw it towards Ourselves – a gradual withdrawal (46)And it is He Who makes the night a covering for you, and the sleep (as) a repose, and makes the day Nushur (47) Evidence of the Existence of the Creator and the Extent of His Power Here Allah begins explaining the evidence for His existence and His perfect power to create various things and pairs of opposites. Allah says: أَلَمْ تَرَ إِلَىٰ رَبِّكَ كَيْفَ مَدَّ الظِّلَّ (Have you not seen how your Lord spread the shadow.) Ibn 'Abbas, Ibn 'Umar, Abu Al-'Aliyah, Abu Malik, Masruq, Mujahid, Sa'id bin Jubayr, An-Nakha'i, Ad-Dahhak, Al-Hasan, Qatadah, As-Suddi and others said, "This refers to the period from the beginning of the dawn until the sun rises." وَلَوْ شَاءَ لَجَعَلَهُ سَاكِنًا (If

God there is no god that is there is none worthy of being worshipped in all existence except Him the Living the Everlasting the Eternal Sustainer the One constantly engaged in the management of His creation. Slumber does not seize Him neither sleep; to Him belongs all that is in the heavens and the earth as possessions creatures and servants; who is there that is to say none is there that shall intercede with Him save by His leave? in this for him. He knows what lies before them that is creation and what is after them of the affairs of this world and the Hereafter; and they encompass nothing of His knowledge that is they know nothing of what He knows save such as He wills to inform of it by way of His messengers. His throne subsumes the heavens and the earth it is said that His knowledge encompasses them both; it is also said that the kursī ‘throne’ itself subsumes them on account of its

and made your sleep for rest? repose for your bodies

Allah! None has the right to be worshipped but He, the Ever Living, the One Who sustains and protects all that exists. Neither slumber nor sleep overtakes Him. To Him belongs whatever is in the heavens and whatever is on the earth. Who is he that can intercede with Him except with His permission? He knows what happens to them (His creatures) in this world, and what will happen to them in the Hereafter. And they will never compass anything of His Knowledge except that which He wills. His Kursi extends over the heavens and the earth, and He feels no fatigue in guarding and preserving them. And He is the Most High, the Most Great (255) The Virtue of Ayat Al-Kursi This is Ayat Al-Kursi and tremendous virtues have been associated with it, for the authentic Hadith describes it as 'the greatest Ayah in the Book of Allah.' Imam Ahmad recorded that 'Ubayy bin Ka'b said that the Prophet ﷺ asked

بِسْمِ اللَّهِ الرَّحْمَٰنِ الرَّحِيمِ In the Name of Allah, the Most Beneficent, the Most Merciful. عَمَّ يَتَسَاءَلُونَ - عَنِ النَّبَإِ الْعَظِيمِ - الَّذِي هُمْ فِيهِ مُخْتَلِفُونَ - كَلَّا سَيَعْلَمُونَ - ثُمَّ كَلَّا سَيَعْلَمُونَ - أَلَمْ نَجْعَلِ الْأَرْضَ مِهَادًا - وَالْجِبَالَ أَوْتَادًا - وَخَلَقْنَاكُمْ أَزْوَاجًا - وَجَعَلْنَا نَوْمَكُمْ سُبَاتًا - وَجَعَلْنَا اللَّيْلَ لِبَاسًا - وَجَعَلْنَا النَّهَارَ مَعَاشًا - وَبَنَيْنَا فَوْقَكُمْ سَبْعًا شِدَادًا - وَجَعَلْنَا سِرَاجًا وَهَّاجًا - وَأَنزَلْنَا مِنَ الْمُعْصِرَاتِ مَاءً ثَجَّاجًا - لِّنُخْرِجَ بِهِ حَبًّا وَنَبَاتًا - وَجَنَّاتٍ أَلْفَافًا (1. What are they asking about?)(2. About the great news,)(3. About which they are in disagreement.)(4. Nay, they will come to know!)(5. Nay, again, they will come to know!)(6. Have We not made the earth as a bed,)(7. And the mountains as pegs?)(8. And We have created you in pair

حَدَّثَنَا نَصْرُ بْنُ عَلِيٍّ، حَدَّثَنَا عَبْدُ الْوَهَّابِ الثَّقَفِيُّ، حَدَّثَنَا أَيُّوبُ، عَنْ مُحَمَّدِ بْنِ سِيرِينَ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِذَا اقْتَرَبَ الزَّمَانُ لَمْ تَكَدْ رُؤْيَا الْمُؤْمِنِ تَكْذِبُ وَأَصْدَقُهُمْ رُؤْيَا أَصْدَقُهُمْ حَدِيثًا وَرُؤْيَا الْمُسْلِمِ جُزْءٌ مِنْ سِتَّةٍ وَأَرْبَعِينَ جُزْءًا مِنَ النُّبُوَّةِ وَالرُّؤْيَا ثَلاَثٌ فَالرُّؤْيَا الصَّالِحَةُ بُشْرَى مِنَ اللَّهِ وَالرُّؤْيَا مِنْ تَحْزِينِ الشَّيْطَانِ وَالرُّؤْيَا مِمَّا يُحَدِّثُ بِهَا الرَّجُلُ نَفْسَهُ فَإِذَا رَأَى أَحَدُكُمْ مَا يَكْرَهُ فَلْيَقُمْ وَلْيَتْفُلْ وَلاَ يُحَدِّثْ بِهَا النَّاسَ قَالَ وَأُحِبُّ الْقَيْدَ فِي النَّوْمِ وَأَكْرَهُ الْغُلَّ الْقَيْدُ ثَبَاتٌ فِي الدِّينِ ‏"‏ ‏.‏ قَالَ وَهَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏

