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MeSH Review

Sleep Initiation and Maintenance Disorders

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Disease relevance of Sleep Initiation and Maintenance Disorders


Psychiatry related information on Sleep Initiation and Maintenance Disorders


High impact information on Sleep Initiation and Maintenance Disorders


Chemical compound and disease context of Sleep Initiation and Maintenance Disorders

  • Some types of primary insomnia have been attributed to diminished melatonin production, particularly in the elderly, but evidence of a causal link is still inconclusive [10].
  • Oxazepam produced some rebound insomnia, consisting of about an hour's reduction of polysomnographically defined sleep, but without gross mood disturbance or the patients' awareness of sleep loss [11].
  • CONCLUSION: In subjects with primary insomnia the administration of 20 mg oral temazepam results in changes in both the pharmacodynamic measures and in quality of sleep [12].
  • We hypothesized that chronic insomnia is associated with increased plasma levels of ACTH and cortisol [13].
  • Withdrawal of triazolam was associated with sleep and mood disturbances (rebound insomnia and rebound anxiety), whereas quazepam exerted carryover effectiveness [14].

Biological context of Sleep Initiation and Maintenance Disorders


Anatomical context of Sleep Initiation and Maintenance Disorders

  • Ultra-rapidly and rapidly eliminated compounds used in the management of transient insomnia should be given in doses that are as free as possible from central nervous system depression as indicated by suppression of REM sleep during the early part of the night [17].

Gene context of Sleep Initiation and Maintenance Disorders

  • We conclude that chronic insomnia is associated with a shift of IL-6 and TNF secretion from nighttime to daytime, which may explain the daytime fatigue and performance decrements associated with this disorder [18].
  • Quality of sleep and P300 amplitude in primary insomnia: a preliminary study [19].
  • CONCLUSIONS: Our results confirm that Beta activity is increased in Primary Insomnia [20].
  • Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment [21].
  • Nocturnal sleep was recorded prior to daytime testing that included the Multiple Sleep Latency Test, profile of mood states, card sorting, and Stanford Sleepiness Scale in 138 volunteers with the complaint of chronic insomnia and 89 noncomplaining sleepers ("normals") [22].

Analytical, diagnostic and therapeutic context of Sleep Initiation and Maintenance Disorders


