Browsing by Subject "insomnia"

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  • Celikkayalar, Ercan; Airaksinen, Marja; Kivelä, Sirkka-Liisa; Nieminen, Jenni; Kleme, Jenni; Puustinen, Juha (2021)
    Purpose: The use of benzodiazepines and related drugs (BZD) is common among older adults although there is growing evidence of their harmful effects. This study investigated how well older people are aware of the potential risks related to the BZD they are taking and whether the risk awareness has changed in the years between 2004 and 2015. Patients and Methods: The data were collected by interviewing BZD using home-dwelling patients aged >= 65 years with normal cognitive function (MMSE >= 20) who were admitted to the hospital within a 1 month study period in the years 2004 and 2015. Patients were asked whether they were aware of the ten main potential risks related to BZD use. A risk awareness score (range 0-10) was assessed for each patient, each known potential risk yielding one point. Results: The study included 37 patients in 2004 and 31 patients in 2015. In 2004,6/37 patients (16%), while 16/31 patients (52%) in 2015 had risk awareness scores between 6 and 10. Awareness of dependence (p=0.047), interaction with alcohol (p=0.001), dizziness (p=0.002) and developing tolerance (p=0.002) had improved, while awareness of the other potential risks remained unchanged, muscle weakness being the least known (3/37 in 2004 and 4/31 in 2015 were aware of it as a potential risk). Regular BZD use had declined (p=0.043) but pro re nata (PRN; when required) BZD use had increased (p=0.003) between the years 2004 and 2015. Conclusion: Older BZD users' awareness of some potential risks related to BZD use (dependence, interaction with alcohol, dizziness and developing tolerance) had improved between 2004 and 2015, while awareness of other potential risks remained unchanged.
  • Aronen, Aino (Helsingfors universitet, 2015)
    The purpose of the study was to examine the associations between the Big Five personality traits (neuroticism, extroversion, conscientiousness, openness to experience and agreeableness) and insomnia symptoms. The insomnia symptoms were difficulties to initiate sleep, awakenings during sleep, waking up too early and feeling tired after a night's sleep. According to theories on insomnia and to empirical research, high neuroticism, low extroversion, low conscientiousness and low agreeableness may be associated with insomnia. In empirical research, high neuroticism has consistently been associated with insomnia but also low extraversion, low conscientiousness and low agreeableness have been associated with it. It was therefore hypothesized that high neuroticism, low extraversion, low conscientiousness and low agreeableness are associated with insomnia symptoms. The participants, aged 30-45, were derived from the Young Finns study. The sample size was 1708. The Big Five personality traits were assessed with the NEO-FFI measure and insomnia symptoms with Jenkins's sleep problems scale. Ordinal regressions were used in analyzing the data. All of the Big Five personality traits were associated with at least some of the insomnia symptoms. In general, high neuroticism and high openness to experience were associated with more insomnia symptoms, whereas low extroversion, low conscientiousness and low agreeableness were associated with better sleep. High neuroticism had the strongest associations with most of the insomnia symptoms. When it comes to the trait openness to experience, the results of this study were inconsistent with previous studies, and therefore more information on the subject would be needed. The results of this study could be used in planning interventions for insomnia sufferers.