Abu Hurairah narrated that the Messenger of Allah (s.a.w) said:"When time draws near, the dreams of a believer will hardly ever fail to come true, and the most truthful of them in dreams will be the truest in speech among them. The dream of a Muslim is a portion among the forty-six portions of Prophet-hood. And dreams are of three types: The righteous dream which is good news from Allah, dreams in which the Shaithan frightens someone, and dreams about something that has happened to the man himself. So when one of you sees what he dislikes, then he should get up and spit, and not tell any of the people- he said:- and I like the fetters in a dream while I dislike the iron collar." And the interpretation of fetters is being firm in the religion

حَدَّثَنَا مَحْمُودُ بْنُ غَيْلاَنَ، حَدَّثَنَا أَبُو دَاوُدَ، عَنْ شُعْبَةَ، عَنْ قَتَادَةَ، أَنَّهُ سَمِعَ أَنَسًا، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، أَنَّ النَّبِيَّ صلى الله عليه وسلم قَالَ ‏ "‏ رُؤْيَا الْمُؤْمِنِ جُزْءٌ مِنْ سِتَّةٍ وَأَرْبَعِينَ جُزْءًا مِنَ النُّبُوَّةِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَأَبِي رَزِينٍ الْعُقَيْلِيِّ وَأَبِي سَعِيدٍ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَعَوْفِ بْنِ مَالِكٍ وَابْنِ عُمَرَ وَأَنَسٍ ‏.‏ قَالَ وَحَدِيثُ عُبَادَةَ حَدِيثٌ صَحِيحٌ ‏.‏

Ubadah bin As-Samit narrated that the Prophet (s.a.w) said:"The dreams of the believer are a portion of the forty-six portions of Prophet-hood

حَدَّثَنَا أَبُو نُعَيْمٍ، قَالَ حَدَّثَنَا سُفْيَانُ، عَنِ الأَسْوَدِ، قَالَ سَمِعْتُ جُنْدَبًا، يَقُولُ اشْتَكَى النَّبِيُّ صلى الله عليه وسلم فَلَمْ يَقُمْ لَيْلَةً أَوْ لَيْلَتَيْنِ‏.‏

Narrated Jundab:The Prophet (ﷺ) became sick and did not get up (for Tahajjud prayer) for a night or two

حَدَّثَنَا ابْنُ مُقَاتِلٍ، أَخْبَرَنَا عَبْدُ اللَّهِ، أَخْبَرَنَا مَعْمَرٌ، عَنِ الزُّهْرِيِّ، عَنْ هِنْدٍ بِنْتِ الْحَارِثِ، عَنْ أُمِّ سَلَمَةَ ـ رضى الله عنها ـ أَنَّ النَّبِيَّ صلى الله عليه وسلم اسْتَيْقَظَ لَيْلَةً فَقَالَ ‏ "‏ سُبْحَانَ اللَّهِ مَاذَا أُنْزِلَ اللَّيْلَةَ مِنَ الْفِتْنَةِ، مَاذَا أُنْزِلَ مِنَ الْخَزَائِنِ مَنْ يُوقِظُ صَوَاحِبَ الْحُجُرَاتِ، يَا رُبَّ كَاسِيَةٍ فِي الدُّنْيَا عَارِيَةٍ فِي الآخِرَةِ ‏"‏‏.‏

Narrated Um Salama:One night the Prophet (ﷺ) got up and said, "Subhan Allah! How many afflictions Allah has revealed tonight and how many treasures have been sent down (disclosed). Go and wake the sleeping lady occupants of these dwellings up (for prayers), perhaps a well dressed in this world may be naked in the Hereafter