  1. Efficacy and safety of midazolam and vesparax in treatment of sleep disorders. Fischbach, R. British journal of clinical pharmacology. (1983) [Pubmed]
  2. Withdrawal symptoms after long-term treatment with therapeutic doses of flurazepam: a case report. Berlin, R.M., Conell, L.J. The American journal of psychiatry. (1983) [Pubmed]
  3. Randomized clinical trial of supervised tapering and cognitive behavior therapy to facilitate benzodiazepine discontinuation in older adults with chronic insomnia. Morin, C.M., Bastien, C., Guay, B., Radouco-Thomas, M., Leblanc, J., Vallières, A. The American journal of psychiatry. (2004) [Pubmed]
  4. The effects of modafinil and cognitive behavior therapy on sleep continuity in patients with primary insomnia. Perlis, M.L., Smith, M.T., Orff, H., Enright, T., Nowakowski, S., Jungquist, C., Plotkin, K. Sleep. (2004) [Pubmed]
  5. Clinical uses and advantages of low doses of benzodiazepine hypnotics. Vogel, G. The Journal of clinical psychiatry. (1992) [Pubmed]
  6. Increased nocturnal interleukin-6 excretion in patients with primary insomnia: A pilot study. Burgos, I., Richter, L., Klein, T., Fiebich, B., Feige, B., Lieb, K., Voderholzer, U., Riemann, D. Brain Behav. Immun. (2006) [Pubmed]
  7. Rebound insomnia: a new clinical syndrome. Kales, A., Scharf, M.B., Kales, J.D. Science (1978) [Pubmed]
  8. Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy. Nowell, P.D., Mazumdar, S., Buysse, D.J., Dew, M.A., Reynolds, C.F., Kupfer, D.J. JAMA (1997) [Pubmed]
  9. Rebound insomnia. A potential hazard following withdrawal of certain benzodiazepines. Kales, A., Scharf, M.B., Kales, J.D., Soldatos, C.R. JAMA (1979) [Pubmed]
  10. Human pineal physiology and functional significance of melatonin. Macchi, M.M., Bruce, J.N. Frontiers in neuroendocrinology. (2004) [Pubmed]
  11. Nighttime and daytime efficacy of flurazepam and oxazepam in chronic insomnia. Bliwise, D., Seidel, W., Greenblatt, D.J., Dement, W. The American journal of psychiatry. (1984) [Pubmed]
  12. Pharmacodynamics of temazepam in primary insomnia: assessment of the value of quantitative electroencephalography and saccadic eye movements in predicting improvement of sleep. Tuk, B., Oberyé, J.J., Pieters, M.S., Schoemaker, R.C., Kemp, B., van Gerven, J., Danhof, M., Kamphuisen, H.A., Cohen, A.F., Breimer, D.D., Peck, C.C. Clin. Pharmacol. Ther. (1997) [Pubmed]
  13. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. Vgontzas, A.N., Bixler, E.O., Lin, H.M., Prolo, P., Mastorakos, G., Vela-Bueno, A., Kales, A., Chrousos, G.P. J. Clin. Endocrinol. Metab. (2001) [Pubmed]
  14. Comparison of short and long half-life benzodiazepine hypnotics: triazolam and quazepam. Kales, A., Bixler, E.O., Vela-Bueno, A., Soldatos, C.R., Niklaus, D.E., Manfredi, R.L. Clin. Pharmacol. Ther. (1986) [Pubmed]
  15. Sex, steroids, and sleep: a review. Manber, R., Armitage, R. Sleep. (1999) [Pubmed]
  16. Eszopiclone for insomnia. Melton, S.T., Wood, J.M., Kirkwood, C.K. The Annals of pharmacotherapy. (2005) [Pubmed]
  17. Transient insomnia and rapidly eliminated hypnotics. Nicholson, A.N. Sleep. (1986) [Pubmed]
  18. Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nighttime to daytime. Vgontzas, A.N., Zoumakis, M., Papanicolaou, D.A., Bixler, E.O., Prolo, P., Lin, H.M., Vela-Bueno, A., Kales, A., Chrousos, G.P. Metab. Clin. Exp. (2002) [Pubmed]
  19. Quality of sleep and P300 amplitude in primary insomnia: a preliminary study. Devoto, A., Manganelli, S., Lucidi, F., Lombardo, C., Russo, P.M., Violani, C. Sleep. (2005) [Pubmed]
  20. Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Perlis, M.L., Smith, M.T., Andrews, P.J., Orff, H., Giles, D.E. Sleep. (2001) [Pubmed]
  21. Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Roth, T., Stubbs, C., Walsh, J.K. Sleep. (2005) [Pubmed]
  22. Daytime alertness in relation to mood, performance, and nocturnal sleep in chronic insomniacs and noncomplaining sleepers. Seidel, W.F., Ball, S., Cohen, S., Patterson, N., Yost, D., Dement, W.C. Sleep. (1984) [Pubmed]
  23. A comparative assessment of the risks and benefits of zopiclone: a review of 15 years' clinical experience. Hajak, G. Drug safety : an international journal of medical toxicology and drug experience. (1999) [Pubmed]
  24. Zaleplon improves sleep without producing rebound effects in outpatients with insomnia. Zaleplon Clinical Study Group. Fry, J., Scharf, M., Mangano, R., Fujimori, M. International clinical psychopharmacology. (2000) [Pubmed]
  25. Case-control study of evening melatonin concentration in primary insomnia. Attenburrow, M.E., Dowling, B.A., Sharpley, A.L., Cowen, P.J. BMJ (1996) [Pubmed]
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