  • MacKeith, Ada (Helsingin yliopisto, 2019)
    Sleep difficulties have been on the rise for the past decade. Insomnia and sleep difficulties have associations with an increased risk of overall mortality, as well as with a diverse array of complex diseases, such as coronary heart disease, major depressive disorder, fibromyalgia and Alzheimer’s disease. Epigenomics provides information on how environmental factors influence the genome via epigenetic mechanisms, such as DNA methylation. Thus far, epigenome-wide association studies looking at the effects of sleep disturbances on the methylome have provided evidence of distinctive methylation patterns in insufficient sleep, involving biological processes related to neuroplasticity and neurodegeneration. However, more knowledge is needed to determine how the severity of sleeping difficulties influence the methylome. This thesis investigates the effects of increasing sleep difficulties on DNA methylation with an epigenome-wide association study. The study sample is derived from the Health 2000 general population survey. Subjects were divided into three different groups by their self-reported level of sleeping difficulty, and methylation measurements performed from whole blood samples utilizing the Illumina Infinium MethylationEPIC kit, encompassing >850,000 CpG sites. To identify differentially methylated sites, a multivariable regression model was used with age, gender, smoking, alcohol use, cell type distribution and plate and array data as covariates. None of the differentially methylated CpG sites identified remained significant after multiple testing correction. To gain more information regarding which biological processes the methylated sites may be part of, those CpG sites with an uncorrected p-value of <0.0005 were subjected to pathway analysis. Notable significant pathways included oxytocin- and serotonin receptor-mediated signalling pathways and Alzheimer’s disease-amyloid secretase pathway. Altogether, six pathways remained significant after multiple testing correction, with a total of 12 different genes appearing in them. Furthermore, a post-hoc regression analysis was conducted between these 12 genes and their corresponding CpG sites, and health-related quality of life questionnaire responses. Significant results included associations between sleep, and discomfort and symptoms (including pain). As an additional analysis, a database search was conducted to learn more about the genes’ functionality at the level of phenotype. Results included some variant trait associations to sleep, Alzheimer’s disease and cognitive performance. The associations to Alzheimer’s disease and cognitive performance warrant further research with a similar additive model, perhaps with a larger sample.
  • Merikanto, Ilona; Kortesoja, Laura; Benedict, Christian; Chung, Frances; Cedernaes, Jonathan; Espie, Colin A.; Morin, Charles M.; Dauvilliers, Yves; Partinen, Markku; De Gennaro, Luigi; Wing, Yun Kwok; Chan, Ngan Yin; Inoue, Yuichi; Matsui, Kentaro; Holzinger, Brigitte; Plazzi, Giuseppe; Mota-Rolim, Sérgio Arthuro; Leger, Damien; Penzel, Thomas; Bjorvatn, Bjorn (2022)
    Study objectives: Individual circadian type is a ubiquitous trait defining sleep, with eveningness often associated with poorer sleep and mental health than morningness. However, it is unknown whether COVID-19 pandemic has differentially affected sleep and mental health depending on the circadian type. Here, the differences in sleep and mental health between circadian types are examined globally before and during the COVID-19 pandemic. Methods: The sample collected between May and August 2020 across 12 countries/regions consisted of 19,267 adults with information on their circadian type. Statistical analyses were performed by using Complex Sample procedures, stratified by country and weighted by the number of inhabitants in the country/area of interest and by the relative number of responders in that country/area. Results: Evening-types had poorer mental health, well-being, and quality of life or health than other circadian types during the pandemic. Sleep-wake schedules were delayed especially on working days, and evening-types reported an increase in sleep duration. Sleep problems increased in all circadian types, but especially among evening-types, moderated by financial suffering and confinement. Intermediate-types were less vulnerable to sleep changes, although morningness protected from most sleep problems. These findings were confirmed after adjusting for age, sex, duration of the confinement or socio-economic status during the pandemic. Conclusions: These findings indicate an alarming increase in sleep and mental health problems, especially among evening-types as compared to other circadian types during the pandemic. Keywords: Chronotype; Circadian Rhythms; Coronavirus; Depression; Eveningness; Insomnia; Sleep quality; Stress.