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ مَسْلَمَةَ، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنِ ابْنِ شِهَابٍ، أَنَّ عُمَرَ بْنَ عَبْدِ الْعَزِيزِ، أَخَّرَ الصَّلاَةَ يَوْمًا، فَدَخَلَ عَلَيْهِ عُرْوَةُ بْنُ الزُّبَيْرِ، فَأَخْبَرَهُ أَنَّ الْمُغِيرَةَ بْنَ شُعْبَةَ أَخَّرَ الصَّلاَةَ يَوْمًا وَهْوَ بِالْعِرَاقِ، فَدَخَلَ عَلَيْهِ أَبُو مَسْعُودٍ الأَنْصَارِيُّ فَقَالَ مَا هَذَا يَا مُغِيرَةُ أَلَيْسَ قَدْ عَلِمْتَ أَنَّ جِبْرِيلَ نَزَلَ فَصَلَّى، فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ قَالَ ‏ "‏ بِهَذَا أُمِرْتُ ‏"‏‏.‏ فَقَالَ عُمَرُ لِعُرْوَةَ اعْلَمْ مَا تُحَدِّثُ أَوَإِنَّ جِبْرِيلَ هُوَ أَقَامَ لِرَسُولِ اللَّهِ صلى الله عليه وسلم وَقْتَ الصَّلاَةِ‏.‏ قَالَ عُرْوَةُ كَذَلِكَ كَانَ بَشِيرُ بْنُ أَبِي مَسْعُودٍ يُحَدِّثُ عَنْ أَبِيهِ‏.‏ قَالَ عُرْوَةُ وَلَقَدْ حَدَّثَتْنِي عَائِشَةُ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم كَانَ يُصَلِّي الْعَصْرَ، وَالشَّمْسُ فِي حُجْرَتِهَا قَبْلَ أَنْ تَظْهَرَ‏.‏

Narrated Ibn Shihab:Once `Umar bin `Abdul `Aziz delayed the prayer and `Urwa bin Az-Zubair went to him and said, "Once in 'Iraq, Al-Mughira bin Shu`ba delayed his prayers and Abi Mas`ud Al-Ansari went to him and said, 'O Mughira! What is this? Don't you know that once Gabriel came and offered the prayer (Fajr prayer) and Allah's Messenger (ﷺ) prayed too, then he prayed again (Zuhr prayer) and so did Allah's Apostle and again he prayed (`Asr prayers and Allah's Messenger (ﷺ) did the same; again he prayed (Maghrib-prayer) and so did Allah's Messenger (ﷺ) and again prayed (`Isha prayer) and so did Allah's Apostle and (Gabriel) said, 'I was ordered to do so (to demonstrate the prayers prescribed to you)?'" `Umar (bin `Abdul `Aziz) said to `Urwa, "Be sure of what you Say. Did Gabriel lead Allah's Messenger (ﷺ) at the stated times of the prayers?" `Urwa replied, "Bashir bin Abi Mas`ud narrated like this on the authority of his father." `Urwa added, "Aisha told me that Allah's Messenger (ﷺ) used to pray `Asr prayer when the sunshine was still inside her residence (during the early time of `Asr)

حَدَّثَنَا قُتَيْبَةُ بْنُ سَعِيدٍ، قَالَ حَدَّثَنَا عَبَّادٌ ـ هُوَ ابْنُ عَبَّادٍ ـ عَنْ أَبِي جَمْرَةَ، عَنِ ابْنِ عَبَّاسٍ، قَالَ قَدِمَ وَفْدُ عَبْدِ الْقَيْسِ عَلَى رَسُولِ اللَّهِ صلى الله عليه وسلم فَقَالُوا إِنَّا مِنْ هَذَا الْحَىِّ مِنْ رَبِيعَةَ، وَلَسْنَا نَصِلُ إِلَيْكَ إِلاَّ فِي الشَّهْرِ الْحَرَامِ، فَمُرْنَا بِشَىْءٍ نَأْخُذْهُ عَنْكَ، وَنَدْعُو إِلَيْهِ مَنْ وَرَاءَنَا‏.‏ فَقَالَ ‏ "‏ آمُرُكُمْ بِأَرْبَعٍ، وَأَنْهَاكُمْ عَنْ أَرْبَعٍ الإِيمَانِ بِاللَّهِ ـ ثُمَّ فَسَّرَهَا لَهُمْ شَهَادَةُ أَنْ لاَ إِلَهَ إِلاَّ اللَّهُ، وَأَنِّي رَسُولُ اللَّهِ، وَإِقَامُ الصَّلاَةِ، وَإِيتَاءُ الزَّكَاةِ، وَأَنْ تُؤَدُّوا إِلَىَّ خُمُسَ مَا غَنِمْتُمْ، وَأَنْهَى عَنِ الدُّبَّاءِ وَالْحَنْتَمِ وَالْمُقَيَّرِ وَالنَّقِيرِ ‏"‏‏.‏

Narrated Ibn `Abbas:"Once a delegation of `Abdul Qais came to Allah's Messenger (ﷺ) and said, "We belong to such and such branch of the tribe of Rabi'ah and we can only come to you in the sacred months. Order us to do something good so that we may take it from you and also invite to it those whom we have left behind (at home)." So he said, "I order you to do four things and forbid you from four things: To believe in Allah" - and then he explained it to them "to testify that none has the right to be worshipped but Allah and that I am Allah's Messenger (ﷺ), to establish the prayers (at the stated times), to pay the Zakat (obligatory charity), to hand me the Khumus (fifth) if you acquire spoils of war. And I forbid from (using) Dubba, Hantam, Muqaiyyar, and Naqir (all these were utensils used for the preparation of alcoholic drinks)

يا طويل الرقاد والغفلات % كثرة النوم تورث الحسرات

وأما السهد فهو أيضا من آثار المحبة ولوازمها فالسهاد الأرق وقد سهد الرجل بالكسر يسهد سهدا والسهد بضم السين والهاء القليل النوم قال أبو كبير الهذلي

الثالث تعلقها به في حال النوم فلها به تعلق من وجه ومفارقة من وجه

1139 عن أبي هريرة رضي الله عنه قال أوصاني خليلي صلى الله عليه وسلم بصيام ثلاثة أيام من كل شهر وركعتي الضحى وأن أوتر قبل أن أرقد متفق عليه والإيتار قبل النوم إنما يستحب لمن لا يثق بالاستيقاظ آخر الليل فإن وثق فآخر الليل أفضل

وبدائع مصنوعاته ولهذا يعيد ذكرهما في القرآن ويبديه كقوله تعالى @QB@ ومن آياته الليل والنهار @QE@ وقوله وهو الذي جعل الليل لباسا والنوم سباتا وجعل النهار نشورا وقوله عز وجل @QB@ وهو الذي خلق الليل والنهار والشمس والقمر كل في فلك يسبحون @QE@ وقوله عز وجل @QB@ الله الذي جعل لكم الليل لتسكنوا فيه والنهار مبصرا @QE@ وهذا كثير في القرآن فانظر إلى هاتين الايتين وما تضمنتاه من العبر والدلالات على ربوبية الله وحكمته كيف جعل الليل سكنا ولباسا يغشى العالم فتسكن فيه الحركات وتأوى الحيوانات إلى بيوتها والطير إلى اوكارها وتستجم فيه النفوس وتستريح من كد السعي والتعب حتى إذا اخذت منه النفوس راحتها وسباتها وتطلعت إلى معايشها وتصرفها جاء فالق الاصباح سبحانه وتعالى بالنهار يقدم جيشه بشير الصباح فهزم تلك الظلمة ومزقها كل ممزق وكشفها عن العالم فإذا هم مبصرون فانتشر الحيوان وتصرف في معاشه ومصالحه وخرجت الطيور من اوكارها فياله من معاد ونشأة دال على قدرة الله سبحانه على المعاد الاكبر وتكرره ودوام مشاهدة النفوس

فأول مراتب هذا النائم اليقظة والإنتباه من النوم وقد ذكرنا أنها إنزعاج القلب لروعة الإنتباه

A sleep intervention study comparing effects of sleep restriction and fragmentation on sleep and vigilance and the need for recovery.: Purpose: Sleep deprivation is present not only in sleep disorders but also in numerous high demanding jobs and negatively affects cognition, performance and health. We developed a study design to distinguish the effects and need for recovery of two short-term disturbances - intermittent sleep fragmentation and partial sleep restriction. Methods: The randomized within-subjects design contained two weeks each with a baseline night, an intervention night of either sleep deprivation (5 h) or sleep f

The effect of group cognitive behavioural therapy for insomnia in postmenopausal women.: The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I an

Investigating the subjective and objective efficacy of a cognitive behavioural therapy for insomnia (CBT-I)-based smartphone app on sleep: A randomised controlled trial.: Due to insufficient treatment options for insomnia, effective solutions are urgently needed. We evaluated the effects of a CBT-I-based app combining sleep training with subjective and objective sleep monitoring on (i) sleep and (ii) subjective-objective sleep discrepancies (SOSD). Fifty-seven volunteers (20-76 years; MAge = 45.67 ± 16.38; 39 female) suffering from sleep problems were randomly assigned to an experimental group (EG, n = 28) or a waitlist control group (CG, n = 29). During the 6-we

Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students.: Sleep problems are a common occurrence in college students. Insomnia, nightmares and impaired sleep quality lead to several mental health issues, as well as impaired academic performance. Although different sleep programmes exist, a systematic overview comparing their effectiveness is still missing. This systematic review aims to provide an overview of psychological interventions to improve sleep in college students. Seven databases were searched from November to December 2016 (MEDLINE, EMBASE,

The effects of a personalized sleep improvement app in subclinical poor sleepers: A randomized controlled trial.: The aim of this study was to determine the effects of a personalized smartphone application on subjective sleep quality, wellbeing and stress in participants with subclinical sleep problems. Healthy participants with subclinical threshold sleep issues that did not meet diagnostic criteria for insomnia were randomly assigned to use the app or be on a waiting list for app usage (control group). Subjective data on sleep quality (sleep quality component of Sleep Questionnaire B [primary endpoint] an

The effect of non-pharmacological sleep interventions on glycaemic measures in adults with sleep disturbances and behaviours: A systematic review and meta-analysis.: Background: Sleep insufficiency is known to negatively impact on glucose metabolism. Consequently, there is interest in determining the impact of improving sleep on glucose metabolism. We conducted a meta-analysis of studies that aimed at improving sleep using cognitive behavioural therapy for insomnia (CBT-I) and/or sleep hygiene or sleep extension on glucose metabolism. Methods: Searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults≥18years, a sle

Telemedicine versus face-to-face delivery of cognitive behavioral therapy for insomnia: a randomized controlled noninferiority trial.