  • Timonen, Veera (Helsingin yliopisto, 2021)
    Masennus on yleinen sairaus väestötasolla ja kansantaloudellisesti hyvin merkittävä, sillä masennus on merkittävä syy työkyvyttömyyseläkkeelle siirtymiseen. Unettomuus on yleinen oire masennuksen yhteydessä, mutta sen on havaittu olevan myös itsenäinen riskitekijä masennuksen puhkeamiselle. Unettomuus ei myöskään ole pelkkä oire, vaan usein itsenäinen liitännäissairaus masennuksen rinnalla. Masennuksen ja unettomuuden välillä on havaittu useita yhteisiä tekijöitä, vaikka nämä kaksi sairautta yhdistävää tarkkaa mekanismia ei vielä tiedetä. Tutkielman tarkoituksena on selvittää FinTerveys 2017 -tutkimuksen pohjalta masennuksen ja unettomuuden yleisyyttä suomalaisväestössä sekä selvittää regressiomallilla, assosioituvatko unettomuuteen liittyvät oireet masennukseen ja psyykkiseen oireiluun. Aineistosta havaitaan, että lääkärin toteamaa masennusta on 6,5 prosentilla ja usein koettua unettomuusoireilua 10 prosentilla. Usein koettu unettomuusoireilu on 5,47-kertaisesti (95 % CI = 4,05–7,40) yleisempää ihmisillä, joilla on lääkärin toteama masennus kuin ihmisillä, joilla masennusta ei ole. Lisäksi havaitaan, että kaikki huonosta unesta kielivät oireet (unettomuus, päiväväsymys, mielipide riittämättömästä unesta ja unilääkkeiden käyttö) näyttäisivät lisäävän riskiä masennukselle ja päiväväsymys assosioituu vahvimmin masennukseen. Tulokset vahvistavat unettomuuden yhteyttä masennukseen ja sen tärkeyttä, että unettomuuden taustalta on hyvä tunnistaa mahdolliset muut sairaudet, ja toisinpäin sitä, että masennuksen yhteydessä olevaa unettomuutta pitää tarkastella omana merkittävänä kokonaisuutenaan.
  • FinnGen; Broberg, Martin; Karjalainen, Juha; Ollila, Hanna M. (2021)
    Study Objective: Insomnia has been linked to acute and chronic pain conditions; however, it is unclear whether such relationships are causal. Recently, a large number of genetic variants have been discovered for both insomnia and pain through genome-wide association studies (GWASs) providing a unique opportunity to examine the evidence for causal relationships through the use of the Mendelian randomization paradigm. Methods: To elucidate the causality between insomnia and pain, we performed bidirectional Mendelian randomization analysis in FinnGen, where clinically diagnosed ICD-10 categories of pain had been evaluated. In addition, we used measures of self-reported insomnia symptoms. We used endpoints for pain in the FinnGen Release 5 (R5) (N = 218,379), and a non-overlapping sample for insomnia (UK Biobank (UKBB) and 23andMe, N = 1,331,010 or UKBB alone N = 453,379). We assessed the robustness of results through conventional Mendelian randomization sensitivity analyses. Results: Genetic liability to insomnia symptoms increased the odds of reporting pain (odds ratio (OR) [95% confidence interval (CI)] = 1.47 [1.38-1.58], p = 4.12 x 10(-28)). Manifested pain had a small effect on increased risk for insomnia (OR [95% CI] = 1.04 [1.01-1.07], p < 0.05). Results were consistent in sensitivity analyses. Conclusions: Our findings support a bidirectional causal relationship between insomnia and pain. These data support a further clinical investigation into the utility of insomnia treatment as a strategy for pain management and vice versa.
  • Lilja, Cecilia (Helsingin yliopisto, 2022)
    Målet med denna undersökning var att ta reda på prevalensen för mardrömmar hos blivande föräldrar under graviditeten och att undersöka om det finns en skillnad mellan hur ofta blivande mammor och blivande pappor drömmer mardrömmar. Målet var också att undersöka ifall mardrömmar är kopplade till psykisk hälsa. De 1673 familjer som deltog i CHILD-SLEEP födelsekohortstudien svarade på frågeformulären då kvinnorna var i 32:a graviditetsveckan och vid senare tidpunkter efter att barnen fötts. I frågeformulären fanns bland annat frågor om den allmänna hälsan, sömnen och hur ofta deltagarna drömde mardrömmar. I studien framkom det att de gravida kvinnorna drömde mardrömmar oftare än vad vuxna i allmänhet gör, medan de blivande papporna inte gjorde det. 7,7 % av de gravida kvinnorna drömde ofta mardrömmar under graviditeten medan bara 1,3 % av de blivande papporna vid samma tidpunkt gjorde det. Logistiska regressionsanalyser utfördes för att ta reda på vilka riskfaktorer som var kopplade till mardrömmar. Det framkom att speciellt depressivitet, ångest och stress var riskfaktorer hos de blivande föräldrarna. Hos de gravida kvinnorna var insomni statistiskt signifikant kopplat till mardrömmar och hos papporna var specifikt insomningssvårigheter, att vakna under natten och en dålig sömnkvalitet kopplade till mardrömmar.