Study objectives: In a randomized controlled noninferiority trial, we compared face-to-face and telemedicine delivery (via the AASM SleepTM platform) of cognitive-behavioral therapy (CBT) for insomnia for improving insomnia/sleep and daytime functioning at posttreatment and 3-month follow-up. A secondary objective compared the modalities on treatment credibility, satisfaction, and therapeutic alliance. Methods: A total of 65 adults with chronic insomnia (46 women, 47.2 ± 16.3 years of age) were randomized to 6 sessions of CBT for insomnia delivered individually via AASM SleepTM (n = 33, CBT-TM) or face-to-face (n = 32, CBT-F2F). Participants completed sleep diaries, the Insomnia Severity Index (ISI), and daytime functioning measures at pretreatment, posttreatment, and 3-month follow-up. Treatment credibility, satisfaction, and therapeutic alliance were compared between treatment modaliti…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial.

Background: Although several large-scale randomised controlled trials have shown the efficacy of digital cognitive behavioural therapy for insomnia (dCBT-I), there is a need to validate widespread dissemination of dCBT-I using recommended key outcomes for insomnia. We investigated the effect of a fully automated dCBT-I programme on insomnia severity, sleep-wake patterns, sleep medication use, and daytime impairment. Methods: We did a parallel-group superiority randomised controlled trial comparing dCBT-I with online patient education about sleep. The interventions were available through a free-to-access website, publicised throughout Norway, which incorporated automated screening, informed consent, and randomisation procedures, as well as outcome assessments. Adults (age ≥18 years) who had regular internet access and scored 12 or higher on the Insomnia Severity Index (ISI) were eligible …

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

The effect of cognitive and behavioral therapy for insomnia on week-to-week changes in sleepiness and sleep parameters in patients with comorbid insomnia and sleep apnea: a randomized controlled trial.

Study objectives: While cognitive and behavioral therapy for insomnia (CBTi) is an effective treatment in patients with comorbid moderate and severe obstructive sleep apnea (OSA), there is concern that the bedtime restriction component of CBTi might dangerously exacerbate daytime sleepiness in such patients. We examined randomized controlled trial data to investigate the effect of OSA severity, and pretreatment daytime sleepiness on week-to-week changes in daytime sleepiness and sleep parameters during CBTi and no-treatment control. Methods: One hundred and forty-five patients with untreated physician-diagnosed OSA (apnea-hypopnea index ≥15) and psychologist-diagnosed insomnia (ICSD-3) were randomized to a 4-week CBTi program (n = 72) or no-treatment control (n = 73). The Epworth sleepiness scale (ESS) and sleep diaries were completed during pretreatment, weekly CBTi sessions, and posttr…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Proinflammatory Cytokines, Mood, and Sleep in Interepisode Bipolar Disorder and Insomnia: A Pilot Study With Implications for Psychosocial Interventions.

Objective: Proinflammatory cytokines are associated with bipolar disorder (BD), but less is known about how cytokines function during the interepisode period. This study examined cytokines, mood symptoms, and sleep in individuals with interepisode BD with complaints of insomnia. We also investigated the effects of a BD-specific modification of cognitive behavior therapy for insomnia (CBTI-BP) on cytokine levels. Methods: Twenty-two adults with interepisode BD type I and insomnia were drawn from a subset of a National Institute of Mental Health funded study. Participants were randomly allocated to CBTI-BP (n = 11) or psychoeducation (n = 11). Participants completed a sleep diary, rated self-report measures of mania and depression, and provided samples assayed for interleukin (IL)-6 and tumor necrosis factor soluble receptor 2 (sTNF-R2). Results: IL-6 was associated with mania symptoms (rs…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Does Mid-Treatment Insomnia Severity Mediate between Cognitive Behavioural Therapy for Insomnia and Post-Treatment Depression? An Investigation in a Sample with Comorbid Insomnia and Depressive Symptomatology.

Background: Recent treatment studies with cognitive behavioural therapy for insomnia (CBT-I) have demonstrated effects on both sleep problems and depression. Two previous studies have indicated that the beneficial effect from CBT-I on depression may come through improved sleep, although insomnia severity during treatment had not previously been investigated as a mediator. Aims: Our aim was to investigate if insomnia severity during treatment mediated between CBT-I and depression severity after treatment, in a sample with co-morbid insomnia and depressive symptomology. We also examined whether depressive severity during treatment mediated between CBT-I and insomnia after treatment. Method: The participants were recruited from advertisements and fulfilled criteria for insomnia diagnosis, and had depressive symptomatology (Beck Depression Inventory-second edition: BDI-II > 13). Two-thirds o…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis.

Background: Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations. Methods: We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251. Findings: Between March 5…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial.

Background: Insomnia disorder is common and often co-morbid with mental health conditions. Cognitive behavioural therapy (CBT) for insomnia is effective, but is rarely implemented as a discrete treatment. The aim of this study was to evaluate the effectiveness of brief CBT groups for insomnia compared to treatment as usual (TAU) for insomnia delivered by mental health practitioners in a primary-care mental health service. Method: A total of 239 participants were randomized to either a five-session CBT group or to TAU. Assessments of sleep and of symptoms of depression and anxiety were carried out at baseline, post-treatment and at 20 weeks. Primary outcome was sleep efficiency post-treatment. Results: Group CBT participants had better sleep outcomes post-treatment than those receiving TAU [sleep efficiency standardized mean difference 0.63, 95% confidence interval (CI) 0.34-0.92]. The ef…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Treating Acute Insomnia: A Randomized Controlled Trial of a "Single-Shot" of Cognitive Behavioral Therapy for Insomnia.

Study objectives: Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia. Design: A pragmatic parallel group randomized controlled trial. Setting: Community. Participants: Forty adults (mean age 32.9 ± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep. Interventions: A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Restoring depleted resources: Efficacy and mechanisms of change of an internet-based unguided recovery training for better sleep and psychological detachment from work.

Objective: This randomized controlled trial evaluated the efficacy of an Internet-based intervention, which aimed to improve recovery from work-related strain in teachers with sleeping problems and work-related rumination. In addition, mechanisms of change were also investigated. Methods: A sample of 128 teachers with elevated symptoms of insomnia (Insomnia Severity Index [ISI] ≥ 15) and work-related rumination (Cognitive Irritation Scale ≥ 15) was assigned to either an Internet-based recovery training (intervention condition [IC]) or to a waitlist control condition (CC). The IC consisted of 6 Internet-based sessions that aimed to promote healthy restorative behavior. Self-report data were assessed at baseline and again after 8 weeks. Additionally, a sleep diary was used starting 1 week before baseline and ending 1 week after postassessment. The primary outcome was insomnia severity. Sec…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial.

Objective: To determine if a treatment for interepisode bipolar disorder I patients with insomnia improves mood state, sleep, and functioning. Method: Alongside psychiatric care, interepisode bipolar disorder I participants with insomnia were randomly allocated to a bipolar disorder-specific modification of cognitive behavior therapy for insomnia (CBTI-BP; n = 30) or psychoeducation (PE; n = 28) as a comparison condition. Outcomes were assessed at baseline, the end of 8 sessions of treatment, and 6 months later. This pilot was conducted to determine initial feasibility and generate effect size estimates. Results: During the 6-month follow-up, the CBTI-BP group had fewer days in a bipolar episode relative to the PE group (3.3 days vs. 25.5 days). The CBTI-BP group also experienced a significantly lower hypomania/mania relapse rate (4.6% vs. 31.6%) and a marginally lower overall mood episo…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Manual-guided cognitive-behavioural therapy for insomnia delivered by ordinary primary care personnel in general medical practice: a randomized controlled effectiveness trial.

Chronic insomnia is a prevalent problem in primary health care and tends to be more serious than insomnia in the general population. These patients often obtain little benefit from hypnotics, and are frequently open to exploring various options for medical treatment. However, most general practitioners (GPs) are unable to provide such options. Several meta-analyses have shown that cognitive-behavioural therapy (CBT) for insomnia results in solid improvements on sleep parameters, and a few studies have demonstrated promising results for nurse-administered CBT in primary care. The aim of this randomized controlled study was to investigate the clinical effectiveness of manual-guided CBT for insomnia delivered by ordinary primary care personnel in general medical practice with unselected patients. Sixty-six primary care patients with insomnia were randomized to CBT or a waiting-list control …

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up.

A unique intervention combining mindfulness meditation with cognitive behavioral therapy for insomnia (CBT-I) has been shown to have acute benefits at posttreatment in an open label study. The aim of the present study was to examine the long-term effects of this integrated intervention on measures of sleep and sleep-related distress in an attempt to characterize the natural course of insomnia following this treatment and to identify predictors of poor long-term outcome. Analyses were conducted on 21 participants, who provided follow-up data at six and 12 months posttreatment. At each time point, participants completed one week of sleep and meditation diaries and questionnaires related to mindfulness, sleep, and sleep-related distress, including the Pre-Sleep Arousal Scale, the Glasgow Sleep Effort Scale, the Kentucky Inventory of Mindfulness Skills, and the Insomnia Episode Questionnaire…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text)

Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.

Introduction: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of actigraphy. Methods: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of actigraphy, sleep logs, and/or polysomnography. Statistical analyses were performed to determine the clinical significance of using actigraphy as an objective measure of sleep and circadian parameters. Finally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence for making recommendations. Results: The literature search resulted in 81 studies that met inclusion criteria; all 81 studies provided data suitable for statistical analyses. These data demonstrate that actigraphy provides consistent objecti…

matched on Sleep Wake Disorders (mesh), insomnia (text), Actigraphy (mesh), Actigraphy (keyword)

Night shifts in interns: Effects of daytime napping on autonomic activity and cognitive function.

Objective: Night shifts have adverse cognitive outcomes that might be attenuated by daytime napping. The neurovisceral integration model suggests that resting vagally mediated heart rate variability (vmHRV) is linked with cognitive function. This study investigated the relationship between resting vmHRV and cognitive function after different nap durations in interns after shift work. Methods: A total of 105 interns were randomly allocated to one of three groups (non-nap, n = 35; 15-min nap, n = 35; 45-min nap, n = 35) to perform cognitive tests and resting vmHRV at 12:00, 15:00 and 18:00. Information processing (digit symbol substitution test; DSST), motor speed (finger tapping test; FTT), response selection (choice reaction time; CRT), and attention shifts (shifting attention test; SAT) were assessed. Resting vmHRV was assessed at baseline and during each cognitive task across groups. R…

matched on Sleep Deprivation (mesh), Sleep (mesh), Wakefulness (mesh)

Sleep deprivation impairs binding of information with its context.