  • Virtanen, Marianna; Myllyntausta, Saana; Ervasti, Jenni; Oksanen, Tuula; Salo, Paula; Pentti, Jaana; Kivimäki, Mika; Ropponen, Annina; Halonen, Jaana; Vahtera, Jussi; Stenholm, Sari (2021)
    Objectives This study aimed to examine the contribution of shift work, work time control (WTC) and informal caregiving, separately and in combination, to sleep disturbances in ageing employees. Methods Survey data were obtained from two prospective cohort studies with repeated measurements of working conditions, informal caregiving, and sleep disturbances. We used fixed-effect conditional logistic regression analysis to examine whether within-individual changes in shift work, WTC and informal caregiving were associated with changes in sleep. Secondary analyses included between-individuals comparison using standard logistic regression models. Results from the two cohorts were pooled using meta-analysis. Results Low WTC and informal caregiving were associated with sleep disturbances in within-individual analyses [odds ratios (OR) ranging between 1.13 (95% confidence interval 1.01-1.27) and 1.48 (95% CI 1.29-1.68)] and in between-individuals analyses [OR 1.14 (95% CI 1.03-1.26) to 1.33 (1.19-1.49)]. Shift work alone was not associated with sleep disturbances, but accumulated exposure to shift work, low WTC and informal caregiving was associated with higher risk of sleep disturbances (OR range 1.21-1.76). For some of the sleep outcomes, informal caregiving was related to a higher risk of sleep disturbances when WTC was low and a lower risk when WTC was high. Conclusions Informal caregiving and low WTC are associated with risk of sleep disturbances among ageing employees. The findings also suggest that low WTC in combination with informal caregiving may increase the risk of sleep disturbances whereas high WTC may alleviate the adverse impact of informal caregiving on sleep.
  • Sipilä, Reetta M.; Kalso, Eija A. (2021)
    Sleep disturbance, pain, and having a surgical procedure of some kind are all very likely to occur during the average lifespan. Postoperative pain continues to be a prevalent problem and growing evidence supports the association between pain and sleep disturbances. The bidirectional nature of sleep and pain is widely acknowledged. A decline in sleep quality adds a risk for the onset of pain and also exacerbates existing pain. The risk factors for developing insomnia and experiencing severe pain after surgery are quite similar. The main aim of this narrative review is to discuss why it is important to be aware of sleep disturbances both before and after surgery, to know how sleep disturbances should be assessed and monitored, and to understand how better sleep can be supported by both pharmacological and non-pharmacological interventions.
  • Baglioni, Chiara; Altena, Ellemarije; Bjorvatn, Bjørn; Blom, Kerstin; Bothelius, Kristoffer; Devoto, Alessandra; Espie, Colin A.; Frase, Lukas; Gavriloff, Dimitri; Tuuliki, Hion; Hoflehner, Andrea; Hoegl, Birgit; Holzinger, Brigitte; Järnefelt, Heli; Jernelöv, Susanna; Johann, Anna F.; Lombardo, Caterina; Nissen, Christoph; Palagini, Laura; Peeters, Geert; Perlis, Michael L.; Posner, Donn; Schlarb, Angelika; Spiegelhalder, Kai; Wichniak, Adam; Riemann, Dieter (2020)
    Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT‐I) should be the first‐line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT‐I Academy that would enable a Europe‐wide system of standardized CBT‐I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT‐I, preconditions for health professionals to teach CBT‐I, the way in which CBT‐I should be taught, who should be taught CBT‐I and to whom CBT‐I should be administered. Furthermore, diverse aspects of CBT‐I care and delivery were discussed and incorporated into a stepped‐care model for insomnia.