Binding information to its context in long-term memory is critical for many tasks, including memory tasks and decision making. Failure to associate information to its context could be an important aspect of sleep deprivation effects on cognition, but little is known about binding problems from being sleep-deprived at the time of encoding. We studied how sleep deprivation affects binding using a well-established paradigm testing the ability to remember auditorily presented words (items) and their speakers (source context). In a laboratory study, 68 healthy young adults were randomly assigned to total sleep deprivation or a well-rested control condition. Participants completed an affective item and source memory task twice: once after 7-hour awake during baseline and again 24 hours later, after nearly 31 hours awake in the total sleep deprivation condition or 7 hours awake in the control c…

matched on Sleep Deprivation (mesh), Sleep (mesh), Wakefulness (mesh)

Insights into behavioral vulnerability to differential sleep pressure and circadian phase from a functional ADA polymorphism.

Sleep loss affects human behavior in a nonuniform manner, depending on the cognitive domain and also the circadian phase. Besides, evidence exists about stable interindividual variations in sleep loss-related performance impairments. Despite this evidence, only a few studies have considered both circadian phase and neurobehavioral domain when investigating trait-like vulnerability to sleep manipulation. By applying a randomized, crossover design with 2 sleep pressure conditions (40 h sleep deprivation vs. 40 h multiple naps), we investigated the influence of a human adenosine deaminase (ADA) polymorphism (rs73598374) on several behavioral measures throughout nearly 2 circadian cycles. Confirming earlier studies, we observed that under sleep deprivation the previously reported vulnerable G/A-allele carriers felt overall sleepier than G/G-allele carriers. As expected, this difference was n…

matched on Sleep Deprivation (mesh), Sleep (mesh), Wakefulness (mesh)

The effects of a mid-day nap on the neurocognitive performance of first-year medical residents: a controlled interventional pilot study.

Purpose: Despite shorter duty hours, fatigue remains a problem among medical residents. The authors tested the effect of a short, mid-day nap on the cognitive functioning and alertness of first-year internal medicine (IM) residents during normal duty hours. Method: This was a controlled, interventional study performed between July 2008 and April 2010. The authors recruited a nap group of 18 residents and a rest (control) group of 11 residents. Investigators connected all participants to an ambulatory sleep monitor before the beginning of their shifts in order to monitor rolling eye movements, a proxy for attention failures. At mid-day, both groups took Conner's Continuous Performance Test (CPT II) to evaluate their cognitive functioning and then were placed in a reclining chair designed for napping. The authors instructed nap group residents to nap for up to 20 minutes and chatted with c…

matched on Sleep Deprivation (mesh), Sleep (mesh), Wakefulness (mesh)

Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans.

Background: In randomized trials, prazosin, an α1-adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. Methods: We recruited veterans from 13 Department of Veterans Affairs medical centers who had chronic PTSD and reported frequent nightmares. Participants were randomly assigned to receive prazosin or placebo for 26 weeks; the drug or placebo was administered in escalating divided doses over the course of 5 weeks to a daily maximum of 20 mg in men and 12 mg in women. After week 10, participants continued to receive prazosin or placebo in a double-blind fashion for an additional 16 weeks. The three primary outcome measures were the change in score from baseline to 10 weeks on the Clinician-Administered PTSD Scale (CAPS) item B2 ("recurrent distressing dreams"; scores range from 0 to 8, with high…

matched on Sleep Wake Disorders (mesh), Sleep (mesh), sleep quality (text)

Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults: A Systematic Review and Component Network Meta-Analysis.

Importance: Chronic insomnia disorder is highly prevalent, disabling, and costly. Cognitive behavioral therapy for insomnia (CBT-I), comprising various educational, cognitive, and behavioral strategies delivered in various formats, is the recommended first-line treatment, but the effect of each component and delivery method remains unclear. Objective: To examine the association of each component and delivery format of CBT-I with outcomes. Data sources: PubMed, Cochrane Central Register of Controlled Trials, PsycInfo, and International Clinical Trials Registry Platform from database inception to July 21, 2023. Study selection: Published randomized clinical trials comparing any form of CBT-I against another or a control condition for chronic insomnia disorder in adults aged 18 years and older. Insomnia both with and without comorbidities was included. Concomitant treatments were allowed if…

matched on Sleep Initiation and Maintenance Disorders (mesh), insomnia (text), sleep hygiene (text), sleep quality (text)

Sleep loss and hypertension: a systematic review.

Hypertension and insomnia are very common and often coexist. There is evidence to suggest that the increasing prevalence of arterial hypertension in the past decade might be related both to an increased prevalence of insomnia and to the decline of sleep duration due to modern lifestyle. The aim of this paper is to reconsider both the clinical evidence of the relationship between conditions of sleep loss and of perceived impairment in sleep quality with hypertension and the potential pathophysiological mechanisms underlying the biological plausibility of their relationship. Through a systematic search from MEDLINE, EMBASE, PsychINFO we selected articles, which reported experimental sleep deprivation designs, or studied sleep duration or insomnia and their relationship with blood pressure or hypertension in participants over 18 years. This analysis shows that experimental sleep deprivation…

matched on Sleep Deprivation (mesh), insomnia (text), sleep duration (text), sleep quality (text)

The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one.

Study objectives: New theory and measurement approaches have facilitated nuanced investigation of how sleep loss impacts dimensions of affective functioning. To provide a quantitative summary of this literature, three conceptually related meta-analyses examined the effect of sleep restriction and sleep deprivation on mood, emotion, and emotion regulation across the lifespan (i.e. from early childhood to late adulthood). Methods: A total of 241 effect sizes from 64 studies were selected for inclusion, and multilevel meta-analytic techniques were used when applicable. Results: There was a moderate, positive effect of sleep loss on negative mood (g = 0.45), which was stronger for studies with younger samples, as well as a large, negative effect of sleep loss on positive mood (g = -0.94). For negative mood only, studies that used total sleep deprivation had larger effect sizes than studies t…

matched on Sleep Deprivation (mesh), Sleep (mesh)

Long-term benefits of digital cognitive behavioural therapy for insomnia: Follow-up report from a randomized clinical trial.

Digital cognitive behavioural therapy (dCBT) is an effective treatment for chronic insomnia and also improves well-being and quality of life (QoL). We assessed whether these benefits are sustained and if the effects of dCBT extend to the use of sleep medication and healthcare. In total 1,711 adults (48.0 ± 13.8 years, 77.6% female) with complaints of chronic insomnia participated in a previously published randomized controlled trial (ISRCTN 60530898) comparing dCBT (n = 853) with sleep hygiene education (SHE, n = 858). At weeks 0, 4, 8, 24, 36 and 48, we assessed functional health (Patient-Reported Outcomes Measurement Information System: Global Health Scale); psychological well-being (Warwick-Edinburgh Mental Well-being Scale) and sleep-related QoL (Glasgow Sleep Impact Index), prescribed and non-prescribed sleep medication use, and healthcare utilization. At week 25, those who received…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (keyword), insomnia (text), sleep hygiene (text)

Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial.

Background: Mindfulness-based cognitive therapy (MBCT) is a potential treatment for chronic insomnia. We evaluated the efficacy of MBCT for insomnia (MBCT-I) by comparing it with a sleep psycho-education with exercise control (PEEC) group. Methods: Adults with chronic primary insomnia (n = 216) were randomly allocated to the MBCT-I or PEEC group. The MBCT-I included mindfulness and psycho-education with cognitive and behavioural components under cognitive behavioural therapy for insomnia. PEEC included psycho-education of sleep hygiene and stimulus control, and exercises. Any change in insomnia severity was measured by the Insomnia Severity Index (ISI). Secondary outcomes included sleep parameters measured by a sleep diary, health service utilisation, absence from work and mindfulness measured by the Five Facet Mindfulness Questionnaire. Results: The ISI score significantly decreased in …

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (keyword), insomnia (text), sleep hygiene (text)

Current Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults.

Exogenous melatonin is commonly used for sleep disorders in older adults, and its use is increasing over time. It appears to have modest efficacy in treating insomnia and circadian rhythm sleep-wake disorders. Melatonin is commonly perceived to be a safe alternative to other hypnotics and is available without prescription in some jurisdictions. New evidence suggests that endogenous melatonin has pleomorphic effects on multiple organ systems, many of which are poorly understood. This narrative review summarizes the current evidence regarding the safety of melatonin in older adults (defined by age over 65 years). Melatonin appears to have a favorable safety profile in this population, however there is a dearth of evidence regarding the safety of prolonged use. There are several factors which increase the risk of adverse effects of melatonin in older adults, and these should be taken into c…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep Wake Disorders (mesh), Sleep (mesh), insomnia (text)

Treatment of Circadian Rhythm Sleep-Wake Disorders.

Circadian rhythm sleep-wake disorders (CRSWDs) are a distinct class of sleep disorders caused by alterations to the circadian time-keeping system, its entrainment mechanisms, or a mismatch between the endogenous circadian rhythm and the external environment. The main clinical manifestations are insomnia and excessive daytime sleepiness that often lead to clinically meaningful distress or cause mental, physical, social, occupational, educational, or other functional impairment. CRSWDs are easily mistaken for insomnia or early waking up, resulting in inappropriate treatment. CRSWDs can be roughly divided into two categories, namely, intrinsic CRSWDs, in which sleep disturbances are caused by alterations to the endogenous circadian rhythm system due to chronic changes in the regulation or capture mechanism of the biological clock, and extrinsic circadian rhythm sleep-wake disorders, in whic…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep Wake Disorders (mesh), Sleep (mesh), insomnia (text)